Phoenix Children’s Hospital recently implemented an electronic medical record, replaced many ancillary clinical systems to create a single database, built an enterprise data analytics program, and significantly increased the size of its organization.
As a result, our team at Phoenix Children’s knew the enterprise needed a large-scale, cross-functional modernization of IT involving all aspects of the organization, from clinical operations and infrastructure to human resources, billing and research.
Many of our peers were committing more than $100 million to replace their clinical IT systems, while we were tasked with delivering similar results for less than 10 percent of those costs. The purpose was to redirect the dollars to improve facilities, provide better care and enhance coverage for Arizona’s pediatric population.
With the knowledge that every penny saved would benefit children in need, our team conceived the Lean IT initiative.
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Running lean in health care is no easy proposition, of course. Heavy regulation, mandates around Meaningful Use of electronic health records, highly complex environments, and the need to support a large number of diverse endpoints – from servers to drug pumps – can be resource- and time-intensive.
Even so, we built a comprehensive infrastructure that ensures the consistent performance, availability and security of critical clinical and operational systems as well as the ability to scale and modernize to meet demand.
Among our efforts, we:
- Reduced ongoing and one-time vendor contracts, creating a savings of $4.5 million per year
- Streamlined IT infrastructure management
- Built and implemented a comprehensive enterprise data warehouse containing real-time data from more than 60 systems and supporting 1,600 self-service reports with 300 active daily users – all in just three months
- Developed patent-pending technology that places secured, managed, and patient-specific iPads in every patient room without any recurring annual costs
- Created a large, scalable and isolated research computing environment – without the cost or complexity of traditional enterprise solutions – to support the hospital’s burgeoning work in research, genomics and imaging. Using open-source technologies, our team built a 180-TB research and video SAN array for $15,000, secured a supercomputer and high-speed fiber network with donated funds, and engineered a complete research environment, all with existing staff.
Moreover, the initiative has produced significant financial and operational results, including:
- An overall reduction in IT Capital Expenditure and Operational Expenditure per employee and per adjusted patient day
- Savings of more than 30 percent per year on major annual IT contracts
- Conversion of all outpatient clinics from paper processes to an EMR within 18 months, which in some clinics reduced net costs and improved patient throughput by up to 30 percent
- Optimization of workflow processes that saved more than $2 million a year, while simultaneously scaling out IT operations and architectures with no increases to IT staffing
“Doing more with less” is long overdue in the IT health care environment. With changing reimbursement models, changes in our population, and the slow conversion from large 1990s client-server software solutions to cloud-based rapid-development cycle services, health care IT must move to a high-return, low-cost model.
The Lean IT initiative is not one person, one system, one innovation or a one-time change. It’s an innovation of thought, approach, and vision – one that has resulted in many other technologies that solve business problems in a long-term, sustainable way.
David Higginson is the CIO at Phoenix Children’s Hospital.