The healthcare industry is changing, and nobody knows that any better than Ed Marx. As the chief information officer (CIO) for University Hospitals Health System, Marx is overseeing one of the most extensive communications technology transformations undertaken by any healthcare provider to date. As northern Ohio's leading medical organization, University Hospitals serves more than 3 million patients from 150 locations staffed by 25,000 physicians and employees. And as an affiliate of Case Western Reserve University, University Hospitals operates the largest center for biomedical research in Ohio.
To continue its healthcare leadership into the 21st century, University Hospitals turned to Cisco Systems. Together, the two are creating an Internet protocol-based multimedia network (both wired and wireless) that supports virtually any type of voice, data, and video communications, making it far easier to coordinate the myriad of information and resources necessary for quality healthcare in the new century.
News@Cisco spoke with Marx about the role of technology in the transformation of his organization. The following is a modified excerpt from a News@Cisco Podcast interview with Marx (A full transcript of this interview is available via Podcast at http://newsroom.cisco.com/dlls/podcasts/audio_feeds.html#MP3_071906.
What inspired University Hospitals to focus on and invest in its communications network infrastructure?
Ed Marx: The task that we set for ourselves was to create a plan for our organization for the 21st century. And, like most healthcare institutions, we found ourselves woefully in the 20th century. So we did an in-depth analysis of what the future would look like and what the future of healthcare was evolving to, because we wanted to hit that target of where it's heading, not necessarily where it's at today.
So we looked at that future state and then did a gap analysis in terms of where we're at today, where should we be in the future, and then we really thought hard and long about what it's going to take. We did a lot of interviewing with customers. We did a lot of research with a number of different entities and consulting firms, and then we talked to a lot of our strategic partners and vendors and crafted a plan for 21st century healthcare.
How is 21st century healthcare different than in the past?
Ed Marx: Historically, healthcare has been hospital-centric and in some cases physician-centric. But the future is all about the patient and improving the patient experience. And a lot of that will take place not in the halls of the hospital but, instead, in a patient's home. Patient-centric care is the key driver, which goes hand-in-hand with quality-of-care. At UH we have excellent quality of care by all standards. However, to get to the next level we wanted to marry technology with that quality-of-care to get it to where it needs to be for the 21st century.
Why rebuild your communications infrastructure? How was your old system limiting your organizations' ability to provide top-notch healthcare?
Ed Marx: You could say that we had the equivalent--in terms of our medical records--biblical stone tablets. We did have lots of data in automated fashion but all in different computer systems, so it was almost like, if you use a biblical analogy again, a tower of Babel in terms of the information. And so what we're doing is bringing all that information together so that the physician or clinician, whoever has the right to see that data and needs that data, can have it any time, any place. Such access, we believe, leads to better patient care, which is our ultimate goal. That access, also, is not just about getting the right information at the right time but also finding the right person at the right time, such as a patient being able to reach a nurse or a nurse being able to reach a doctor immediately and talk to them remotely, regardless of where in the hospital or the organization they might be.
What are some examples of how modern communications networking technology is changing they way your organization provides healthcare?
Ed Marx: Today there are many tasks in a hospital that are still very manual. So, for instance, we still use a paper medical chart. Where is that medical chart? Thirty percent of the time, nationally, a physician sees a patient without having a medical chart because they can't find it. It's burdensome to send a technician or someone to find that medical record. And, more importantly, it takes time away from the patient.
Our vision is that with our converged, IP-based communications network, a clinician will be able to use a hand-held tablet computer to access the medical record wirelessly. They don't need to find the record; they just look it up and modify it on the digital device. By creating this capability, we eliminated the logistical distraction of finding the medical chart, as well as ensuring the doctor has the information he needs to make a proper assessment of the patient. It's estimated that with the adoption of this electronic health record, our nurses will be able to spend up to 25 percent more time per shift with their patients instead of running around looking for charts and other pieces of information.
Another simple example of how our modern, converged, IP network will make us a better healthcare provider is with nurse calls. In the old way of doing things, if you're a patient and you want your nurse, you pull on a chain at your bed, and it rings a bell at the nurses' station--a time-tested technology from 40 years ago. The nurse needs to respond by walking back to that patient room. But the patient might have a very general question that that nurse could have answered from any location. Instead, in the future with our converged network, patients will be able to ring a nurse electronically and talk to them as well, no matter where that nurse is. This not only saves the nurse trips to the rooms, but, more importantly, makes it easier for the nurse to respond quickly to the patient.
Many organizations, including those in the healthcare industry, worry that their investments in communications and computing technologies will be expensive and will not provide an adequate return on investment. How does your organization ensure that your technology investments succeed?
Ed Marx: One of the principles that my group has developed along with senior management is that we will not pour new wine into old wine skins. So in every IT project, there is a management component to ensure that we're not just layering new gee-whiz technology onto old patterns and processes. Instead, we make sure that we also change patterns and processes, melding them with the technology component in order to deliver higher quality of care. So everything that we've done in the last couple of years is aimed around that. To ensure accountability we review a project after one year. The sponsor of the project--a doctor, a clinician, or a manager--has to come back to our steering committee, which is chaired by our CEO and co-chaired by myself, and talk about what transformation has happened as a result of this investment in technology. They must demonstrate that the technology has been implemented together with changes in process, and that together these two efforts have created a new and better way of doing things. The bottom-line question on all these projects is: how did it improve patient care? If the sponsor can't prove the project achieved that, then we have to take a serious look at what went wrong.