IT Governance in a Complex Health System Environment

Peter B. Sachs, MD Vice Chair of Informatics University of Colorado

#SIIM18 @SIIM_Tweets Disclosures

Epic Radiant Advisory Council (unpaid)

Philips Healthcare Trusted Advisor (unpaid)

Nuance Executive Client Council (unpaid)

#SIIM18 @SIIM_Tweets Radiology Involvement with the Management of IT Resources

41% of PRED leaders were satisfied or very satisfied (Practice of Radiology Environment Database)

28% of PRED leaders were dissatisfied or very dissatisfied

• Harolds JA, Bluth EI. The 2017 ACR Workforce Survey: Management Trends and Strategic Needs. JACR, 2018 March; 15(3 Pt A):475-478. #SIIM18 @SIIM_Tweets #SIIM18 @SIIM_Tweets About UCHealth

• UCHealth is a private, nonprofit Poudre Valley Hospital health system based in Colorado. Fort Collins

• We have 8 hospitals (2 new sites Medical Center of the Rockies Loveland under construction), 22 freestanding Greeley Hospital EDs and over 100 clinics. Greeley (opening 2018) Longs Peak Hospital • UCHealth is not state or taxpayer Longmont supported Broomfield Hospital Denver Metro • We partner with University of University of Colorado Hospital Northern Colorado, University of Denver Metro Colorado, and Colorado State Highlands Ranch Hospital University. Denver Metro (opening 2018) Grandview Hospital • UCHealth includes the region’s only Colorado Springs Academic Medical Center and is Memorial Hospital North Colorado Springs uniquely able to provide advanced Memorial Hospital Central care, clinical trials and nationally- Colorado Springs renowned specialists

5 #SIIM18 @SIIM_Tweets About UCHealth

• UCHealth is a private, nonprofit Poudre Valley Hospital health system based in Colorado. Fort Collins

• We have 8 hospitals (2 new sites Medical Center of the Rockies Loveland Private Practice under construction), 22 freestanding Greeley Hospital Group #1 EDs and over 100 clinics. Greeley (opening 2018) Longs Peak Hospital • UCHealth is not state or taxpayer Longmont supported Broomfield Hospital Denver Metro • We partner with University of University of Colorado Hospital Northern Colorado, University of Denver Metro Academic Colorado, and Colorado State Highlands Ranch Hospital Practice University. Denver Metro (opening 2018) Grandview Hospital • UCHealth includes the region’s only Colorado Springs Academic Medical Center and is Memorial Hospital North Private Colorado Springs uniquely able to provide advanced Practice Group Memorial Hospital Central #2 care, clinical trials and nationally- Colorado Springs renowned specialists

6 #SIIM18 @SIIM_Tweets Oh Wait, They’re Not Done

#SIIM18 @SIIM_Tweets North

Metro Yampa Denver UCHealth Valley

South

#SIIM18 @SIIM_Tweets #SIIM18 @SIIM_Tweets The Good News

Private Practice folks do not have the time or $ to devote to this stuff

Soooooo

I kind of get to run the show and lead things

#SIIM18 @SIIM_Tweets The Bad News

I kind of have to run the show and lead things

Every decision affects everyone so everyone has to have input

It is a real pain to get everyone together to make decisions

#SIIM18 @SIIM_Tweets How do we do this in practice

• Monthly Imaging IT Steer Committee meetings

• CIO • VP of Application Services • Director of Imaging IT (Rad and Cards) • Manager of PACS/IT (Rads only) • Director of EPIC Radiant team • Administrative Directors of the 4 Radiology groups • Radiologist From each group

#SIIM18 @SIIM_Tweets Monthly Imaging IT Steer Committee meetings

• North attends

• South never did, now they do • a lot less complaining now

• Yampa rarely attends

#SIIM18 @SIIM_Tweets Bi-Weekly Epic Radiant Steer

• North attends

• South never did, now they do • a lot less complaining now

• Yampa rarely does

#SIIM18 @SIIM_Tweets Weekly PACS team huddles

I’m the only one

#SIIM18 @SIIM_Tweets I go to everything else

• Monthly with CIO • Monthly with CMIO • Joint Informatics Group (monthly) • CDS Steer (monthly) • CDS Governance • Clinical Content Build Out (monthly) • WONK Order Set (monthly) • CT Dose and Protocol Optimization (monthly) • Bi-weekly call with PACS vendor

#SIIM18 @SIIM_Tweets Lessons Learned

1. Communicate

2. Sometimes you just have to make a decision

3. You can’t please everyone (especially when you have multiple bosses)

4. You will need a LOT of patience and a very thick skin

5. Nothing you accomplish will be permanent

#SIIM18 @SIIM_Tweets Protocol Standardization as an example

• RIEs

• Agreement

• New group members

• Want to change everything again

#SIIM18 @SIIM_Tweets