Transcript: Denni McColm, CIO Citizens Memorial Hospital

How can an organization successfully deploy I.T. projects?
I think what we have found that's so important in our organization, was to get commitment up front, not only the resources—the financial resources, the human resources—but the emotional resources of the top administration, management, and even the staff people within the organization, so that everyone is on board and can see the project through when it gets difficult.

I know one of the things we did was almost a big bang theory within a one year period of time. We brought the physicians and the nurses up all at the same time, kind of intertwined. I think my advice would be to bring nurses up first and have that sort of settled so that that information is available in the EMR for the clinicians, and that's another benefit to the physicians when they start using CPOE, that they see all that there is to know about that patient's record as they're doing that implementation.

What is the best strategy for securing ARRA grants?
It looks like that a large chunk of the money is not going to be grant funding, it's going to be incentive reimbursement. On the other hand, 2 billion dollars isn't a small amount of money, and that's what it looks like will eventually be doled out in grants. I think we're all going to have to be very cognizant of watching for, who's going to dole those out, which agency, and for what kind of programs they're going to be for? And then, just like with any other grant, is to be sure that, I know what we're going to do, is we're only going to apply for grants under this program, that meet the strategic initiatives that we want to do as an organization anyway, and not let those grants take us off on a tangent that doesn't make sense for our organization. 

And the second thing I think, is always important with grants, is we think about what we want to do with the money, but we need to re-frame that when we're applying for the funding, in terms of what the agency wants to accomplish with that grant funding, and restate what we want to accomplish in their terms. They're getting evaluated also on how much they achieve with that grant funding, and the idea is to help them meet their goal while we use their money.

I think it's critical because, even though grants come with funding and they give you additional resources, when it's over you're left with that project to either maintain or not maintain and that takes a lot of resources into the future. A lot of times grants can accelerate projects that you already have on the table and that you want to achieve. But if they're not projects that you need to achieve or they don't fit with long term goals, they're nothing but a burden and are very likely to not be sustained in the long run, and who has time for that? We don't have time for that at CMH.

What advice can you give about preparing for ARRA?
I think it's important for us all to be engaged, to read these early definitions of "meaningful use", and to comment on those. There are surprises in there, in the 2011 and 2013, some things that, maybe, are switched around. And I think it's important for everybody to be aware, those comments, I know from being on some committees where we received comments from the public, they make a difference. And there's some short time frames, so everyone needs to be alert to that.

I would say one thing is to make sure that your administration and your board are prepared that there is something that you're going to have to do in your organization. Even as advanced as we are, we know that we're going to have to make some tweaks to our system. Beyond that, it's to make sure that you understand, as the definitions of "meaningful use" are coming out, what those will mean to your organization and where the gaps are. And then finally, I know that I'm relying a lot on MEDITECH to help us know which applications and which modules of software we're going to need to be able to fulfill those. And within those applications, to know which functionality we need to implement to be able to qualify for the stimulus funding, which is significant dollars for our organization, as it is for everyone's.