Rx for Provider Success: How a Forward-Thinking CIO and CompuCom Took Kings County Hospital’s IT Infrastructure from 10 Years Behind to Leading Edge | Article
In 2003, Al Porco took over as CIO of the Central Brooklyn Family Health Network, anchored by Kings County Hospital Health Center, a member of the largest municipal hospital network in the United States. The administration was ready for IT to help transport the 175-year-old hospital into the future. The health network was building new buildings, and everyone in the hospital understood that IT would be a critical part of being a healthcare leader for the next several decades.
The IT department was in need of an overhaul. Support was lacking, but it was not because of effort. Instead, the IT staff wanted to provide service but did not have the tools, infrastructure, or processes in place to even make a dent. When Porco arrived, there were unhappy customers, frustrated IT staff, and little time for quick fixes.
The 900-bed integrated healthcare delivery network “needed a better level of support,” says Porco. “They had significant challenges and a lot of room for improvement.” adds Josh Gervey, principal consultant responsible for managing the on-site team at Kings County Hospital Center for CompuCom Systems, Inc., a Dallas-based IT outsourcer and the health center’s supplier.
Today Kings County Health Center is on the bleeding edge of healthcare technology. This is the story of its prescription for IT success.
The original challenges
The first goal was to strengthen the infrastructure, but that takes time and end users want to see tangible changes. “It is a challenge to start on a multi-year infrastructure project while giving end users something to whet their appetites,” continues Porco.
The next challenge for Kings County Hospital was its IT service desk. The health center had a system of paper tickets, which frequently got lost. Overall perceptions of the department were low, and the lack of resources meant that it could not meet demand.
“The overarching issue for Kings County Hospital was finding quality people at the salary range we offered,” continues Porco. Since Kings County is a municipal facility, there are also employee residency requirements. “You can imagine the difficulty of finding a host of people in New York to fill our positions,” explains the CIO.
Porco says the health center had two choices: spend significant sums on new technology and people to bring the hospital up to date or select key components that the IT community has already tackled and outsource them.
“We found the idea of hiring the correct number of people daunting,” says Porco, who points out the IT department must service a facility that is open 24/7 every day of the year.
The health center elected to outsource its services desk, including level one and two support, phone support, desktop, help desk and break/fix functions to CompuCom. “It’s a lot less bumpy for us to simply buy these services as an option to support the needs of our organization,” Porco says.
The first step in updating the IT department was automating its processes. Porco purchased Computer Associate’s software suite to do this. “I didn’t have a large in-house IT staff to implement this,” he says. So he looked for a provider that could.
Since Kings County is owned by the city of New York, it had to follow a set procurement process. It put out a Request for Proposal in an open-bid process. The health center received seven proposals. “Our main criterion was selecting the right service provider which would give us the best bang for our buck,” says Porco.
CompuCom submitted the “best package for the value,” according to Porco. The 20-year-old IT outsourcer was also the logical first choice, since it ran its own business on the same software. “CompuCom had real-world experience,” he says. The two partners signed their outsourcing agreement in October 2005.
The first task was to install and build the tool set. CompuCom retained some of the former subcontractors to provide IT continuity. “The transition was painless for us,” says the Kings County Hospital CIO.
When CompuCom arrived, the health center had no standardized IT processes. “We had a blank slate,” Gervey says. This was an advantage because none of the 30 IT employees had an investment “in keeping something that wasn’t working,” he says.
Meeting service level agreements (SLAs) can be a life-or-death issue for hospitals; King’s County has the only pediatric level-one trauma center in Brooklyn and a very busy emergency room. “The level of support we need in a crazy environment dictates what we expect,” says Porco.
Setting the initial service levels was an easy task because the IT department knew what it had to do to satisfy its internal customers. Its successful service desk implementation provided “a wealth of data which made it easy to come up with our SLAs,” says Porco.
Why this relationship works
Porco says from day one he has treated CompuCom as a partner rather than a provider. “I don’t view them as ‘the enemy,'” says Porco. He says this attitude “empowers both sides since their success is my success, too.” He says each person on both teams works hard so they don’t disappoint their counterparts on the other side. “I view them as part of my IT infrastructure,” he says.
The CIO says open communication is key to understanding. “CompuCom knows what’s important to us,” he says. He says he has personally spoken with someone at CompuCom every day since the outset.
In discussions regarding business-based prioritization of calls, the Kings County Hospital-CompuCom team determined that a call from the ICU is more important than a call from the CEO, notes Gervey. They translated this business need into a system customization.
Disagreements become conversations. “We have never reached a crisis level yet. “You can’t put 50 people together for three years and not have personality conflicts and misunderstandings. So far we never gotten to the point of reaching for the contract,” reports Porco.
Instead, one side will say, “Here’s the problem. What do you think are the potential solutions?” Porco says his team “doesn’t come down from Mount Olympus and say, ‘This is what we are going to do.’ Instead, we have conversations.”
The cost savings are there. Porco estimates he saves more than 30 percent of an IT person’s salary by outsourcing.
There has been a “huge increase” in customer satisfaction, reports Porco. He says ticket volumes are increasing; this is a good sign because people are now using the system. Before, they knew no one would help them, so they didn’t bother calling. “They had given up,” says Porco.
Today, CompuCom handles about 3,600 tickets a month plus several hundred change orders. Currently, the outsourcer maintains 5,000 of Kings County Hospital’s assets under management.
The new IT system produces reams of data, which the health center uses to monitor its spend. “Measuring data turned into smarter spending,” observes Porco.
Porco appreciates the opportunity “to tap into CompuCom’s expertise.” He says CompuCom receives “a reality check” because CompuCom serves IT departments in cities across North America and in industries other than healthcare. “We can tap into new things because of their breadth and depth,” he says. This is important because with such a high-pressure position “it’s easy to become insular,” Porco says with a laugh.
Better data and access to expertise also has helped Porco determine which IT projects to tackle next. For example, Porco learned from the data that the biggest pain point was password security.
The CIO now has an IT system that enforces and measures process. “My people are now accountable,” Porco says.
Porco appreciates the fact that CompuCom is there when he needs them. “You can’t have hand-held devices running around if you don’t have someone to call for help,” says the CIO.
Now that the two partners have built a stable foundation, the health center is about to tackle new IT projects that are on the cutting edge of healthcare such as closed-loop and bar code medication administration. Kings County Hospital just rolled out virtualized PCs and MD proximity badging “in a non-disruptive way,” says Porco. “We can accelerate the introduction of new technology and start to change the way our hospitals deliver services to our patients.”
Today there’s a level of sophistication in the IT department “that we couldn’t have achieved without outsourcing,” says the CIO.
“Al is not afraid to take chances,” says Gervey. “Because of this, Kings County Hospital is doing great things with the service desk.”
Porco has been able to add new groups that aren’t typical IT functions to the outsourcing process, including housekeeping and telecommunications. This produced additional project scope for CompuCom.
“We are ready to go forward now and add real value; we are no longer 10 years behind. Now we are on the cutting edge,” Porco says.
Lessons from the Outsourcing Journal:
- Starting out with a blank slate can be beneficial because employees are not willing to defend a system that isn’t working.
- Relationships work when there’s open communication. These two partners discuss problems early to keep them from growing into a crisis.
- The buyer doesn’t “come down from Mount Olympus and bark orders.” Instead, the partners together look for the best solution.
- Once there’s a stable IT foundation, you can add cutting-edge solutions.
- Outsourcing solves the resource problem by letting the provider supply top talent.