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November 6, 2013 Readers Write No Comments

Organizational Mergers
By Anonymous CIO

Last fall, a full asset merger of our hospital into a larger health system in the region was announced. This has become a common event in our state and was strategically important to our organization.

Both organizations had developed working relationships in several clinical areas over the years, so at least some synergy had already been established. Geographically, the merger appears logical and based on sound thinking. Ours will become branded as part of the larger, well-regarded health system, and positioned well to confront the ongoing evolution of health care in our region and the country.

The agreement amongst the parties established the agenda for IT. From the outset, project plans were developed and staffing focused on achieving important goals by the established milestone dates. Fortunately, some date slippage in the regulatory approval process provided us with a bit more breathing room than what was originally expected.

Short-term initiatives have included the following:

  1. Establish connection between the entities and the trust among disparate networks to enable coexistence of e-mail, calendar, and access to each other’s systems.
  2. Migration of all personnel to the health system’s payroll and human resources applications including the replacement of all aspects of time collection, payroll, and people management by Day 1.
  3. Establish the larger health system’s financial systems as the final collector and reporter of all numbers and statistics, meaning that all data from our systems (comprised primarily of a core, integrated, community hospital system) would be fed to the designated systems of the larger enterprise. Support the consolidation of business office functions at the enterprise’s corporate headquarters.
  4. Retain our clinical systems for now due to our progress with Meaningful Use, ICD-10, clinical documentation improvement, and local acceptance of that system. Become part of a larger enterprise-wide clinical system decision and migration within the next two to three years.
  5. Continue local initiatives such as participation with HIE, ARRA Stage 2, expansion of our electronic patient records efforts, physician compliance with on-line documentation, and individual physician bonding efforts such as BYOD, electronic rounding tools, etc.
  6. Replace our physician practice/EHR system deployment efforts with the solution provided by the health system.
  7. Prepare for absorption of our IT infrastructure team (network, hardware, PC support) into that of the health system; retain the core applications team to continue to support our legacy system for the duration of its existence.
  8. Prepare for my own absorption into the health system with a different title along with changing roles and responsibilities. This includes the adjustment of my vision and plans from that of a single entity CIO to a role that will cross all aspects of the enterprise.

Observations on the effort to date:

  1. Attitude. Although it’s clear who will run (or, is running) the larger health enterprise, those who we’re working with from the health system have the strength of character not to conduct this combined work effort as a siege of greater over lesser. As a result, our team does not feel besieged, and cooperation prevails.
  2. Project management. Efforts of this magnitude don’t go well without the expertise of highly engaged and empowered professionals to oversee the details. The health system has several of those and the ones assigned to our project are excellent.
  3. Few versus many. Many project teams have been established to execute each of the planned efforts. It’s truly comical when our community hospital team shows up with so many of the same people for each effort while the health system often brings a unique set of experts. It’s the best visual representation of working vertically versus working horizontally that I’ve seen in a while.
  4. Disagreement management. Both sides need a clear path of hierarchy to resolve differences in understanding of the goals. Even in the best of cases this can (and does) occur so a time-efficient escalation process is needed to discuss, digest, and resolve issues as they arise.
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