The Grill: James Turnbull driving change in healthcare IT

This CIO sees new opportunities for patient care with mobile solutions.

As a healthcare CIO, Jim Turnbull promotes the use of technology as a tool to improve care and reduce patient costs. He has guided IT initiatives, including the deployment of electronic medical records and computerized physician order-entry systems, at several healthcare organizations. Now CIO at University of Utah Health Care in Salt Lake City, Turnbull was recently named the 2012 John E. Gall Jr. CIO of the Year by the College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society. Here he shares his thoughts on how IT is changing healthcare and how he's guiding IT transformation at UUHC.

What has been your biggest success as CIO at UUHC? It's working with the team that was here when I arrived and having them deliver excellent results. We focused on some core disciplines, getting a good security plan in place, implementing the discipline of ITIL and project management, and really ramping up our game on that side. We focused on what we call strategic management -- or strategically aligned management -- and there's a big focus on recruitment and retention, customer advocacy and focusing on tracking, measuring and communicating our results.

Is it difficult to inherit a team? In my experience -- and I've worked at four healthcare organizations -- the typical thing I find when I walk in is there tends to be a high level of dissatisfaction with IT from other parts of the organization. That's something I felt when I walked in here. I found that, rather than replacing the team, there's a lot of talent here and it was a matter of getting them aligned and getting them back to the basics.

What was the biggest technology challenge you've faced at UUHC? We have a main campus and a health sciences campus. There's the more traditional university and adjacent to it is the health sciences campus, which includes the hospital and some of our research clinics as well as the schools of medicine, nursing, pharmacy and allied health. The infrastructure teams were split between the two. And when I got here, we realized we had an opportunity to bring those two teams together, but the next challenge was to bring the data centers together. That meant moving seven separate data centers on campus to a single data center. As you can imagine, that's a pretty complex process. From beginning to end it was about a three-year process, and it was completed without any serious hiccups.

What about the biggest nontechnical challenge? It was getting buy-in for the development and communication of a strategic plan for IT, staying focused on that plan and reaching a stage where the organization had a great deal of confidence in our IT organization based on our delivery of results. There was a fair degree of skepticism that the IT team could work together with the rest of the organization and deliver on the plan. But now there's very little disagreement within the organization that we did that.

How do you recruit and retain top talent? Our leadership team in IT felt that the people best able to answer that is our team. So we organized a committee without any senior leadership on it. About 15 of them got together and came up with 85 recommendations on how we could address the issue. They wanted to do a community day of service event, do things socially together, have broader recognition opportunities. They gave us the top 10 [to implement as a start]. It's the reason that one recent quarter we had zero turnover, and for four quarters our turnover is under 6%. Our annual turnover in the broader organization is about 15%. You can feel the change in morale. We stayed with the first 10 they brought us, and now we're biting off the next 10.

What's the top IT initiative you now have on your plate? We're trying to move to a single-vendor solution. We laid the groundwork for that, but we're about 14 months away from doing a major conversion for our in-patient applications. We'll turn off all our legacy applications and turn over to that. Our budget is about $46 million to do that.

Now that many healthcare organizations are firmly working with technology, what are the next big opportunities to use IT to improve healthcare? The action is shifting quickly to mobile health solutions with much greater involvement of the patients in their healthcare. It's just an incredibly exciting opportunity, and all types of applications are being developed that are smartphone- or tablet-based. I think most of us have the environments in place technologically to support it, but it's a very different focus. It's really individualizing the care. It's having them hooked into us.

What are the biggest challenges to taking advantage of those opportunities? Part of it is getting that initial traction and having some great use cases to demonstrate the benefits. It's been fun to see the doctors so engaged and having our team work so collaboratively.

Are patients more willing to use technology to help manage their own health? There are so many apps out there for healthcare right now it's just unbelievable. There's not a day that goes by that I don't bump into someone using a smartphone app for health or fitness.

-- Interview by Computerworld contributing writer Mary K. Pratt (marykpratt@verizon.net)

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