A physician or a service line administrator can champion the change in thinking, but one option not available is to put another layer of people on the problem, Boyer says. "We're working very hard to make it part of your everyday work, so that you do it right the first time, and we don't have to do this collecting of data later," she says.
"It is a culture change to say we can manage these things, and I think we are," Boyer says. It's the same thinking behind New York-Presbyterian's aspirations to be a Level 3 patient-centered medical home. Using a combination of EHR data and analytics, the hospital is targeting diabetes patients and several other diagnosis groups to reduce readmissions and emergency department visits.
As a registered nurse, Boyer has moved up through the management hierarchy of New York-Presbyterian during her 18 years at the institution. "Whether it's as a director of nursing and being administrator on call and having more and more responsibility, I have a fairly process-oriented view of the hospital," she says. "And I actually do this job really to have that impact."
Boyer also represents the kind of CIO who moves more into traditional CMIO roles than usual. "I may be more clinically focused," says Boyer. "I really interact with my IT team about patient care all the time. I'm doing some great desktop work with the guys, asking, 'Do you really understand how the clinicians use this desktop?' Then I try to find the right doctor or nurse or administrator—to partner with them—to make those kinds of things really happen, and I think it energizes the IT staff, because they're pushed closer to the actual hospital business than they would otherwise."