How much effort does a digital hospital require?

The best kept secret in Healthcare IT may be St. Clare’s hospital in Weston, WI. St. Clare’s opened in October 2005 without a single file room. It is Wisconsin’s first digital hospital. Some hospitals have received tons of recognition, including the one in Birmingham that probably will never open. St. Clare’s, however, has flown under the radar despite being a state-of-the-art facility with everything from e-learning to full CPOE.

The entire project is the vision of Steve Pelton, the CIO for Ministry Health Care’s central region (Ministry and Affinity are sister organizations). The project enjoyed comprehensive project management support from the Ministry PMO. As a result, there are some good numbers regarding the total overall effort. St. Clare’s is a new hospital, so there weren’t any conversions or worries regarding existing paper records.

In total, the IT effort for this digital hospital has been just over 100,000 hours (including intense post-opening support). I calculate that to be just under 50 man-years. If you are going to take on the effort alone you will want to get an early start.

A Virtual Way To Address Your Frustrations

I found a fun new web site at It allows you to virtually deface someone’s web site. It is a great way to take out some vendor and competitor frustrations.

Likewise, a vendor may use this site as a way to take out their frustrations with me.

I had toyed with the idea of using my competitor’s web site with for this demonstration, but I was afraid the press would mis-interpret that as being something other than healthy competitive spirit.

Also, I don’t have any vendors that currently deserve such treatment.

Meet The Bloggers: a non-sanctioned HIMSS event

Updated with event details…

I really enjoy being part of this emerging Healthcare IT blogosphere. Better than the exposure that I have gotten is the fact that I am exposed to a lot of ideas.

Several of us bloggers have decided that HIMSS will be a great chance to meet the faces of those ideas. Please consider joining us to share your insights and reactions to the hot topics.

If you are looking for free food and drink then this is the wrong place. This is an unsponsored event to preserve the independent spirit of blogging. This is the place to come if you thirst for knowledge (poetic, eh?).

The event will be on Sunday, Feb. 12 at 8:30 p.m. at Hennessey’s Gaslamp, 708 4th Ave., San Diego. That’s walking distance from the convention center and most of the HIMSS hotels. Click here for a map. So far we have 36 attendess. A manageable number.

If you think you might be able to join us, visit the HIMSS 2006 Blogger and Reader Meetup Registration site. Your e-mail addresses and private comments are not shown to the public.

Hard-to-find CPOE Data

I couldn’t seem to get my hands on good numbers regarding Computerized Physician Order Entry (CPOE). So, I have decided to do my own research. These numbers are based upon the Leapfrog Group survey reported on their web site.

You may ask “but Will, what if there are hospitals that have implemented CPOE but have not reported it to the Leapfrog Group?” I cannot imagine that someone would go through the effort of a CPOE implementation and not report their success to the Leapfrog Group. At many hospitals “Leapfrog” is the reason to do CPOE.

Is it possible that a lot of hospitals have gone live on CPOE since that last survey submission deadline? After all, each large HIS vendor claims they have hundreds of hospitals implementing CPOE. Well, it is possible that some new CPOE installations have recently gone live but, according to the Leapfrog site, only 58 hospitals claimed they were within 12 months of bringing their CPOE system live.

The other cautionary note is that all of the Leapfrog Group surveys are self-reported. I am going to write a separate post on why I am skeptical about many of these self-reported surveys.
So, how many hospitals claim they have implemented CPOE, as defined by Leapfrog?

68 hospitals operated by 43 different health systems claim to have fully met the CPOE leap. This represents 1.7% of all hospitals in the US according to my database.

Here is a breakdown by Type:

  • Academic Medical Center: 30
  • Community Hospitals: 26
  • Government Owned Facilities: 6
  • Children’s Hospitals: 5
  • Heart Hospital: 1

This means that only .08% of American community hospitals have implemented CPOE (according to my database). But, I would be the first to admit that the definition of a “community hospital” is open to interpretation. I think this is a more important number, because Academic Medical Cetners can rely on residents to enter orders online without much regard to their desires. Community hospitals risk losing their top admitters to the competition.

I also think it is interesting to look at these hospitals by bed size (staffed beds):

  • 101 – 249 beds: 14
  • 251 – 400 beds: 14
  • >400 beds: 34

The fact that most of the hospitals are big is no surprise. The real eye opener is the 6 that are under 100 beds. Again, I will write about this in a future post (we will have some fun with that).

I also plan to run the numbers by software vendor in a future post.

I hope this is helpful. I think the numbers can help set some expectations.

Who visits

I am pleasantly surprised that my blog receives 30 – 60 unique visitors a day. I have to admit that I have become a bit addicted at looking at the logs to see what I can learn about the visitors and how they arrived here.

I had to laugh out loud when I saw one person arrived here by searching “i hate meditech” on MSN’s search engine. I can only wonder what caused such an action. BTW, I am ranked 6th on that search even though that exact phrase (or any such connotation) does not appear on my blog.

Speaking of MEDITECH, they are frequent visitors here. I am sure my account exec is keeping an eye on me (Hi Priscilla). But, it appears other MEDITECHers are visiting too. Maybe even Howard Messing, who I have never met.

Some of my other vendors that have stopped by include Valco, McKesson, Quadramed, and Wellogic.

I have also received some visits from organizations that may have been less than thrilled with the attention that I gave them. Even though the Leapfrog Group and Avaya have been here, they did not respond to my posts.

I also get emails from people that discovered me through my blog and want to sell me something. I am slightly more open to listening to somebody that took the time to learn about me, than someone mis-pronouncing my last name off of a call list. Still, that isn’t very interested.

But, it appears that most visitors are like-minded healthcare IT professionals looking for an exchange of ideas and some fresh thinking on tricky topics. A few visitors are from my own organization. Some visitors are with competing organizations (Aurora, not ThedaCare yet). But most from hospitals and health systems in other parts of the country and the world.

Traffic really began to become noticeable when I became a part of the healthcare IT blogoshpere. Other, more established sites linked to me and referenced my posts. I appreciate the attention they have brought my posts. If you want to be exposed to other healthcare IT bloggers the best starting point is Shahid Shah’s HITSphere.