Rx for Change
Whatever the cause, Lawrence says he's more sober about the challenges ahead but no less committed. New CIO Clifford Dodd, a former software systems chief for American Express and ex-CIO of Qwest Communications, will not face all of the problems Sullivan did. Kaiser now has one public Web face, down from dozens, enabling it to better control its brand. The HMO, as of December, had fully rolled out its digital patient record system in Hawaii. In Colorado, pilot projects are under way. Kaiser doctors in both states now look at 1 million digital medical records and write 200 to 400 progress notes in cyberspace per month.
Dodd says he will continue working to bring the other regions online and build an IT infrastructure to electronically link its hospitals and clinics with Kaiser's doctors and technical, administrative and clerical employees.
Lawrence is optimistic. He hired Dodd for speed: As Qwest's CIO, Dodd moved two huge back-office systems onto a single platform in six months. But Dodd acknowledges that the cultural roadblocks facing him at Kaiser are considerable. "Success for IT people at Kaiser is never 100 percent," says the HMO's Neidermeier, adding that even Kaiser's push to cut its data centers from 13 to two has been flawed by the fact that there are still a couple of mini-data centers operating in Oregon in violation of the nationalized IT operation. "You decide what fights you are going to fight," Lawrence says, citing his 80-20 Rule and applying it to management in this case. "Most of the switch to centralization has been made."
But Dodd says he's battle-ready for whatever lies ahead. Since coming on board in January, he has formed a half-dozen cross-cultural software development teams within the IT organization. Each team is charged with helping to build consensus from the ground up for a set of technology priorities going forward. "IT can go a long way to knit together warring camps," Dodd says. The carrot: new performance review processes that make cooperation a virtue and reward the goal of measurable ROI over cultural squabbling.
But can Kaiser change fast enough? Wiesenthal, though an IT convert, is less sanguine. Sure, Kaiser's digital revolution could be just what the doctor ordered on the cost-cutting and care front, but the patientKaiser, in this casewill need to stay on life support for a while longer. With Kaiser's number-one IT champion, Lawrence, set to retire in June, it's not clear whether the HMO will keep taking its medicine. "It's important that we keep focused on IT," Wiesenthal says. "I don't think anything will happen to distract us, but without [Lawrence], it's still possible we could lose our way." Not a hopeful prospect for an HMOand a CEOso keen on recovery.
ERIC W. PFEIFFER is a consulting editor for Forbes ASAP and a contributor to Red Herring magazine. CIO Insight researcher Kathleen Paton contributed to this story.