Ismelda Garza, CIO for Cuero Regional Hospital, is a rural health IT leader with sage advice for hospitals and health systems preparing for or in the middle of an EHR replacement. In this interview with Phil Sobol, Vice President of Business Development, Ismelda talked about her experiences in healthcare IT, journeying from systems analyst to CIO where she has been working for the past several years to prepare her hospital for their READY implementation of MEDITECH Expanse.
Proper planning and assessment of existing technical infrastructure is critical, and third-party app contracts and integrations can take longer than expected. Ismelda cautioned that these negotiations could have major technical and financial implications. Read an excerpt of the conversation below with tips for successful EHR implementation planning.
Listen as Ismelda explains her passion behind streamlining EHR adoption for community hospitals and clinics and the invaluable impact technology can have on the health of families and friends in rural areas.
- Solidify your infrastructure
In the 5 years leading up to their Expanse READY go-live, Cuero Regional Hospital focused intently on evaluating network stability and taking stock of often overlooked IDF networking closets. The infrastructure uplift laid a solid foundation technically, and it helped build confidence and expertise for their local IT technicians.
“I always compared it to trying to operate on a person who hasn't had any anesthesia,” said Ismelda. “You're trying to pick apart and trying to open and cut when this person's moving. And it's the same thing when you're cleaning up closets. You're working on something that's living and breathing and trying to get it all cleaned up and fixed up. It’s a really big must-do—taking a look at your backbone infrastructure.”
- IT is an ongoing investment
Core EHR platforms are not the type of technology that you can “set and forget.” For example, WiFi can still be a source of surprises and may require improved wireless access. The exponential growth of WiFi-connected devices like workstations on wheels can still sometimes overload access points.
As a result, wireless infrastructure requires constant monitoring and optimization. No matter how robust the WiFi seems during upgrade projects, the expanding demand will stretch any enterprise WiFi environment.
Ismelda said, “We're making this investment on this huge implementation. So how do we make it where it's a tool? How do we make it to where it's not so invasive to the patient? To help them get in and get seen and let the clinicians treat them and get them to where they need to be.”
In a previous podcast interview with Cuero Regional Hospital CEO Lynn Falcone, Lynn said that she was looking forward to the investment in MEDITECH Expanse paying off in areas like increased patient safety, ease of use, and access to data.
Ismelda discussed the importance of her relationship with her CEO Lynn Falcone and Ismelda said, “She [Lynn] has compared a new hospital build with the EHR system implementation, and she says hands down, the EHR implementation system is a lot harder than a new build of a construction of a hospital. So, I think that just speaks volumes on the type of project that we're dealing with. And how important it is to have leadership understand that.”
- Involve others: partners, clinicians, operations, and hospital leadership team
Flexibility and support are essential to leading major IT transformations, especially while IT teams juggle competing priorities. Ismelda covered several key strategies that could help teams stay on track and focused:
- Pursue automation to ease workflows
- Form strategic partnerships to augment expertise and offset resource constraints
- Collaborate early with third party application vendors
- Communicate often with healthcare leadership teams, stakeholders, and clinical teams
“I'm so passionate about rural health. I do think it's a part of healthcare that a lot of people don't realize—how hard they work in regular operations day to day,” said Ismelda. “When you add a project of this magnitude, and really consider the limited resources, just because a lot of people don't want to come to rural America and live. You have those additional challenges.”
“Don't forget to laugh. Have some fun in this role. There's a reason we're in it. Find your passion. Find why you are wanting to do this. And remember that your team -- they need you just as much as you need them. Sometimes you're going to learn more from them than anybody else.”
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