In December 2014, Phyllis Teater, CIO of The Ohio State University Wexner Medical Center in Columbus, saw the fruits of many years of labor come to pass when one of its HIMSS Analytics Stage 7 hospitals moved to a new home.
The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research 
Institute moved to a newly built 1.1 million-square-foot hospital with 306 inpatient beds on 21 floors, now known as the "New James."
For Ms. Teater —who has served as CIO since 2010 — helping to launch a massive, advanced new hospital meant overseeing state-of-the-art technology — a lot of it.
Here, Ms. Teater discusses her role in the go-live and the lessons she learned along the way.
Note: Interview has been edited for length and clarity.
Question: As CIO of OSU Wexner Medical Center, what are some of the specific responsibilities you had regarding the New James' health IT go-live?
Phyllis Teater: I oversee a large IT department of about 350 people. We do all the traditional IT services from the network all the way through PCs, mobile devices and the EMR system. We provide the computing services for the healthcare delivery organizations and the college of medicine at Ohio State.
As the CIO, I've been involved in this project since the folks in IT started designing the network infrastructure — which was before construction even began — all the way up through Dec. 14, when all of the patients were moved into the new building and we began supporting the production environment. There are hundreds of systems supporting this building and we broke them up into two categories. The first category included systems already in use that were going to be extended to be available in this new building, such as the EMRs and the hospital admitting system. The second category included systems that were going to be used in this building for the very first time, and then extended back into our older buildings. We wanted to have uniform processes across our hospitals. During the live, we were there 24/7, supporting all the technology including the new PCs, printers, surgical systems, robotics, phones and more. All of the technology that went into that hospital is running on our network and was deployed by our folks to get hooked up to the hospital.
In my role, I had to make sure resources — both funding and personnel — were available to get the job done and make sure we were using our resources wisely. Obviously, we started out with a budget and we had to do a lot of work around the funding of the initiative, securing it first of all, but then monitoring the spending as well. I also served as leadership support, helping with organizational communication and awareness, facilitating decisions about what kind of technology we could use in the building and making sure I set the expectations of what will be in the hospital for my peers and C-level executives around the table.
Also, a particular mission we had with this hospital — as you would have with any advanced hospital — was making sure we were making technology decisions for the future, and that was hard. We had been working on this hospital for roughly six years and trying to predict that many years ago what technology was going to be available by the time the hospital opened was a little dicey. So our team had to envision the future of technology so we would plan the right things for a building like the New James, which needs to open with the latest and greatest technology to help cure cancer.
Q: In the days, weeks and months leading up to the launch, what was your biggest source of anxiety?
PT: I think for me, my biggest source of anxiety was managing the people who were involved and helping them so they wouldn't get totally fried. With this type of effort, we really had to watch the amount of hours they were working and the amount of stress it was putting on their lives. We had to make sure people were getting some time off, at least weekends, which they didn't even always get leading up to the launch. We had to make sure we were taking care of the people doing all the work. I'm not the one hooking up cables or programming any systems, so the boots on the ground needed someone to help them and watch over them. We have this wonderful staff with mountains of work so I had to always ask, "How can I help them?"
Also, tactically, we had a couple of pieces of brand new technology that we had to make some big calls on. For instance, one of the decisions that was a little anxiety-ridden was making the call a couple of years ago to not include coaxial cables — like regular cables in your house — into this hospital to deliver TV. We think we are the only hospital in the country to be delivering IPTV, which is like TV over your computer connection, not coaxial cable. We had to make that decision a year and a half ago, and then we had to make it work or we wouldn't have TVs in the patient rooms. In retrospect, it was a great decision because the TVs are really nice and we saved a lot of money, but it could have been a problem if our team hadn't made it work.
Q: How did you manage to juggle so many tasks? What was your process?
PT: I was fortunate to have a couple of talented staff members for whom that project was their whole focus. Several project managers lived, ate and breathed the project for years, and by the time we went live, there were a lot of staff members dedicating their whole time to that project. For us to stay abreast with what was going on and ensure we were being responsive, we had to make sure that when things came up, we handled them right away or by the deadline. Most of the things that would come up with this project became some of our highest priorities. We also had to make sure we were staying ahead when it came to resource needs, so that when we got to whatever stage of the project, we had the right resources and personnel for it.
While the staff was putting out fires on a day-to-day basis, my role included having regular touch bases to make sure we were always informed and were asking them what they needed to solve problems. We had regular status meetings on the calendar with the team so they could bring forth barriers or issues to our leadership team, and we could help solve them. You really need to have those regular touch points with different factions of the team and the different executives.
Q: What are some of the other exciting health IT features of the New James?
PT: One of the modules now available from Epic is deployed to patients on a tablet. If it's medically appropriate, patients of the New James are offered a tablet when they are admitted. On it, they can do two categories of things: they can interact with their EMR and caregivers and they can connect to the Internet through a private Wi-Fi network. Things patients can do include ordering food appropriate to their diet, seeing a portion of their charts and results, sending non-urgent notes to the nursing staff, reviewing pictures of their caregivers and taking notes on physician directions, questions they have or anything else they want to write down. For patients who aren't tech adept or are too sick, we have a proxy service in which the patients' caregivers can also use the system on the tablets.
Q: When overseeing the entire health IT go-live, what was the biggest challenge (or challenges) you ran into?
PT: Our entire patient care complex is roughly 4 million square feet and we added 1.1 million, so our whole hospital increased by roughly 25 percent. The hospital is 21 floors, which is now the tallest building on the campus, and when you think about the sheer size of it and the miles and miles and miles of cable in that building, it's daunting. We decided to have a PC in every inpatient room for nurses and physicians, and any time we had to work on those computers, it would take two days to walk the building and get to every room. The sheer size of the building, the number of rooms and the density of technology in a modern hospital like the New James is incredible. This was also the first time OSU built an inpatient hospital since the advent of modern technology, so coordinating everything to be ready on the same day — rather than implementing everything over several years — was challenging.
Q: Having managed such a huge project, what advice do you have for CIOs embarking on similar initiatives?
PT: Advanced planning and making sure the IT department is involved from the time of envisioning the building is crucial, as is understanding all the expectations about how the workflows will operate in the new building as early as possible. There will always be surprises, but we were fortunate to have had some experience constructing smaller buildings, so we had a pretty good process during pre-construction meetings. That helped tremendously. When you are building something as big as the New James, you have to do that pre-planning because everything happens all at once and by the time you realize you didn't plan enough, it's too late and you're in trouble. You have to get on the runway early.
Also, creating partnerships with the leaders of construction is extremely important for a CIO. You need to understand them, understand what issues they have, have conversations with them about what to do when issues come up. Issues are going to come up, so building that relationship before there is a big ugly problem makes addressing it that much easier.
Another aspect we spent significant time on was figuring out the live support structures. The CIO has to make sure everyone understands the process when patients are moving onto a floor and there are problems with IT. Structures should be in place and everyone should know how those issues are managed and who should be called. Typically, IT has more experience than operations in big project live events, so creating partnerships with operations is also useful. IT skills combined with operational knowledge can make sure a live event is a success.
