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St. Vincent's and CSC Merge Diverse Systems Into One
Luis Taveras' CSC team began an outsourcing project in 2001 that would merge three separate New York City hospital systems into one unified healthcare organization — St. Vincent Catholic Medical Centers (SVCMC). Taveras says that the key to this complex project, which will continue through the next five years, is the working relationship between CSC and SVCMC, which functions as a partnership, not just a contract.
This unique relationship between CSC and SVCMC was recently recognized by Outsourcing Journal, which awarded the pair its top award, Best Partnership. Taveras cites mutual trust and deep knowledge of his client’s business as being key to his partnership with SVCMC. Taveras frequently reports to the organization’s chief executive officer, and he is in the unique position of serving on St. Vincent’s Leadership Council, where he advises about IT matters in addition to other issues facing the organization. “I’m in the room when executives talk about financials, patient care process improvements and compliance,” he says. “They know I’ll provide input to whatever issue they’re talking about — even if they are discussing the nursing shortage. I’m a technologist, that’s true, but I’m also a healthcare person.”
 David Campbell, SVCMC’s chief executive officer, says that CSC’s knowledge and experience in healthcare have been reassuring, given the challenging nature of the project. “It’s invaluable, the level of commitment that Luis and his team continually demonstrate,” says Campbell. “During the application rollout, they absorbed the cost of additional resources just to ensure that it went smoothly. When we were flooded with patients on September 11 [2001], the CSC team helped move patients in for treatment. These are the actions of a partner, not a vendor.”
Taveras and his staff are implementing a complicated plan: merging Catholic Medical Centers of Brooklyn and Queens, St. Vincent’s Hospital and Medical Center of New York and Sisters of Charity Healthcare in Staten Island into the entity of SVCMC. The complete SVCMC system includes eight hospitals: Bayley Seton, Staten Island; Mary Immaculate, Queens; St. John’s, Queens; St. Joseph’s, Queens; St. Mary’s, Brooklyn; St. Vincent’s, Manhattan; St. Vincent’s, Staten Island; and St. Vincent’s, Westchester.
The project began with four separate help desks, multiple data centers without a common network, diverse and often incompatible applications for the same functions and non-standard operations and procedures. CSC launched a four-pronged system-integration and process-improvement effort that dramatically changed the operation and structure of the organization.
Consolidation of data centers and help desks
In the first step all data centers and help desks were consolidated, stabilized with CSC’s processes and migrated along with servers and mainframes to CSC's Norwich, Conn., Data Center, which is now the operations center for SVCMC. This largely reduced costs and helped bring cohesiveness to the organization.
Another major priority was to redesign the network infrastructure in Manhattan. It was common for SVCMC to experience four to five hours a week of network downtime, which made the applications inaccessible and forced the hospital staff to run operations manually until the network went back up. In the first three months of the project, CSC replaced network switches and processes.
To avoid random downtimes, CSC structured network outages that ran from 7:50 a.m. to 8:00 a.m., allowing recycling time and maintenance to ensure the network would stay up the rest of the day. After 30 days, this step wasn’t needed. “In prioritizing what needed to be done, we were guided by a standard of service set by CSC. A well-functioning network was critical,” says Taveras.
Desktop refresh
CSC inherited a diverse desktop environment, with a wide range of models, vendor configurations and ages that weren't able to handle the new suite of applications CSC was designing. It was clear that establishing a stable desktop environment would make application rollouts simpler. During the first 15 months, CSC replaced 6,000 desktops with an IBM standard configuration and set up a standardized desktop image.
As CSC rolled out the desktops by geographic location from the top floor of the hospital down, the greatest challenge was coordinating time with unpredictable floors like the emergency rooms. But the effort created a more ideal environment for the help desk, eliminating a great deal of guesswork since all of the equipment was standardized. “We gained control of the environment, which has allowed us to provide better service,” says Taveras.
Better service also includes remote resolution. This is a setup that gives CSC the ability to take over a workstation remotely and perform repairs, which is an ideal service for physicians and nurses. “We’d much rather have them spend time treating patients instead of talking to a help desk, describing a computer issue,” says Taveras.
Application unification
CSC built additional stability through its application unification program. Through it, CSC established single applications that govern processes for the entire organization. CSC recently completed all of the management systems, shrinking six general ledgers to just one and established patient accounting and clinical applications. Consequently, processes like admitting patients are handled the same way, regardless of whether patients are being admitted in Manhattan or Queens.
The program has created faster and broader access to information. Before the application rollout, lab results were calculated overnight and distributed in a paper format to the various hospital floors in the morning. Now physicians and nurses are able to view electronic test results simultaneously. Increasing access to patient information for everyone who is involved in treatment improves the quality of care and cuts down on medical errors, an issue that providers are facing across the entire U.S. healthcare system.
For the most part, the clinical applications allow SVCMC to speed up already-established processes and, in some cases, revolutionize them. CSC created new applications that automate the processes for testing and dissemination of results for cardiology, lab, radiology and pathology.
The applications created for behavioral health and radiology specifically address the labor-intensive process of reporting. Behavioral health clinicians can now enter notes directly into the system, which forwards the information directly to insurers for payment. Similarly, the application for radiology incorporates a speech recognition system that translates physicians’ verbal notes into an electronic patient report. The system spares SVCMC the expense of sending dictation tapes out for transcription, and physicians are freed from writing a patient report. The favorable response to time saved has led to plans for a rollout across other departments.
Saving time on the administrative side meant redesigning entire processes in addition to the applications. Procurement for SVCMC formerly involved stocking its warehouse in Brooklyn with medical supplies for distribution across the system when hospital floor supply closets were depleted. That process required nurses to manage medical supply inventory — a task that can be challenging given busy nursing schedules.
To save time and manage inventory more accurately, CSC installed scan modules in each supply closet. Now nurses have only to scan supplies they are removing for treatment. The system updates the inventory log and assesses stock needed on each floor, allowing SVCMC to receive supplies just in time. The system links the nurses’ stations and other points of service to local supply rooms and vendors. The system, which can place daily orders with vendors and eliminate excess inventory, is so effective that SVCMC is planning to get rid of its warehouse by the end of the year – another major cost savings.
Demand management
Before CSC came on board, SVCMC did not have a way to track time spent on repairs and improvements. To increase service to SVCMC users, CSC formalized a service request process. Now users call a single help desk to report desktop and application malfunctions. If users need to request an improvement for an application or system, they follow a separate process to create a tangible request. The formalization of this process helped CSC evaluate how much time was being spent on activities ranging from creating reports to setting up new e-mail accounts.
To date, CSC has built standard applications and a stable operating environment, but Taveras expects the greatest cost savings to kick in once the SVCMC corporate center is completed this summer. The corporate center will pull together administrative staff from each hospital location and place them in a central location where they will manage functions for the entire organization. The result will be an elimination of redundancies and a more efficient organization.
According to Taveras, the project has amounted to centralizing a decentralized organization. “More importantly, the applications environment and infrastructure will allow Saint Vincent’s to function like a system and reap the efficiencies of the merger,” he says.
Related Information:
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Read the Outsourcing Journal article in full.
Find out about CSC’s Health Services offerings and view client case studies.
Read the press release about the Outsourcing Journal award recently received by CSC and SVCMC.
Read more about CSC's IT Infrastructure Outsourcing offerings.
Find out more about the outsourcing trend in healthcare.
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