Mergers and acquisitions in health care have been common in recent years. Small community hospitals are becoming part of much larger integrated health systems.  One of the common challenges these systems face is providing effective local service from central corporate departments.

Health systems may span a large metropolitan area, a portion of a state, or a multi-state region. And there are systems with a national footprint.

The health systems I’ve worked for are mostly the first; they have covered a large metropolitan area. Local hospitals may be as much as 100 miles apart and the corporate office somewhere in the middle.  While much of the work goes on every day without face to face interaction, people are often expected to drive to key meetings either at the corporate office or at the hospitals. But the distances and the traffic can challenge support models for corporate functions.

University Hospitals serves patients in northeast Ohio through an integrated network of 18 hospitals, 40 outpatient health centers, 1,700 employed physicians and primary care physician offices in 15 counties.  There are 26,000 employees. I am continuing my “meet and greet” sessions as the interim CIO meeting with the hospital presidents. One afternoon this week, I drove 130 miles round trip to one of our smaller hospitals.

I’m learning that our IT support model needs improvement. We are deploying common systems and infrastructure across five newly acquired hospitals in the next several years. We have to make sure that they are adequately supported now on their current systems and on our shared systems in the future.

We’re talking basics. They need to know who to call for what. They need someone to help them navigate and see problems through to closure. They need to have service tickets handled efficiently, especially for local problems. They need responsive onsite support for problems that require hands-on work. One hospital president told me that they struggle every day with simple things and that when those little things are unresolved, they blow up to be big things. The CIO (that’s me) finds out about those “big things” in a long trail of emails escalated by a frustrated leader.

They are not arguing about standards or the overall integration plan. They want us to understand their unique needs. Smaller hospitals are used to knowing all of their own IT staff by name and being nimble. Being part of a larger integrated system means giving that up for other benefits.

I have worked with different support models in integrated health systems in the Boston and Chicago markets. But I don’t want to jump to any conclusions on how best to address local support here at University Hospitals. I am partnering with Jennifer DeFrancesco to review the current situation, define the problem we need to address, and determine a better approach. She is the director for change management and training and works with all of our hospitals. It’s also an opportunity for her to work with A3 thinking as part of our lean journey.  While I have some thoughts already of what we need to do differently, we will take the time to look systematically at the problem. And we will look at any best practice models from other corporate functions within the health system that provide local support.

We will be able to float our proposed approach to the hospital presidents as a group to get their feedback and support. They come together weekly at the corporate office. My goal is that we respect the uniqueness of each hospital and its culture as we roll out a common, system-wide approach.