CIO 100 Award-winners Are 'Risk Busters'

Many of the honorees in the 25th annual CIO 100 awards program are using IT innovation to reduce risks that threaten employees, customers and entire business models.

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Gaboriault led a project to automate and streamline these processes with workflow and collaboration applications, combined with interactive visualization software. Now, an emergency clinician signs in to a workflow application on a computer right in the exam room and requests, via the software, that the clerk contact a specialist. The clerk does, and logs the information electronically from his desk. The clinician doesn't have to leave the patient to find the clerk.

In trauma cases, each clinician swipes his smart badge at a computer outside the trauma bay. The application accesses the hospital's human resources database to identify him and to populate an interactive display. While there, he can touch the monitor to claim an area of the patient's body to treat, such as the airway or left chest. The doctor enters the bay, where he can see another screen displaying statistics and data about the patient. The display also shows names and pictures of the clinicians at each area of the patient's body, for everyone's reference.

"They have all the same information at the same time," Gaboriault says. The treatment bay is quieter and the documentation nurse isn't confused. "Even if it's seconds of friction out of the process, it speeds up the time between knowledge and action."

Compliance records are more accurate and no one pours over paper logs to fulfill data requests.

Risk: Excessive Downtime Costs, Deficient Patient Care, Data Errors

In 2008, the Cancer Treatment Centers of America (CTCA) did something many healthcare organizations struggle to do: implemented a full electronic health record system. Having gone fully computerized, patient care was now dependent on 100 percent IT uptime--a nirvana not achieved, says Chad Eckes, CIO of the CTCA, which runs a network of five hospitals across the United States.

The electronic health record system and other software require weekly updates and patches, which meant that the system had a planned downtime of four hours each week. Unplanned downtime last year averaged an additional 43 minutes per year. When the system was unavailable, up to 3,000 doctors, nurses and other staff members had to use workarounds, Eckes says.

Patient safety was not at risk, he says; read-only copies of patient records were available locally to the medical staff during these periods, which were usually 11:00 p.m. to 3:00 a.m. But clinicians had to write out the necessary information and enter it later. They also were unable to care for as many patients during the downtime as they could when the systems were up, necessitating extra staffing. Downtime, Eckes says, "is inexcusable in a world where you have applications impacting patient care."

Re-keying data always heightens the risk of errors, he says. Plus, using paper, even for a short time, disrupts the workflow of the staff, especially for younger clinicians who may have never worked in a paper world.

Eckes built a private cloud in a backup data center that mirrors the virtualized servers and 342 applications in its primary data center. The systems communicate with each other continuously, moving the work of physicians, nurses and other users between production environments without disruption, he says. The CIO likes to perform a dramatic test where he cuts power to a full rack of equipment and the SAN that runs the electronic health record software and watches the system self-heal by bouncing to the backup cloud. In the 18 months since the system launched, the company has had no downtime in the data center. "The end user sees nothing. Not a pause or blip. The response time is sub-second."

Risk: Injury, Death, Property Damage

Brampton, Ontario, is the second-fastest-growing city in Canada, but the city budget isn't keeping up, putting the fire department in a tough situation. It has to serve more citizens, who are packed more densely, while it controls costs. This risk caused by this familiar "do more with less" demand becomes more intense when you consider that human safety is at stake.

In 1995, for example, Brampton's fire department handled 7,597 emergencies, including fires, car accidents and hazardous materials incidents. Last year it was 17,607--more than double.

"It's not sustainable to continue to add staff and vehicles as the city grows. We have to look at how to sustain growth with fiscal pressures," says Rob Meikle, CIO of the City of Brampton.

The city's IT group worked closely with the fire department to determine how to route vehicles more efficiently, to save time and improve service. But several factors complicate routing.

In a fast-growing city, traffic patterns continuously change, which disrupts time-tested fire truck routes. Also, the fire department used to dispatch trucks from the station nearest the location of the incident, even though a truck and crew that was already out of the station may have been closer. There was no electronic system to track that information. Staff members used radio to share information about their whereabouts and the details of the emergency.

For Matt Pegg, deputy fire chief, the goal is to put responders on the scene as fast as possible, equipped with as much information as possible. But any new tools, systems or procedures had to be impeccably reliable, Pegg says. "In the world of fire, the only thing worse than not giving me a tool I need is giving me a tool I can't rely upon."

IT worked with the fire department to build a new system where trucks carry location-based sensors so the routing software can find the nearest fire truck, rather than just the nearest station.

Next, the team had to deal with the physical risks of navigating heavier and less-predictable traffic. Before, signals would detect the flashing lights of an approaching truck and change to red, to stop traffic and let the truck weave through the intersection. As the city grew, however, more buildings went up, blocking the trucks' flashing lights. Now, GPS data from trucks is transmitted to the system that controls traffic signals by a new data network, which the city was already installing for smart buses and a rapid transit system. That happens as soon as a truck is dispatched. The signals then immediately start to "precondition" intersections, meaning they adjust green, yellow and red lights to clear traffic from the truck's route, Pegg says, and ensure fire vehicles always have a green light.

"In the past, we were required to stop at a red light, then proceed through it. That's dangerous," he explains. "This is an efficient and fast response to the specific emergency but also improves public safety along the way."

Risk: The Wrong Business Model at the Wrong Time

As its name suggests, Mohawk Fine Papers is--or was (we'll get to that)--a maker of high-end specialty paper. Fancy stationery, book covers and the like. But the 81-year-old, family-owned business faces a triumvirate of forces gathering strength in the past few years and threatening to put the company out of business: the shift from paper to online publishing, the environmental push to conserve trees, and global competitors that offer cheaper printing services.

"Our survival was at stake," says Paul Stamas, vice president of IT at the $300 million Mohawk.

Senior executives set a goal two years ago to become an agile company that could create new products and services to embrace, rather than fight, the disruptive trends, Stamas says.

"This was no IT-only exercise, Stamas says. "The CEO issued a call to action to the rest of the company [saying] 'We have to change or we won't survive.'"

Mohawk closed one plant and stopped making low-margin products such as brochure paper, outsourcing that work to Asian companies. It started making envelopes to go with the paper product lines it had kept. It also started selling products directly to consumers and businesses, cutting out some of the distributors it had previously used. The company wanted to be closer to its ultimate customers to sense trends more quickly, Stamas says.

Mohawk also got into a new business: online photo sharing. It now runs a site that offers printing services for calendars and books. "We're driving demand for our paper but creating an entirely new business," Stamas says. It also bought a plastics company so it could sell magnets and signs customized with photos--products with higher profit margins than paper.

In April, Mohawk felt confident enough in its new endeavors to drop the "fine papers" portion of its name from marketing materials and other corporate communications.

With an IT staff of just five people, cloud computing has enabled Mohawk to experiment with new business ideas and partnerships, then extricate itself from them quickly if necessary, Stamas says. For example, the company learned its envelope business from six smaller manufacturers, connecting with them via the cloud. Mohawk combines Amazon's cloud with its own EDI, warehouse management and financial systems. When Mohawk was ready to start making its own envelopes, it dropped the partners with little impact on its internal IT systems, he says.

Mohawk is now smaller and makes fewer products but is twice as profitable as it's ever has been, Stamas says. He and his staff, he says, "are business process orchestrators. I'm not thinking much about the technology."

Follow Senior Editor Kim S. Nash on Twitter: @knash99. Or read her blog, Strategic CIO.

Copyright © 2012 IDG Communications, Inc.

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