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Waller named medical informatics director by George Spain IS Technical Publisher Neither a geek nor a wonk, John Waller, M.D., the new director of medical informatics in the Office of the Chief Information Officer, didn’t set out to become a technology guru, but the job found him anyway.   After just one of his almost 15 years at Emory University School of Medicine as the chairman of the Department of Anesthesiology, he found that the college’s sprawl led to geographical isolation among various departments, which in turn led him to become an early adopter of emerging desktop technology.    “In those early years, I saw both the promise and shortcomings of technology in health care. I guess I complained about the shortcomings one too many times, because 10 years into my chairmanship, I was asked to take on the additional job of CIO,” Waller said. Dr. John Waller   He took the job at Emory, but on the condition that he only spend 24 months at it before the administration picked “a real CIO.”   “John expressed a keen interest in getting involved in clinical IT activities at MUSC when I arrived in 2003,” said Frank Clark, vice president for information technology and chief information officer. “He had experience in this area at Emory and he chaired the IDX Flowcast Steering Committee overseeing the implementation of the professional billing and scheduling system for UMA. Based on this, we felt he would be a good interim, so we hired him to serve as full-time director.”   He will continue to serve in his capacity as professor of anesthesiology and perioperative medicine and practicing physician in the College of Medicine.   Waller says his job is one of an interpreter, a middleman between technology specialists on the one hand, and clinicians on the other. He lives on both sides and knows what each needs.   “Health care isn’t like banking. It isn’t a matter of transaction in and transaction out. Health care is fundamentally chaotic—there are emergencies, twists, and surprises on every turn. The automated systems that keep up with health care have to take this into account. Tomorrow won’t be like yesterday.   “In health care, training is a constant. In other businesses when there are a few turnovers, you can gather new employees into a room and teach them what they need to know. In a hospital, especially a teaching hospital like this one, there’s a constant turnover of personnel, students, and patients, and training has to keep up with this turnover,” Waller said.   But the toughest part of merging health care and technology is predicting and keeping track of costs.   “It was an eye-opener for me when I became a CIO for two years. At the time, we didn’t have any way to measure what a project would cost. We’d set aside $100,000 for a project, and spend it on software. We’d turn around and it was gone and still no solid results,” he said.   This led Waller to implement one of the first “total cost of ownership” IT budgets in health care and the results were a bit of a shock to others.   “What we found was that software and hardware combined accounted for only about 30 percent of the total cost of a technology project. Most of the remaining 70 percent was implementation, infrastructure, and ongoing support, and that hadn’t been factored in.”   Cost of ownership is something Waller will keep an eye on, but it’s not the only driving factor in information services. Technology’s usefulness is what attracted Waller to it in the first place.   “We will soon see the day at MUSC when an order is entered electronically (eliminating illegibility), sent to the pharmacy where a barcode is assigned along with the medication (eliminating mishandling), delivered by robotic conveyance to the floor where the patient is (eliminating misdirection), where the nurse will read the name, scan the barcode on the medication then scan the barcode on the patient’s wrist (eliminating misidentification). If there is a conflict between the medication, dose, or patient, then the scan will pick up a red flag,” said Waller.   He said that this new technology will help caregivers keep an eye on the five rights of medication safety—right patient, right drug, right dose, right time and right route.   True interoperability—the fitting together of different systems from different vendors into a unified flow of shared information—will bring about a highest level of patient safety, said Waller.   “We are working to reduce the number of vendors and one-of-a-kind systems we employ in the hospital to a bare minimum. If a proposed new system doesn’t operate smoothly within our unified flow of information, we won’t adopt it.”   From this comment, it’s easy to see why Waller is the point man on the new Advanced Point of Care (APOC) systems proposed and adopted by the administration. MUSC recently signed a contract with McKesson Corporation, one of the country’s largest providers of information and care management products.   When it’s completed, the partnership between McKesson and MUSC should result in one of the most modern automated care systems in the country.   Waller joins Clark’s team in the OCIO: Kurt Nendorf, director of infrastructure systems; W. Roger Poston II, Ph.D., director of academic and research computing; Dave Northrup, director of clinical systems; Melissa Forinash, controller and director of support services; John Dell, director of financial and administrative systems.     Friday, Dec. 16, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.