Before 2012 most of us were at about 3% of total spend. Now we're just getting to the 4% to 6% range, although some of the more advanced organizations are higher. Private industry has been in the 9% to 12% range, because they've viewed it as a competitive differentiator. In the past, we [in IT] were looked at more of a cost center and as something the business had to do to keep the business running. That's changed in the past few years, so you're seeing more investments.
Has that dynamic made you as a CIO a better salesman?
CIOs have had to become very skilled in sales, because our competition is fierce. You're going up against facilities and also medical equipment, which is needed for direct patient care. You need to be able to balance [your spending requests] against that; you don't want to sell something that takes away from other initiatives that may be more important than the IT. You have to understand your agenda and the agenda of the organization.
Now, though, it's a little easier because it's easier to show the benefits of the technologies. There are real examples out there where we can show the returns on investment that were difficult to find in the past. In the early '90s, I was doing electronic health records and computerized physician-order-entry systems, but it was very difficult to get budget approval on projects like that. You were dealing with other leaders in the organization who really didn't have a good understanding of the technology or what it could do, and there was no ROI. We had to implement it first to get the ROI. It was a leap of faith.
What's the biggest challenge you're facing now in your current role?
It's the project with UC San Diego. We're using a lot of the system they've already built. But it's a collaboration, and the shared governance aspect of it is tremendously challenging. You have to get operational leaders from both organizations to work together and say, "You do that better, so we're going to change our system," instead of saying, "You have to change to how we do it."
What was the reason for the partnership?
There are five medical systems within the University of California system. The other four were all on the same EHR – different instances but they all contracted with Epic. So I started looking at this and saying it would be crazy to have a fifth instance.
I thought we could save money and support our patients better by being on a single EHR. That would also help get us ready for things like population health because it helps with research and analytics to have a larger patient population in a single database. So we did some analysis that showed a lot of savings. Once the organization saw that, the big implementation made a lot of sense.
Sign up for CIO Asia eNewsletters.