The cycle for planning and building a new hospital can easily be five years, and up to 10 for really big ones. The cycle for change in information technology is maybe three years--less if a game changer like the iPad pops up mid-plan.

That's why building a new hospital with state-of-the-art information technology is harder than it sounds.

"Change is inevitable-it's how you manage it that's important," says James Brownrigg, head of the health care division for Turner Construction, the nation's largest builder of hospitals. Turner works on 125 or more health care projects every year, and did health care builds worth more than $2.7 billion in 2010. Brownrigg says virtually every client is trying to get "hospital of the future" information technology. "It's a must-have discussion today."

In the middle of that five-to-10 year planning cycle, there's usually a two-year design phase where I.T. needs to make its move, getting enough space for wires and data centers, enough money for both infrastructure and equipment, and enough of the right kinds of connections to accommodate future gadgetry, Brownrigg says. CIOs need to ensure they or their representatives are present for all those discussions, to make sure their needs are taken into account and to avoid costly rework later.

"Sometimes a particular technology is selected too late, after the design and construction has been done," Brownrigg says. One of his clients decided at the 11th hour to add a distributed antenna system to its wireless infrastructure, but after the vendor was selected and signed the hospital discovered that neither the DAS vendor nor its vendor for wireless telemetry would guarantee compatibility between their products.

One common problem is that I.T. people don't understand construction people, and vice versa. Teal Heath, program director for information technology and low voltage at Centura Health, Denver, has spent the past six years managing the I.T. aspects of all the organization's construction projects, from new hospitals to medical office buildings to expansions and renovations of existing facilities. When she began, the learning curve was steep. "I didn't understand that they pulled cable after installing the drywall but before putting in the ceiling grid," she says. "From a general contractor's standpoint, the phases of a project are consistent and there are I.T. deliverables for each one."

"Starting from Scratch," Elizabeth Gardner's feature story in the September issue of Health Data Management, examines how new hospitals can install state-of-the-art everything--if their CIOs get to the table early and are always ready to tear up their plans.


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