Jim Noga, CIO, Partners HealthCare, Chapter 1

“Change is hard. It’s always hard.”

One of the most important lessons Jim Noga has learned during his 17 years in health IT leadership is that no matter how much education and planning go into a project, there will be a period of adjustment — and there’s no way leaders can avoid it. What they can do, however, is take steps to ease the burden. When Partners embarked on a five-year initiative to implement Epic across the system, Noga made sure that various stakeholders were at the table, providing input. The goal was to have a system that didn’t just meet the needs of clinicians, but all users — including patients.

In this interview, he talks how Partners viewed the Epic project as a “foundation” on which to build future functionalities, why innovation can never take a backseat, and why data governance is “necessary for the sustainability of the entire organization.” He also speaks about the key challenges in transitioning from Mass General CIO to Partners CIO, why it’s time to stop viewing IT as a component of the organization’s strategy, and how something as simple as wayfinding can have a huge impact on patient care.

Chapter 1



* About Partners

* Growing through M&A to support “the entire continuum of care.”

* Rolling out Epic in “logical clusters”

* Ambulatory go-live playbook

* From “a lot of heterogeneity” to an integrated system

* Optimization & innovation – “You have to do the run and build first.”

* Partners eCare: “It was not a rip and replace of IT systems.”



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Bold Statements

Even though Partners eCare is through that initial phase, I’m guessing with the new affiliations and ambulatory strategy growth, we’ll never really be complete in terms of implementations, but the focus is shifting to support optimization.

We were spending more and more time on regulatory initiatives, and so by putting in Epic, especially now with their open APIs, we can start to focus on innovation in healthcare IT, understanding that you have to do the run and build very well.

The last five years was about what we needed to be done; we needed to get the enterprise EMR in. But now we’re looking at how, in an innovative way, are we able to deliver a better patient experience as well as extend our expertise of our physicians.

We wanted to make sure that Partners eCare was not viewed as a rip and replace of IT systems, but more a platform for clinical transformation and innovation. But change is hard. It always is hard. It takes time to really learn a new system.

Gamble:  Hi Jim, thanks so much for joining us today. I think everybody is pretty familiar with Partners at this point, but just in a nutshell, what do you have in terms of hospitals and ambulatory care?

Noga:  We’re not-for-profit system with a focus on patient care, research, and teaching, and service to the community, both locally and globally. Its founding members were the Brigham Women’s Hospital and Massachusetts General Hospital. We also have community hospitals, specialty hospitals, home care, and rehab. The number of what I would call community and non-acute is about 12 different community and non-acute organizations. Additionally, we also have the MGH Institute of Health Professionals, which is an accredited college. We have over 64,000 employees and are the largest employer in the Commonwealth of Massachusetts.

Gamble:  With the hospitals, what has the strategy been with acquisitions and things like that? Partners has obviously experienced growth over the last couple of years.

Noga:  The growth strategy has been very deliberate in terms of supporting the entire continuum of care as we move to population health management and value-based care,