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Early in his career, Lyman Dennis, chief information officer (CIO), Partnership HealthPlan of California (PHC), was project manager of a grant from the National Institutes of Health to develop a system that planned diets.

Dennis took the findings and worked with a professor to develop a product for use by hospitals and the National School Lunch Program. His least-cost diet satisfied both nutritional and variety requirements. How did he cook up a formula? Mathematically, of course.

Dennis holds a PhD in management science (applied mathematics for business) from Tulane University.

With respect to IT, Dennis believes that healthcare would fare better with a steady diet of interoperability, linked electronic health records (EHRs) and usable clinical decision support systems. "Interoperability is crucial given the large number of clinical and administrative systems that currently do not link or must be cobbled together to build a comprehensive system," he says.

"EHRs are going to be tried by a lot of organizations that haven't tried them before," he continues. "It will be interesting to watch how quickly EHRs become essential to medical practice. Larger medical groups now are moving toward EHRs and that will put pressure on independent practitioners and small groups to affiliate with larger groups or medical centers that have EHRs."

According to Dennis, a linked system of EHRs-such as a RHIO [regional health information organization]-has immense value in situations like the aftermath of Hurricane Katrina, when ill and at-risk persons are separated from their normal caregiver locations and those medical records.

"The real issue in EHRs is the right of each patient to have a nationally accessible electronic record and his or her right to provide caregivers access to it at his or her own discretion," he says.

As for clinical decision support, Dennis says, "The medical community knows how to practice medicine far better than the care actually delivered. Convenient systems that provide protocols at the ER beside and in high-stakes care venues will improve clinical outcomes."

Q. Is the CIO now within the CEO's inner circle?

A. Definitely! PHC is run by the CEO and nine department directors, all of whom report to the CEO. Health plan decisions are considered at a weekly meeting of the department heads (includes CIO) with the CEO, with major decisions also considered at the Finance Committee and Board levels. The department heads also attend the Board meetings and participate when relevant.

Q. How do you decide how to best harness IT potential when there is so much of it?

A. IT receives project ideas from several sources:

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