Sailing into a new platform

As a surface warfare officer with the U.S. Navy in the 1990s, Daniel Barchi sailed the world in American efforts to intervene in international conflicts. During the Bosnian War in 1994, his ship stationed in the Adriatic Sea, Barchi led armed boarding parties that searched ships for weapons and contraband in support of NATO sanctions.

“My ship carried Tomahawk missiles,” Barchi says. “During one of our deployments we were ordered to make a high-speed transit through the Suez Canal into the Red Sea.” Although his crew never had to take action, the ship spent several weeks stationed in the middle of the Red Sea, calmly patrolling in case conflict arose.

Barchi himself is calm, polite, and businesslike, with a military bearing and a spartan, orderly office. Now chief information officer (CIO) for the School of Medicine and the Yale-New Haven Health System, he says military life gave him “the ability to jump into almost any role.”

After leaving the Navy, Barchi worked for the telecommunications company MCI WorldComm, and then was president of the Carilion Biomedical Institute in Roanoke, Va., before joining Carilion Health System as CIO.

“I had never done IT before,” says Barchi, who relied on central principles of leadership in solving a basic problem: Carilion was using multiple electronic tools that didn’t work together.

Barchi’s strategy was to introduce a single software system that would unite these disparate tools. Today Barchi is managing the rollout of that same system, Epic, at Yale, an ongoing project since his arrival in 2010.

At Yale, installing Epic means introducing electronic medical records (EMRs) for all patients. The system, which cost more than $250 million, went live at Yale-New Haven Hospital (YNHH) at midnight on February 1, and was in operation the following day—with operating and imaging suites heavily booked—just in time for the next monthly billing cycle.

“It went really well,” says Barchi, attributing the smooth transition to well-coordinated training sessions, talented medical staff, and the work of IT support teams that included many workers from outside organizations.

Another lesson Barchi learned in the Navy: “Good leadership is about asking appropriate questions.” Until recently, however, health information technology was ill-equipped to provide useful answers. Early EMRs were merely digital versions of paper records, he says, and systems were designed primarily for billing, limiting the availability of data needed to answer clinical or research questions.

By providing a single platform for all Yale users, Epic opens doors to numerous new possibilities. For instance, the system can offer prompts to physicians when a given patient might qualify for a clinical trial—a feature that has enabled the Cleveland Clinic to recruit more than 10,000 new research volunteers.

Bridgeport Hospital and the Saint Raphael campus of YNHH will come online later this year, and Epic will be fully implemented at Yale and the Yale New Haven Health System by early 2014. “Now we’re focused on using the tool well,” Barchi says, adding that he hopes that Epic will serve Yale for another 20 to 30 years.

Importantly, Epic also allows patients to access important health information—quickly, and from any computer. Increasingly, Barchi predicts, the U.S. government will insist that patients have immediate access to health information. If history is any measure, under Barchi’s watch, Yale will be prepared.