Becker's Hospital Review

Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 13 Health IT Roundtable: What Are the Biggest Health IT Issues Going Into 2013? By Bob Herman M ost hospitals and health systems across the country have had a laundry list of items on their health information technology checklists over the past several years, and refining the role of health IT will only become a more urgent and pressing issue as hospitals enter into year three of healthcare reform. for meaningful use and are getting everyone on a common platform to exchange information amongst the organization. We went to Epic because our legacy platforms couldn't really support this. We are also doing that in the business areas, too. We are standardizing purchasing, payroll and the other business applications as well. Here, five hospital and health system leaders — Rodger Baker, president and CEO, and Donna Staton, CIO, of Fauquier Health in Warrenton, Va.; Peter Banko, president and CEO of St. Vincent Health System, a Catholic Health Initiatives system based in Little Rock, Ark.; Chris Belmont, CIO of Ochsner Health System in New Orleans; and David Kaelber, MD, PhD, CMIO of MetroHealth in Cleveland — explain what health IT issues are at the top of their agenda next year, how "big data" should be interpreted in a health system, where telehealth fits into the picture and just how complex it can be to manage hundreds of different IT systems at once. Two, infrastructure. How do we make sure [our technology's infrastructure] is secure and meets security requirements going forward? We are going toward more electronic and less paper — so you have to have good disaster recovery and business continuity initiatives. We are drastically reducing downtime and increasing responsiveness as well. Building a stable, high-performing infrastructure is important as we go completely digital. Question: Starting in 2013, what are the most pressing health IT issues and projects on your health system's plate? Rodger Baker: We have efforts going on with our small number of employed physicians. We needed to replace their electronic medical record, and coincidentally, at the same time, we talked to our primary care physicians about some of the changes that were coming down the pike with value-based purchasing and accountable care. Certainly, primary care physicians are going to be integral in all of this. We asked them what we can work on together. They needed some help in re-evaluating their own EMR. Donna has led the evaluation and selection of [an EMR] product that we hope to purchase. We hope to subsidize some of the first-year costs, and we have some monies in our capital budget for 2013 for these costs. This [past] year was big for due diligence. They learned a lot, we learned a lot, and hopefully we have a good product the community can rally around. Peter Banko: We just went live with our EHR, which is part of a $2.2 billion effort by Catholic Health Initiatives. We are the first system to go live with the Cerner OneCare. It's basically our shared, universal EHR, mostly on the acute-care side. We just went live before Thanksgiving. We also are doing a lot of work behind the scenes for data and clinically integrated networks, but our major thrust is this OneCare initiative with CHI. Chris Belmont: Our strategic initiatives can be broken down into four big buckets: One, core systems replacement. We are getting ready Three, user experience. [IT systems] are somewhat of a scavenger hunt. If you want information, you have to know what system to go to. We have 225 different applications and systems that we know of, and that includes systems for our cafes and coffee shops and our fitness center locations, for example. You have to know where to go and what password to use, and we are trying to streamline that user experience for our employees to make our systems more intuitive and user-friendly. One way to do that is consolidate systems. Four, analytics. How do we measure and do better with the data we have at our hands? That's the real game-changer. That's where we are going to focus a majority of our time. Healthcare is reactive, but we want to be proactive. We want to know what's happening right now so we can manage the population one month from now. Let me know what's going on with a population of diabetics, for example. How can I act on that to prevent them from having an event? Predictive analytics are going to be a game-changer. Dr. David Kaelber: One of the top issues is meaningful use. Not only is it making sure we're doing all things to be meaningful users now at stage 1, but how do we become stage 2 meaningful users as well? A theme related to that is enterprise-wide deployment of a single EHR. We installed an EHR, Epic, in the late 1990s: We installed outpatient Epic, then Epic in the emergency department, then inpatient Epic. But now, the real value of these systems comes from having the same system across all domains. One of the, I think, underappreciated values of health information systems is the ability to integrate with each other. We've got to go with a single vendor among all these different systems. Chris Belmont Donna Staton Another major item is we've invested in EHRs going on 15 years. We have the tools and a ton of data, but now it's, "How do we use the tools with the data to really use the things that are meaningful to the healthcare system and our patients?" I've done work with Habitat for Humanity, and this is the analogy I use: The paper record is to the EHR as the manual hammer is to the power nail gun. If you know several skilled workers who know how to use a manual hammer, but you just give them a power nail gun and tell them to build a house, bad things can happen. There's no guarantee of high quality and safety. Once you have access to the new tool, you have to ask, "How can I redesign how I build this house to take advantage of this new tool I have?" Ultimately, the house will be built cheaper and faster

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