HIMSS: In seeking interoperability, remember patient and physician
ATLANTA—In order to achieve true interoperability within a healthcare system, the IT leaders must consider the value of leaving physicians in the comfort zone, as well as adopting a patient-centric model, to which all data is anchored, according to a session Tuesday at HIMSS10.
Using his implementation process as a case study, Mrunal Shah, vice president of physician technology services at OhioHealth Information Systems, stressed that all the stakeholders involved in the process need to be taken into consideration. Specifically, in OhioHealth’s case, the stakeholders were the reference lab, reference radiology, marketing/communications, operations, the legal team, finance, physician leaders and key physician practices with an EMR.
“Because these practices have already invested in an EMR, this is a particularly important group to speak with when beginning an interoperability project,” Shah said. He also spoke of the importance of keeping physicians using their current technologies, and not disrupting their current workflow too drastically.
OhioHealth is the largest nonprofit healthcare system in Ohio, with five core hospitals, as well as 23 health surgery centers, home health providers, medical equipment and healthcare service suppliers. The system chose a hosted interoperability model.
While Shah acknowledged that expectations of the American Recovery and Reinvestment Act (ARRA), and definition of meaningful have yet to be clarified, he said that there are “core objectives” upon which everyone agrees, such as:
Also, for an interoperability project to be effective, the business drivers need to be clearly defined, according to Shah. OhioHealth’s business drivers were a patient-centric model, more at point of care treatment, physician outreach, competing with lab companies and integrating EMR data.
“Inherently, if we keep the patient in the middle—in a patient-centric model—then all information is anchored to that particular patient. Then, how we use the information in other applications will be dependent on where we are, as it relates to the patient care,” Shah explained. “We tend to look at our environment, such as a hospital, as the center of the care structure. If you are trying to bridge care and improve patient safety, you have to put the patient in the middle, with all data anchored to them.”
The second most important concept was leaving “clinicians in their space,” he said. “If they work in the EMR, leave them in the EMR—they shouldn’t have to exit their EMR, and utilize a new tool to find additional information. In most cases, that will be seen as a barrier, and the physicians shouldn’t see these additional applications as barriers.”
However, Shah cautioned that facilities undertaking this interoperability process remain “cost conscious. It cannot grow to where it is unsustainable, and it won’t necessarily result in a reduction in FTEs.”
OhioHealth developed core objectives, which they shared with their physician community: EHR deployment, e-prescribing and data interoperability.
The projected outcomes were to increase patient safety with point of care data; improve physician and staff satisfaction with efficient processes; and exponentially expand their network of care.
On the flipside, Shah said the roadblocks include “strained economic budgets often call for new priorities.”
In order to implement interoperability at OhioHealth, they have a dedicated physician technology services team of “six individuals with multiple hats,” explained Shah.
As a result of its project, OhioHealth now has 30 connected practices. The system is now able to move lab and radiology transcribed data, as well as ADT data into offices. It built a radiology ordering tool for physician offices and implemented a patient identification (EMPI) solution. It also has 200 physicians using EMR today (GE Healthcare’s Centricity) and 200 physicians using e-prescribing (standalone). Also, OhioHealth now has 18,000 users of its online clinical data repository.
Shah said objectives for 2010 include: bringing data back into OhioHealth because now they can only send data out. The system also hopes to match ADT with problems, meds, allergies (CCD); expand interoperability to 12 more practices; grow EMR usage by 85 physicians; and implement embedded e-prescribing in its EMR practices
Shah noted that transforming care delivery and preparing for ARRA funding with an interoperable healthcare platform can simplify access to care, facilitate coordination of care, optimize treatment and improve satisfaction.
Using his implementation process as a case study, Mrunal Shah, vice president of physician technology services at OhioHealth Information Systems, stressed that all the stakeholders involved in the process need to be taken into consideration. Specifically, in OhioHealth’s case, the stakeholders were the reference lab, reference radiology, marketing/communications, operations, the legal team, finance, physician leaders and key physician practices with an EMR.
“Because these practices have already invested in an EMR, this is a particularly important group to speak with when beginning an interoperability project,” Shah said. He also spoke of the importance of keeping physicians using their current technologies, and not disrupting their current workflow too drastically.
OhioHealth is the largest nonprofit healthcare system in Ohio, with five core hospitals, as well as 23 health surgery centers, home health providers, medical equipment and healthcare service suppliers. The system chose a hosted interoperability model.
While Shah acknowledged that expectations of the American Recovery and Reinvestment Act (ARRA), and definition of meaningful have yet to be clarified, he said that there are “core objectives” upon which everyone agrees, such as:
- Bridging care (“Institution B needs to pick up wherever institution A finished, and institution B shouldn’t have to wonder about missing data,” Shah said.)
- Managing medications safety
- Communicating more effectively (“We need to allow more free flowing information, especially as the communication become more complex,” he said.)
Also, for an interoperability project to be effective, the business drivers need to be clearly defined, according to Shah. OhioHealth’s business drivers were a patient-centric model, more at point of care treatment, physician outreach, competing with lab companies and integrating EMR data.
“Inherently, if we keep the patient in the middle—in a patient-centric model—then all information is anchored to that particular patient. Then, how we use the information in other applications will be dependent on where we are, as it relates to the patient care,” Shah explained. “We tend to look at our environment, such as a hospital, as the center of the care structure. If you are trying to bridge care and improve patient safety, you have to put the patient in the middle, with all data anchored to them.”
The second most important concept was leaving “clinicians in their space,” he said. “If they work in the EMR, leave them in the EMR—they shouldn’t have to exit their EMR, and utilize a new tool to find additional information. In most cases, that will be seen as a barrier, and the physicians shouldn’t see these additional applications as barriers.”
However, Shah cautioned that facilities undertaking this interoperability process remain “cost conscious. It cannot grow to where it is unsustainable, and it won’t necessarily result in a reduction in FTEs.”
OhioHealth developed core objectives, which they shared with their physician community: EHR deployment, e-prescribing and data interoperability.
The projected outcomes were to increase patient safety with point of care data; improve physician and staff satisfaction with efficient processes; and exponentially expand their network of care.
On the flipside, Shah said the roadblocks include “strained economic budgets often call for new priorities.”
In order to implement interoperability at OhioHealth, they have a dedicated physician technology services team of “six individuals with multiple hats,” explained Shah.
As a result of its project, OhioHealth now has 30 connected practices. The system is now able to move lab and radiology transcribed data, as well as ADT data into offices. It built a radiology ordering tool for physician offices and implemented a patient identification (EMPI) solution. It also has 200 physicians using EMR today (GE Healthcare’s Centricity) and 200 physicians using e-prescribing (standalone). Also, OhioHealth now has 18,000 users of its online clinical data repository.
Shah said objectives for 2010 include: bringing data back into OhioHealth because now they can only send data out. The system also hopes to match ADT with problems, meds, allergies (CCD); expand interoperability to 12 more practices; grow EMR usage by 85 physicians; and implement embedded e-prescribing in its EMR practices
Shah noted that transforming care delivery and preparing for ARRA funding with an interoperable healthcare platform can simplify access to care, facilitate coordination of care, optimize treatment and improve satisfaction.