Creating the IT Foundations for Healthcare Reform

October 8, 2012
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Cornerstone Health Care’s CIO Tim Terrell talks about the mission-critical IT foundations needed for medical groups to participate in healthcare reform
Creating the IT Foundations for Healthcare Reform

Cornerstone Health Care is a 340-provider multispecialty group practice (with nearly 240 physicians) that is physician-owned, and located in the Greensboro-Winston Salem-High Point Triad area of North Carolina. It was established in 1995. Tim Terrell has been CIO at Cornerstone since 1998. Terrell spoke this summer with HCI Editor-in-Chief Mark Hagland, as part of the process that created a virtual roundtable of medical group IT leaders, all interviewed regarding the top strategic IT issues facing medical groups in the current environment, for the October cover story. The entire cover story can be found here.

Meanwhile, below are excerpts from Terrell’s extended interview with Mark Hagland.

What are you seeing as the most significant strategic IT issues facing medical group leaders like yourself in the current at emerging operating environment at the moment?

Overall, for us [at Cornerstone Health Care], it’s the challenges presented by healthcare reform, in its broadest sense.

From your perspective, what unites all of thehealthcare reform-related programs in terms of the strategic IT foundations required for them?

Number one is analytics, and number two is integration. Those two things will be the biggest elements of it, and both are enormous.


Tim Terrell

And where are you on those two elements?

We're actually investing pretty heavily in analytics. And we’re working with Teradata, one of the three biggest data warehouse vendors (the other two are IBM and Oracle); also, we’ve got Humedica for the clinical analytics and clinical predictive modeling. And we’re in the process of implementing the OptumImpact suite from OptumInsight, to give us claims-based analytics.

Are you live on all three yet?

Right now, we’re live on one, Humedica; we’ll be live on Teradata by October, and will be very close on the Optum.

When you say healthcare reform, does that also include meaningful use?

There are a lot of regulatory changes that have happened, and I would put meaningful use out there as a regulatory change. If you address it early, you gain some advantage. We have attested for stage 1. Not all of our physicians qualify, for example, the hospitalists, and a number of our pediatricians and OB/gyns did not qualify; but we attested for meaningful use stage 1, for about 150 of them, in December 2011. That’s mostly because our EMR vendor was really fighting to get the capability for us to be able to attest. We’re Allscripts.

You’re going to participate in ACOs?

We were announced for the July start.

Are you involved in patient-centered medical homes or bundled payments?

We’re in the process  of shifting to entirely value-based contracts with all our payers. We’re doing healthcare reform very intensively here. So we’re going to have a variety of flavors of contracts in place very soon.

What unites all these healthcare reform-related programs in terms of the strategic IT foundations required for them?

Number one is analytics, and number two is integration. And when you look at it, those two things will be the biggest pieces of it, and both are enormous.

And where are you on those?

We’re actually investing pretty heavily in analytics. And we’re working with Teradata, one of the three biggest data warehouse vendors (the other two are IBM and Oracle); also, we’ve got Humedica for the clinical analytics and clinical predictive modeling. And we’re in the process of implementing the OptumImpact suite from OptumInsight, to give us claims-based analytics.

Are you live on all three yet?

Right now, we’re live on one, Humedica; we’ll be live on Teradata by October, and will be very close on the Optum.

Will the three solutions have to talk to each other in some way?

No, not really with analytics. But we’re using each one to drive different types of analytics. Now, we probably will use one or more of them to drive data back into our warehouse. Also, you can’t treat every patient the same way anymore; you basically have to divide your patients into the generally healthy versus the chronic with one illness, versus the poly-chronic, versus those in end stages of illness, and each category you have to treat differently. With poly-chronics you have to work on poly-pharmacy and managing those patients more intensively. And with the end-stage people, it will be about getting them to the lowest-cost, best-outcome setting for care. The patient who is terminal with cancer actually lives longer, and at much lower expense, in hospice, versus in the hospital.

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