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HIE That Facilitates Population Health in South Jersey

November 28, 2013
by Mark Hagland
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Tom Gordon, senior vice president and CIO at Virtua health in New Jersey, shares his perspectives on facilitative HIE

Virtua Health is a four-facility, community hospital-based, integrated health system based in the southern New Jersey town of Marlton, just outside Philadelphia. The largest healthcare provider in South Jersey, Virtua encompasses 1,000 inpatient beds and three community outpatient centers. At Virtua, Thomas F. Gordon, senior vice president and CIO, has been leading transformational change around the leveraging of technologies to facilitate population health management across the organization’s entire service area.

Among other initiatives, Virtua became a Medicare Shared Savings Program (MSSP) accountable care organization (ACO) in December 2012, with 13,000 lives so far, covered under that federal contract. It has also established its own patient-centered medical home (PCMH) program, covering 100,000 lives so far. One core facilitative technology in all this is health information exchange (HIE).

Within the context of the HIE initiative, already, clinicians can view hospital data, laboratory data from Quest, LabCorp, and Virtua labs; radiology data from South Jersey Radiology Associates, Larchmont Imaging, and Virtua Radiology; and soon, data from rehabilitation facilities, nursing and long-term care facilities, home health, and urgent care sources.

Not surprisingly, all the current initiatives, including the HIE initiative, are keeping Tom Gordon and his team of 185 IT professionals very busy; indeed, by his reckoning, they currently have 299 IT projects active at the moment. Gordon spoke with HCI Editor-in-Chief Mark Hagland about all this work recently, and about his perspectives on it all. Below are excerpts from that interview.

Tell me about your journey around HIE and population health management so far?

We have a strategy around technology vendors, but it’s just a Virtua strategy altogether. We do partnerships with vendors. They really are partnerships, and we tell the vendors upfront, we’re not just looking for a software solution, we’re looking for a partner, and we want you to be as invested in this as us. So it can be a pretty intensive process, as it was with HIE. And we saw some of the bigger problems happening around governance in some of the state and regional entities. So we found Wellogic [now Alere Accountable Solutions, a division of the Waltham, Mass.-based Alere) at the time, now Alere and we actually host the HIE in my data center. It’s privately funded, so we don’t have ownership problems. And we avoid most governance problems.

Thomas F. Gordon

And early on, we spent a lot of time around policies and procedures. And you can Google “Virtua HIE policies and procedures,” you’ll see that. We had put a lot of time, effort, and money into it, and it really was a situation where we wanted people to follow standards, and not just go through the motions. So yeah, it was an absolutely conscious decision to try to get others to use that same process.

And we had this partnership with Wellogic; and they had never allowed a customer to host an HIE So we hosted the solution. We partnered with another company through them, EnableCare, which does sensitive data-scrubbing. So anything that comes in, only authorized users have the ability to get to the data. And we knew other HIEs had had to deal with such security issues.

And right away, we connected our HIE to some local radiology centers, as well as Quest and LabCore, some laboratory vendors in the area. So we  currently have 20 participants sending data into the HIE.

When did you go live?

About two years ago. And we’re collecting something like a million records a month. It’s become such an unbelievable data repository. So, two big things right off the bat that came into play. Last year, we started our accountable care organization planning. And we actually put out 25-30 RFPs for vendors offering accountable care-related solutions. So we ended up picking our HIE vendor for a portion of it, and another portion involved a company called TriBridge, and they had a solution around ACO using a CRM [customer relationship management] package, Microsoft Dynamics from Microsoft. It does all the normal CRM functions, but in a hospital environment, so, tasking—who are you calling that day, what appointments do you have for that day? On our HIE side, we already had this huge amount of data, where basically we have our patients’ entire record.

 Siemens Soarian [from the Malvern, Pa.-based Siemens Healthcare] is our acute-care record, and our physician practices use NextGen [the Horsham, Pa.-based NextGen Healthcare]. And we don’t have anything in the middle except for this HIE, which has all the data for the continuum, so it made perfect sense At the same time, Alere went out and purchased a company called DiagnosisOne, for the clinical decision support. And now that’s called Alere Analytics, which a great decision support engineer, which covers not only the data we have internally at Virtua, but also the external data. It’s been a huge success using that data. We’re able to send near-real-time data to the care coordinators to make decisions.