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Intermountain Healthcare's Marc Probst: Time for More Concerted Federal Action on Data Standards

February 27, 2013
by Mark Hagland
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Marc Probst of Intermountain Healthcare shares his perspectives on meaningful use—and beyond

Marc Probst has been vice president and CIO at the Salt Lake City-based Intermountain Healthcare for nine years. In that time, he has continued and expanded on the work of his predecessors, leading a large team of IT experts and professionals in the integrated health system’s ongoing journey as a pioneer organization in leveraging IT for performance improvement and patient care quality optimization.

Probst will be speaking twice at the HIMSS Conference in New Orleans next week, including as the closing keynote speaker at the Meaningful Use Symposium. In that capacity, on Sunday, March 3, he will be speaking under the session title, “Update and Insights Regarding Meaningful Use,” from his standpoint as a member of the federal Health IT Policy Committee.

Probst spoke this week with HCI Editor-in-Chief Mark Hagland regarding his upcoming role as a HIMSS Conference presenter, and the broader issues around the meaningful use process and the current state of healthcare IT’s evolution more generally. Below are excerpts from that interview.

You’re speaking at HIMSS, including delivering the closing keynote address at the Meaningful Use Symposium, correct?

Yes. In the Meaningful Use Symposium, I’m closing out, with my perspective on some of the issues associated with meaningful use, because of my membership in the HIT Policy Committee. I continue to believe that we’ve been successful with meaningful use, but I think some things could be improved.

Marc Probst

What things could be improved?

Standards, whether they’re around patient identification, or data transfer standards. I think the industry hasn’t achieved everything that the investment in EHRs [electronic health records] would allow it to achieve, because I think the government hasn’t been as focused on a host of standards, primarily around data, which is what I’ll be talking about on Sunday.

Within the patient identification and data transfer standards, areas, what issues would you like to point out?

Well, we can’t even reasonably move a lab result from one system to another and have the data be reliably transferred, because even with LOINC standards, you still can’t support physicians without a lot of extra work mapping data. In one system, they may define a nurse as a “1” and in another, as an “N.” Developing standards for data transfer is where you get value out of systems; and meaningful use is meant to help the country.

Is it providers or the government who need to focus more on standards?

This is a bit more controversial; I do believe that the government needs to, since the industry has not focused enough on it yet. And so if we’re going to do it more expeditiously, I think the government should get more detailed on this. And to be fair, Farzad [Farzad Mostashari, M.D., National Coordinator for Health IT] does get the concept, as does the HIT Policy Committee; but we’re doing it pretty incrementally. I have lobbied pretty hard up in Congress on this, but I have only one voice.

Certainly, I would think Dr. Mostashari would listen to you carefully.

And he is doing things, but the meaningful use process is getting ahead of standards development, and that’s going to be a problem. So I am bullish on ONC [the Office of the National Coordinator for Health IT]; given what meaningful use was asked to do, I think the Policy Committee is doing an excellent job; they’re an amazing group of people.

Is it your sense that we’re now reaching a critical mass industry-wide in the shift towards IT-leveraged clinical transformation?

Absolutely. I’m in awe of organizations like Sentara [the Norfolk, Virginia-based Sentara Healthcare, an integrated system with 10 hospitals and three medical groups]; and I’m in awe of Judy [Judith Faulkner, founder and CEO of the Verona, Wis.-based Epic Systems Corporation]. There have been so many investments in healthcare IT; and I think IT is absolutely critical to leveraging change. Ten years ago, you had to send a fax to share a patient’s information with another provider, and now you can virtually get someone’s key patient information electronically, even if that process is not necessarily seamless. And now we are focusing on how to making things more seamless and accessible, and improving the workflow.

What would you advise your colleagues about what’s been learned from pioneering organizations like yours so far?

The danger in my offering advice to others is that not everyone has the same level of resources. Intermountain has 60 people in the Homer Warner Center [the Homer Warner Center for Informatics Research, located at Intermountain Medical Center in Murray, Ut.] spending all their time on leading-edge innovations. The average community hospital organization doesn’t have that. And in terms of developing and implementing best-practice protocols for clinical practice, support and operations and in clinical information systems, and 90 percent of what we’re using, the concepts were actually developed elsewhere. We speak a lot about the 39-week induction protocol for inducing labor, for example. We didn’t come up with that; we just took it and implemented it, and were able to use our systems to support it.

What would your advice about using medical and clinical informaticists be? Obviously, Intermountain has created a culture of innovation and clinical transformation.