Christ Hospital, a 381-bed acute care facility in Jersey City, N.J., offers a range of services from primary angioplasty for cardiac patients to intensity modulated radiation therapy (IMRT) for those battling cancer. The medical staff includes more than 500 physicians, most of whom are board-certified in specialties ranging from allergies to vascular surgery. HCI Editor-in-Chief Anthony Guerra recently had a chance to talk with CIO Martin Grossman about his work at the hospital.
AG: Since I met you at the show, I’d like to know your impressions of HIMSS this year.
MG: It looks like everybody is excited about the new standards that are being presented to get folks that develop EMRs to be interoperable, and it looks like folks are trying to figure out how to do the HIE-type of conductivity now that RHIOs have not quite done what they were advertising they were going to do. HIMSS itself was great, and it’s interesting to see the different strategies that the major vendors have to address – the long-term solutions.
AG: When you talk about the standards that are being released, anything specific you have in mind; CCHIT or HL7?
MG: CCHIT comes particularly to mind. I’m actually pretty excited by that, I think that has a great degree of potential. For me, at a community hospital level, I’m going to be given the chance to do this once, and probably not again. (CCHIT) helps me with an objective view on the evaluation of the different niche of vendors, because one of the considerations I have when selecting the clinical information system is to see if it will last pretty far into the future. The way I see that working right now is through the use of the standards that have been employed.
AG: What do you have in place now?
MG: We basically have a McKesson shop for the transactional part of IT. We are just beginning to embark upon our clinical journey, if you will. We have a pretty robust lab information system and a suite of lab products (also McKesson). I have GE’s Cardiac Cath suite of systems. The first part of this year, we’re going to employ GE’s OB data systems, the perinatology systems, and some others. So we’re really concentrating on some of our product lines that we want to go ahead and enhance and provide them a value-add to get to be state-of-the-art. We’re beginning to evaluate more robust, advanced clinical information systems in preparation for the EMR/EHR journey that we’re about to embark on.
AG: We may be getting into semantics here, but how is an EMR different from what you currently have in place?
MG: An EMR is basically an electronic version of paper charts that folks are used to seeing in a medical records department, the old medical record department. So, you may have an X-ray film and you have the health record and you want to see that electronically, so you may have a mini-PACS or a PACS that will be employed to create that in a visual format. The same thing with your history and physicals, your nursing documentation, your labs, all the different components of that chart; and to be able to use that chart concurrently by different healthcare providers, interdisciplinary. So the pharmacist can see the drug that they distributed to the nursing floor at the same time the nurses administer it and can look at things like allergies and any other types of clinical alerts that need to go in the dosage. It really assists in patient safety, and that whole closed-loop medication effort that folks talk about.
AG: The products that you have from McKesson currently don’t give you that view?
MG: No, we have processes in place that provide the same, or very similar, function, if you will, but the automation of going electronic will greatly enhance our ability to apply that much more effectively and safely.
AG: Are you looking at McKesson for your EMR?
MG: They’re going to be one of many that we’re going to look at. There’s grand scale like the Epics of the world that have a pretty robust system but a very expensive system, through to McKesson, which is more midrange, but not as integrated, more interfaced. Then you’ve got even Meditech that are not as expensive but not as flexible in dealing with other vendor devices. That’s the journey that we’re going on, as a midsize urban community hospital. We do have our challenges, and we’re trying to fit our technology needs with the reality of the financial world.
AG: Are those the three that you’re looking at?
MG: No, they’re samples of suites of products that are not so expensive, midrange expensive and very expensive, and then a different degree of integration, if you will. I’m really looking for a truly integrated suite of products, rather than a lot of stuff that requires a heck of a lot of interfacing.
AG: What are the main pieces in the IT architecture that you want, the main applications that you want to be able to exchange information?
MG: On the ED application, with the pharmacy application, with the nursing documentation application that results in what’s called an eMAR — all that working in conjunction with our ancillaries: the labs, the radiologies and cardiologies.