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One-on-One with Dublin Methodist Hospital CIO Michael Krouse, Part III

May 5, 2008
by root
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In this part of our interview, Krouse talks about his feelings on the best of breed vs enterprise approach.
Dublin Methodist Hospital is a part of OhioHealth, a not-for-profit, charitable healthcare organization consisting of 15 hospitals and 20 health and surgery centers throughout a 46-county area. The new 94-bed hospital, which opened in January, can expand to 300 rooms if demand increases in its northwest corner of central Ohio. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Michael Krouse.

Part II

AG: Is e-prescribing and pharmacy also covered by McKesson in your hospital?

MK: It is. It’s called Admin-Rx. Our PACS is Fuji Synapse.

AG: Is there a RIS that sits on top of the PACS for workflow?

MK: Yes, it’s a GE RIS system, Centricity. You asked an interesting question about the electronic medical record. I don’t know if you’re interested, but in the private practice environment, the EMR is a whole different ballgame. The EMR is more often than not a single product, a vendor product, like NextGen or Allscripts. Really what they’re saying is that in a private practice environment, it’s everything that billing and practice management don’t do. So it’s all of the scheduling. It’s all of the tracking of the information on the patient. It’s the problem list. It’s all of that bundled up together. That’s the electronic medical record in the private practice setting.

AG: The revenue cycle management part is McKesson?

MK: Correct. It’s what we call STAR, kind of our core patient billing system.

AG: Now that’s the patient billing, and then you also need enterprise resource planning and business intelligence.

MK: We do. We have a company called PeopleSoft from Oracle.

AG: It seems like people either pick PeopleSoft or Lawson.

MK: Correct, within healthcare that’s probably true.

AG: Do you use any aggregation product, like Microsoft’s Azyxxi (now Amalga)?

MK: No, we have a homegrown product here. It’s called Ohio Health Results Browser (OHRB), and it’s as close to a physician portal as you will ever see. But it sits as a viewer over the top of all of our back end systems. It allows our physicians and our clinicians to go to a single place to see all relevant information about a patient, slice and dice it any way you want, look at and run reports, see past lab results, pull up images actively, read remote strips, whether they be EKG or other components, see all of that. That has been built and running and continually enhanced probably for the last 12 years. We’ve got about twelve years worth of data on our patient population that is at the fingertips of anybody that has the authority to get in and see it. That, in essence for us, is probably the solution, at least for the time being, that we’ll continue to run with, that front end viewer. It’s pretty slick. It’s a Web-based tool. You can get access to it wherever you happen to be that provides Internet access and again, through appropriate provisioning, allows you to see what you need to see.

I talked earlier about the positive ID function, and I talked about the mobility of supporting our physician community. One of the things that I’ve implemented is when you’re at home today, for example, it’s 2:00 in the morning, and you want to place an order, you can. We worked with the State Board of Pharmacy such that, at home you may not have a biometric scanner and the State Board of Pharmacy requirements are: “something you have, something you know, or something you are.” If you meet two of those three, you, in essence, meet their requirements for a positive identification. So at 2:00 in the morning, a physician doesn’t believe it’s necessary for them to jump in their car and drive down to take a look at the patient because they’ve got access to the NICU and all they need to do is place an order, whether that be a test or a lab or a med.