One-on-One With Memorial Healthcare CEO Patty Page LaPenn, Part III

In my experience, ER docs being able to see the ambulatory record will have some benefit but it doesn’t necessarily change what they do.

The hospital that just rolled out the new EMR has only seen a 7 percent reduction in lab costs. So it’s decreased a little bit of lab usage. Where is the data that shows this saves money? Where is the data that installing an EMR decreases costs for Medicare? Does Medicare have evidence? Medicare should provide that to us. They should be able to say, “This hospital during this time period before they went on the EMR, their average cost was this and after they went on the EMR their costs went down to this.” There should be either a level trend when others are going up or it should be a downward trend. I want to see that it saves money. And if you’re saying it just improves care, I want to see that data too.

You can get the drug information at SureScripts better than anywhere else. Surescripts works.

GUERRA: Why does it work?

LaPENN: Well, first of all it’s nominal data. It’s not qualitative data. There are specific names of drugs with specific doses. It’s not like when you read an MRI, the doctors don’t say normal or abnormal. They describe. It’s not nominal data. It’s not something where you can say it’s positive or negative. There’s nothing like that on most of the data that you get from the medical system. Lab data is the right kind of data, pharmacy data is the right kind of data, but radiology, you can’t do it with radiology, you can’t do it with heart procedures, and you can’t do it with surgeries, because it’s not the same thing.

GUERRA: The bottom line seems to be hospitals want tight integration to lock in patient flow but physicians want to maintain some level of independence. How do you see it?

LaPENN: I am with the independent physicians. What independent physicians want is a portal with a quick search where they can get their information. They do not want to change 90 percent of what they do to get access to that data. For the hospital, it’s mainly the ER that needs rapid access to information out of the ambulatory model. That’s where I think the biggest problem is. Do you have a portal where they could get rapid access of information? It doesn’t have to be pretty. Just put some metadata on it so you know where the patient is, what the date of the admit is, make it a diagnosis.

We need some standard metadata, attach it to a file and send it. Let’s do it like Google, rather than trying to structure it, because it’s not there yet. It feels like a Commodore computer in the early ’80 s. That’s what EMRs look like to me. It looks to me like when ATMs came out, that was really easy to do because a dollar is either plus or minus and you have an account number. That’s a real easy technology shift to me. A cholesterol level of 120 means one thing if it’s coming up from 90, but it means quite another if it’s coming down from 300. Doctors love technology, but they can’t adopt things that make it harder for them to do their job.