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One-on-One with Methodist Hospital CIO Kara Marx, Part II

April 10, 2008
by root
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In this part of our interview, Marx talks about her philosophy on the best-of-breed vs. enterprise vendor debate.

Methodist Hospital, founded in 1903, is a 460-bed, not-for-profit hospital serving the central San Gabriel Valley in California. The JCAHO-accredited organization provides acute care services such as medical, surgical, perinatal, pediatrics, oncology, intensive care (neonatal and adult), and cardiovascular, including open-heart surgery. HCI Editor-in-Chief Anthony Guerra recently had a chance to chat with Marx about her work.

Part I

AG: Tell me about your IT architecture. You mentioned your work with Eclipsys. Is that your core clinical vendor?

KM: Historically they have been a Quadramed Infinity organization here. They have run that probably for 12-13 years. It’s been a great solid app here. They had all their modules filled out. But right before I came, when they did an internal selection and picked Eclipsys, the driving force was not really CPOE as their first initiative, but nursing documentation to improve quality and patient care. The Quadramed architecture didn’t necessarily support clinical, it didn’t support as robustly as they wanted. So that’s why they went with Eclipsys, and we only signed on for a handful of clinical applications. The reason that I say that is I prefer to consider us of a more best-of-cluster organization, where we savor our existing relationships on new acquisitions, but we would never be monolithic. If it makes more sense to keep the Quadramed financials, then that’s what we’ll do. We have Quadramed financials and Eclipsys clinicals, and then we have our other big systems — Picis surgery, and we have McKesson Pharmacy, and we have SoftLab (from SCC Soft Computer) in the lab.

AG: What about a PACS system?

KM: DR PACS is our PACS, and they’ve been a partner here since 2001. We did step outside our comfort level and started a new relationship with a company called MedPlus. That is going to be our document imaging vendor with our ChartMaxx applications. Because of their best-in-breed status, we felt that it did override our looking at our other partners. We will occasionally make exceptions if it’s compelling enough.

AG: How difficult is it to integrate data flows between applications from different vendors?

KM: I think that if I had my choice and I could have a dream environment, I would have as much integrated as possible. I do believe in integration from a single vendor, but I think you have to kind of pick your battles and your value. Sometimes certain interfaces are really not that challenging, and it’s okay to have them interfaced. But in other areas, there are particular interfaces which I just would not want. So it really depends on the scenario and the value of how that application stands alone. The functionality, the reputation, the stability, and price, and all these things of why we pick a vendor is that more powerful than the challenge of integration. If the interface has been successful in the past, I’m willing to take that risk to get the stronger application to meet my strategic goals. Each time, we look at it that way. For instance, with MedPlus, we purchased MedPlus as our document imaging vendor, and we’re going to use it in HIM and in PFS (Patient Financial Services).

We’re going live in the spring. We purchased their portal. The reason that we purchased their portal is because it’s a physician portal. The physicians are going to be doing remote electronic signature and deficiency analysis. It’s the same vendor, ChartMaxx does the in-house e-signatures and chart deficiency. It made sense to the organization that we would also pick their portal product to be the front facing to the physician population because then we have more opportunity to hold that vendor accountable. So for my physician population, that’s extremely important, so that’s why we didn’t pick some other vendor.

AG: What would it be about an application that could make you refuse to integrate it into your current environment?

KM: What we did when I came onboard is we did develop an IT strategic plan, and part of that includes the IT Guiding Principles. We wrote guiding principles that have been adopted by the organization that state we will always give preference in a selection to an existing partnership or relationship. We’re a bit risk averse, so another thing is we are not an early adopter, but we like to consider ourselves a fast follower. We require that a vendor have three to five successful installs or interfaces that match our environment to get them to be considered.

AG: How difficult is it when one vendor upgrades their product? Do you have to retest all the interfaces?

KM: We run everything in test environments whenever possible. Most of our upgrades are just tested in test and, hopefully, we don’t have to remap a lot of stuff. It really just depends on the level of the upgrade, and its variable.

AG: Can you tell me some of the major projects you are working on this year.