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

April 15, 2008
by root
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In this part of our interview, Marx talks about budgeting, governance and employee recruitment and retention.

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

Part II

AG: What exactly are you using Eclipsys for right now? You said you are working on a CPOE project, so you're not using Eclipsys for that currently?

KM: We’re using their order entry at a department level. We use them for results review, department order entry. We are testing a handful of forms for nursing documentation, and we will do full-blown nursing documentation in the fall. It’s actually an extension of the project from last year. We’re calling it a Phase 1B. We will go paperless with nursing documentation probably in September.

We’re also doing emergency room electronic forward tracking, and we’ll do medical device interfaces in the ICU, as well.

As far as CPOE goes, we’re a community-based hospital. We don’t employ any physicians. Right now, we really are doing more of the groundwork, and we’re gaining value from lessons learned by other organizations, and we’re trying to work on getting physician buy-in to technology just to begin with. To get there, we’re using the portal as a stepping stone, making sure that we can even get them to use the computer, and then move to standardization efforts. Some of those ground-building things before we launch into CPOE will increase our chances of success.

AG: Do you have any plans to take advantage of the Stark relaxations?

KM: We’re just having discussions about it, but we haven’t made any decision. We have two large IPOs that work with us, and they already have investments into ambulatory care products. The rest of the physician population is made up of small physician offices, and we’re discussing it. We hope to do something, but we really don’t know.

AG: Do you think that hospitals will inevitably have to integrate electronically with their local physician offices?

KM: I think if you look at care holistically, you almost have to. You have to have the vision that to truly treat a patient, we have to be able to share data across the care continuum. This includes long-term care and into the patient’s home. I don’t know when it’s going happen, but I think that if we want it to work, that has to be the endpoint.

I’m pleased to see that the government is supporting removing the financial burden from the physicians, and I think it’s a starting point. I think that there are also other ways that you can achieve some communication. We have outbound interfaces today from our transcription system into our major physician practices, with the big ones out here in California with 200 docs. We’re already sending outbound discharge summaries and populating their records, and that we didn’t need any Stark help on. I think there are other ways of achieving, making little steps towards it too.

AG: What is your annual IT budget?

KM: I can tell you that it’s 3 percent of the total hospital budget — 3-3.5 in line with the industry standard.

AG: Do you feel that’s enough for you to accomplish your goals?

KM: I can get done the projects that I have on my plan. Projects get added. I think if we take projects off of budget and out of planning, it will become difficult. I don’t have extra staff — we don’t have a lot of wiggle room.

AG: What’s the process of getting monies budgeted beyond that 3 percent if you have some specific, large-scale initiative you want to do?

KM: I make sure that all IT incentives are linked to the hospital strategic plan in some fashion. In that way, they sell themselves. If the hospital’s mission statement is providing high quality healing services for the patient as a whole person, and I want money for a disaster recovery project, some type of security, then we can get it. My latest thing is I’m really reevaluating all our HIPAA policies, but it all ties back to the patient. They will support it within reason. Obviously, I’m not going to ask for 10 projects and $10 million, but everything is strategically driven. I think then that speaks for itself.