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One-on-One With New Hanover Regional Medical Center SVP & CIO Avery Cloud, Part I

September 21, 2009
by root
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Cloud says independent practices are asking CIOs for IT advice, providing a great opportunity to foster alignment.

Southeastern North Carolina-based New Hanover Regional Medical Center is the ninth largest healthcare system in the state with a dedicated team of 4,400 employees, 565 physicians and 800 active volunteers. Recently HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Avery Cloud about just how HITECH is effecting his plans.

GUERRA: Tell me a little bit about your organization. I know it’s a three-campus integrated health system.

CLOUD: Three campuses, one hospital on each campus. We do have a behavioral health, or a psych hospital, I should say. We employ hospitalists. Total beds would be just under 800. We also own practices. We’re developing an ambulatory care strategy where we are inviting physicians to become a part of our organization. We have distributed diagnostic centers. It’s pretty much the gamut of what you would see in an integrated health network. We serve about seven counties, and we are the largest employer in our city, with about 4,600 people.

GUERRA: How many physicians do you employ?

CLOUD: I think it might be somewhere around 40.

GUERRA: And about how many physicians have privileges that are independent and don’t work for the actual facilities?

CLOUD: Just over 500.

GUERRA: Tell me about your software environment.

CLOUD: I’m very fortunate because my CEO is married to the idea of integration. Now, integration for us doesn’t necessarily mean the same vendor – although most times it does – because it’s very difficult to achieve integration having a multi-vendor shop. But integration essentially means the idea of a common interface, a common database, common architectures. Anything you put the word “common” in front of, for us, is what integration is about. And so, every once in a while, we may find a reason to step outside of our primary vendors strategy.

Our primary vendor is McKesson. We are on their Horizon platform and beginning to move any products that we own of theirs that are not on Horizon to Horizon.

In terms of what we’ve accomplished, we have barcoded meds administration. We have paperless EMR after discharge. So essentially, any medical history is only accessed through the computer. All of our physicians engage our portal to access patient records.

I would rate us somewhere around 85 percent down the EMR road. We intend to complete that journey over the next three to four years. We’re going to implement CPOE and physician progress notes, so that would round out our EMR efforts. Obviously with the stimulus stuff going on, we’re trying to figure out how to do some of the things that are being asked for in meaningful use. One of those is we have plans in the coming year to go down the HIE road. We are, in cooperation with 11 other hospitals in surrounding counties, working together in a very interesting cooperative to join our communities through an HIE strategy. So that’s going to be very important for us in the coming year.

On the financial side of the house, we’re a Lawson shop and well automated there.

GUERRA: Regarding the owned practices, do you have them on a McKesson product? It looks like Practice Partner was their old product.

CLOUD: Yes. That’s a great question. We’re in the throws right now of evaluating what would be our two recommended EMRs. And our strategy is to pick two and then pre-build any interfaces and integration to those two. We would become the recommender in the area, because a lot of our docs have asked us to serve that role. Some of them are holding back on making a selection in order to see what the hospital does. And so if we can become the recommender, even for docs that are not owned or employed by us, we create great integration in the region. We also have an owned clinic and we’ll probably install the HAC (Horizon Ambulatory Care) product, which is tightly integrated with the hospital EMR.

Basically the ambulatory care product would share the same database with the hospital EMR. And we think that is a best fit for our clinics. But for our outlying docs or remote docs and their practices, we’ve narrowed the field down to about seven products, and we’re going to get it down to two that that we would recommend to any of those physicians.

GUERRA: Can you name those seven?

CLOUD: I’d love to, but I don’t have it in front of me. Let’s see if I can give you some of them off the top of my head. GE’s Logician product is in there. McKesson’s Practice Partner is in there. eClinicalWorks is in, Allscripts is in. Those are samples of what’s in the seven at this point. Over the next two months, we should have it narrowed down to two and become the recommender of those products. And, of course, we have to work with those vendors and create any necessary interfaces back to our systems.

GUERRA: Let’s talk about the control issue there. The interesting thing is that under Stark you had some control, but under HITECH, they can do what they want. Is there a loss of control now?