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One-on-One With North Shore-LIJ CIO John Bosco, Part I

November 25, 2009
by root
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John Bosco says physician integration strategies hinge on one sensitive issue: data ownership.

At the end of September, 13-hospital North Shore-Long Island Jewish Health System announced it was subsidizing up to 85 percent of the cost of implementing Allscripts ambulatory EHR in the offices of its more than 7,000 affiliated physicians, constituting a $400 million investment. Specifically, the plan calls for North Shore-LIJ to provide physicians with individual subsidies of up to $40,000 over five years. To learn more about the project, HCI Editor-in-Chief Anthony Guerra recently talked with CIO John Bosco about the strategy behind this massive tactical move. (Read a related interview with Allscripts CEO Glen Tullman)

GUERRA: You’ve signed quite an interesting deal.


BOSCO: Yes, it is. A few weeks ago we had our first, of what I’ve been calling, community forums. We had it in a catering hall, and we brought together a bunch of community physicians. I think 50 or 60 of them made it, and we’re going to be doing this twice a week for the next few months. At the first one, there was a lot of excitement and a lot of interest. There were good questions, so it was very positive.


GUERRA: What’s are your goals for these meetings?


BOSCO: There were three main things that we spoke to. The first was – and these are our credentialed physicians, voluntary physicians, the ones who could participate in this program – to educate them about the program itself and the vision for the program, so that they could understand what we’re trying to accomplish and why.

Secondly, for them to actually see a demonstration of the Allscripts system, and so we had Allscripts there and they actually walked through a lot of those screens and did some workflows based on sample patients. And then in the middle of those things, we actually give them a little bit of information in a few slides about HITECH and meaningful use. That was productive also because we’re finding it really runs the gamut as to physicians’ awareness and knowledge about the incentives and the stimulus act. So I was surprised. I had two quick slides. I was going to race through them, and I think we wound up spending about 15 minutes talking just about the incentives and meaningful use and certification and all these concepts. So they seemed very engaged.


GUERRA: Were you pleased with the turnout?


BOSCO: I think it was good. A few weeks ago we already had almost 400 docs that had registered for one of the forums. So considering that we only went to press a few weeks ago, we thought that was a really good sign. We were doing this twice a week in our various communities around our hospitals and different locations. You know, 400 in a week is a good number; 50, 60 a night I think is a good crowd.


GUERRA: Four hundred is a good number, but it’s quite a way from 7,000 which was the number of licenses in the deal. How do you plan to extend your outreach?


BOSCO: Since they are credentialed physicians and we have essential credentialing system that we use to establish and maintain their credentials, we have all of their names and addresses and fax numbers and email addresses and everything. So we have actually multiple marketing tools that we are using, and we’re intending to scale them as needed.

Initially, the focus is just to drive physicians to one of these forums – I think we’re calling them, “Program Information Sessions and Demonstrations” – so that they can get more information and see a demo. So we’ve started off with just some correspondence from our CEO, and then Allscripts and our marketing departments, to drive them to the Web site to register. We have a new Web site that we put up and a new hotline number for the initiative. We can escalate that all the way to a team of full time dedicated salespeople that are both from Allscripts and Henry Schein (one of the partners in the deal). So we’re gauging what the response is and what tools are best for getting their attention.


GUERRA: It’s always fascinating when you have to convince people to let you buy them something, isn’t it?


BOSCO: You know it really is. A few weeks ago was the first community forum, but we’ve already done at least 50 or 60 demos, I would say, because we first had to do all of these to our own internal committees and medical executive committees and medical staff societies and all the various groups that are internal to us. We did that to make sure that within our own health system, all of our physician leadership and others are aware of what we’re doing. We’ve also identified, and we have a phase for, early champions, so we’ve been running around doing demos for them also.

We’ve been pretty good at predicting what the big questions are going to be, but it’s interesting to see that they’re waiting for us to tell them what the trick is. And at one point, when we got to the end and I did some closing remarks, I had a slide up that said, “Why choose the NS-LIJ program,” and then one of the bullets said because you’d have the backing of the major health system that can demonstrate a proven and replicable process. I said, “You know guys, there’s no trick here. There’s no hidden meaning, there’s nothing that you need to be trying to figure out.”

But they come in with a certain level of suspicion, wondering, “What’s really going on here that I’m not catching yet,” but I think by the time it was over, we did a pretty good job of making them understand what it’s all about.


GUERRA: What were the major concerns?