Virtua is a multi-hospital healthcare system headquartered in Marlton, N.J. A non-profit organization, it employs 7,900 clinical and administrative personnel and has 1,800 physicians as medical staff members. Virtua is an early adopter of clinical and digital technologies, led on the IT side by CIO Al Campanella. Recently HCI Editor-in-Chief Anthony Guerra caught up with Campanella to see if HITECH was changing his strategic plans.
GUERRA: Can you give me the 10,000-foot overview of Virtua?
CAMPANELLA: Sure. Virtua has four hospitals with a little over 1,000 beds. We have a little over $1billion in revenue. We own 150 physician practices. We also have two nursing homes, a very large home health agency with 400 nurses, and we have two large ambulatory care centers.
GUERRA: And I would imagine there’s a large population of physicians down there that are independent and refer to the hospitals?
CAMPANELLA: Yes. We have 1,100 office-based physicians who are completely voluntary, and then we have another 600 that are employed by other health systems that also admit here, or they are hospital-based physicians such as anesthesiologists and pathologists, so roughly, 1,700 altogether. And then, separately, we have 150 employed physicians.
GUERRA: The employed physicians – the office-based physicians that are owned – are they allowed to refer patients to other hospitals or do they have to refer inside the Virtua network?
CAMPANELLA: No, they don’t have to refer to us. If we offer the service, then they’re encouraged to refer the patient here, but if we don’t offer the service, then of course, they can refer elsewhere.
GUERRA: How long have you been CIO of Virtua?
CAMPANELLA: Just 18 months.
GUERRA: Eighteen months, and were you a CIO before that somewhere else?
GUERRA: Did you come up in Virtua?
CAMPANELLA: No. The eight years prior to Virtua, I was a consultant.
GUERRA: But you’ve been in the industry for awhile?
CAMPANELLA: Yes, I’ve been in the healthcare industry for over 20 years. I guess 10 of those years I was on the operational side. I worked really at two places, John Hopkins Hospital and the University of Pennsylvania Health System. I did hospital and physician practice operations and some IT, and then I worked for the last eight+ years as a consultant, and the last year and a half here.
GUERRA: You certainly have been involved with the market for a long time. How would you describe the difference between the pre-HITECH world and the HITECH world we’re living in?
CAMPANELLA: I think, in the post HITECH world, there’s definitely a greater awareness that technology can be one of the enablers of true healthcare reform, and secondly, that there’s no question there’s a great need for data to be shared amongst disparate providers to truly provide patients with the high level of care they deserve. I think that the goal of the bill is really the sharing and the exchange of data between different healthcare providers – that’s the essence of it. The true end point is really sharing data across a continuum for more efficient quality care. The EMR itself is simply a means towards that.
GUERRA: What is the most difficult part of making that happen?
CAMPANELLA: I think the most difficult part is overcoming physician concerns about their workflow and productivity. Physicians in a community are paid on a pay-as-you go basis. So anything that is perceived as a barrier to their daily productivity directly effects their income. So they’re concerned that the use of a computer is, in some respects, minute by minute less efficient than just talking or speaking, such as dictation, or even just telling an employee in their practice to do something, to place an order, for example. That human voice is a very efficient tool compared to typing or using a stylus at a computer.
They do agree fundamentally that structured data, and having electronic availability of data, is very valuable, but it’s at the price of slower workflow for them. I do not think the cost of EMRs is really the barrier. It’s really the effects on their personal workflow. If they just lose a few minutes per patient because of working with a computer, that translates to having to work one to two hours at night to catch up – or seeing less patients – and to them, that’s unacceptable. If they found that computers made their life personally more efficient, then I think they would be buying them very easily, very readily.
GUERRA: Would you agree that currently the systems on the market do not make them faster?
CAMPANELLA: I would say they make them marginally faster, if they really know how to use them well. The systems have to be usually customized to meet their style of practicing medicine. Every physician has a slightly different style in how they practice medicine, how they obtain information from the patient and, in turn, how they record it.