Hospital and health system CIOs are working intensively to help physicians achieve meaningful use; but, given limited resources and the foreshortened timeframes involved, most are putting the bulk of their focus on their employed physicians. Still, some CIOs are also finding creative ways to engage their affiliated physicians and move forward on several fronts at once.
Thomas Smith, CIO of NorthShore University HealthSystem (formerly Evanston-Northwestern Health System), based in the Chicago suburb of Evanston, Ill., is very clear about what to do to help his physicians achieve meaningful use: He is going all-out to implement core electronic medical records (EMR) and computerized physician order entry (CPOE) systems for the four-hospital, 916-bed health system's 675 salaried physicians, while providing training and support for its remaining 2,000 affiliated, non-salaried physicians. And his strategy is typical of those of most CIOs right now.
When it comes to employed physicians, Smith says, “We're essentially implementing the current copy of the EMR we have in the hospitals,” which is the core EMR from the Verona, Wis.-based Epic Systems Corp. As for non-salaried physicians, “We're offering them the Epic EMR and Epic registration and billing, and about 25 affiliated physician offices are live today” on those systems. For both groups, he says, “We're going through the meaningful use rules right now and trying to figure out what we need to do.”
The core difference has to do with the level of detail and coordination of effort involved. Smith and his colleagues in corporate IT are working very closely with NorthShore's employed physicians on every detail of implementation and meaningful use compliance. But because the affiliated physicians are not employees of the health system, there is naturally a greater detachment involved, he says.
“Let's say we offer help on medication reconciliation; one of the standards is you have to meet that standard 80 percent of the time. So we offer training, encouragement, and reports that tell them what their status is, and expect to continue to help them until the date when they'll make an application. We basically are looking at our analysis of whether we're compliant, in terms of our own functionality and ability to meet clinicians’ needs,” Smith explains. The affiliated physicians can then turn to NorthShore for advice and tips, but will have to follow through on their own in terms of the details of implementation.
This is pretty much the pattern being played out nationwide, as CIOs prioritize their levels of involvement with salaried and non-salaried physicians in their organizations’ orbits. Like Smith, most CIOs are caught between and among competing priorities. These are the need to optimize their own internal hospital processes, the desire to help both types of physicians, and the complex politics of working with independent-and independent-minded-non-salaried physicians.
WE OFFER TRAINING, ENCOURAGEMENT, AND REPORTS THAT TELL THEM WHAT THEIR STATUS IS, AND EXPECT TO CONTINUE TO HELP THEM UNTIL THE DATE WHEN THEY'LL MAKE AN APPLICATION.-THOMAS SMITH
Having to focus and prioritize is especially important for organizations like the three-hospital, integrated Sinai Health System in Chicago, which with large Medicaid and uncompensated care populations, is always short on resources. At Sinai, vice president and CIO Peter Ingram is working intensely right now to get both the hospital and medical group of the health system qualified for meaningful use in 2011.
The flagship 320-bed Mt. Sinai Hospital is live on the Meditech Magic system from the Westwood, Mass.-based Meditech. Ingram and his staff of 55 are working diligently to go live with the Horsham, Pa.-based NextGen EMR at the 200-doctor Sinai Medical Group. Given his small staff and limited resources, Ingram says, “It's going reasonably smoothly, but we're also putting in an enterprise master patient index [MPI] at the same time. The MPI will be the traffic cop between Meditech and NextGen here,” he says.