Split Screen: CIOs Help their Physicians with Meaningful Use

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.

For that capability, he and his colleagues have chosen the Chicago-based Initiate Systems (now an IBM company). In fact, such moving forward on the roll-out of their MPI has compelled Ingram and his colleagues at Sinai to scrub the MPI of the health system; “We have four or five FTEs in the health information management area currently scrubbing our MPI,” he reports. The initial go-live was scheduled for this month. Ingram is also working far more loosely with two medical groups affiliated with Sinai Health System, but whose physicians are not salaried employees. In that case, one of the complications is that those two groups have a different EMR vendor and their own CIO.

Other CIOs are working through equally complex situations. In the case of the 450-bed Mercy Medical Center in Cedar Rapids Iowa, senior vice president and CIO Jeff Cash is working with an affiliated group of 90 physicians to help them achieve meaningful use, while also beginning to plan a bridge to modernization of the hospital's Meditech Magic inpatient EMR and CPOE systems.

Given the complexities of the situation, Cash and his colleagues have gone live with a physician portal solution supported by the Newton, Mass.-based PatientKeeper Inc., in order to facilitate physician documentation. Using PatientKeeper, the affiliated physicians can now log in, view results, create new notes, and, will soon be able to order through CPOE, all via PatientKeeper.

The interoperability that Cash and his colleagues have created falls somewhere between true EMR and a kind of quasi-health information exchange. It sounds complicated, but, says Cash, given the need for the hospital to update its core EMR system at the same time that it creates CPOE, physician documentation, and other capabilities for the physicians, this is an approach he feels he can live with.

“This allows me to give my physicians and clinicians the systems they need, without having to do a complete replacement of my current healthcare IS. Otherwise, we might be forcing ourselves into a timeline that we might have difficulty with, and our vendor might also have difficulty,” Cash explains. “Thus, we're using a niche vendor who can come in and give us some capabilities as a layer on top of our existing systems, and provides needed capabilities to our physicians. This could also give me the flexibility to migrate away from Meditech if necessary, though I'm comfortable with them and with moving towards their new system.”

THE DOCTOR IN THE ONE- OR TWO-DOC PRACTICE DOESN'T WANT TO HANDLE ALL THE COMPLEX TECHNOLOGY CHALLENGES, DOESN'T WANT TO HIRE AN IT PERSON FOR SUCH A SMALL PRACTICE, AND DOESN'T NECESSARILY WANT TO BECOME PART OF A BIG ACADEMIC MEDICAL CENTER'S EMR SYSTEM.-GEORGE BRENCKLE