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Vermont in the Vanguard: Catching Up with Fletcher Allen's Chuck Podesta

April 23, 2013
by Mark Hagland
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At a time when virtually everyone in healthcare and healthcare IT is incredibly busy, Chuck Podesta is still busier than most. As senior vice president and CIO of Fletcher Allen Partners, Podesta’s role continues to evolve forward. Just a year and a half ago, he was SVP and CIO of Fletcher Allen Health, a Burlington, Vermont-based health system with one hospital facility, Vermont’s sole academic medical center. But then in October 2011, Fletcher Allen Health came together with Central Vermont Medical Center (Berlin, Vt.), becoming Fletcher Allen Partners. And then in January of this year, Champlain Valley Physicians Hospital in Plattsburgh, N.Y., and Elizabethtown Community Hospital in Elizabethtown, N.Y., joined the group, creating a four-hospital system caring for patients in both Vermont and the adjacent region to the west in northern New York state.

What’s more, the Fletcher Allen organization in January launched an accountable care organization (ACO) under the Medicare Shared Savings Program for ACOs; and Fletcher Allen is moving full-steam ahead with its participation in two different health information exchanges (HIEs), the Vermont statewide organization known as VITL (Vermont Information Technology Leaders), and the northern New York organization known as HIXNY (Healthcare Information Xchange New York).

Needless to say, Chuck Podesta has been busy. But he took time out of his packed schedule recently to speak with HCI Editor-in-Chief Mark Hagland, to fill him in on all the latest developments in his world. Below are excerpts from that interview.

You’ve had a tremendous amount going on lately! Please share with us some of what you and your colleagues have been up to in Vermont and northern New York.

Two years ago, we were a single academic medical center. Now, we’re a four-hospital system, within two years. And my guess is, we’ll probably add a couple more within the next few years. Two are in Vermont, and two are in northern New York, across the lake. We’re now called Fletcher Allen Partners.

So I’m at the system level now, so now I’m CIO for Fletcher Allen partners; and the IS leaders in the other organizations have a dotted line to me. Altogether, we’re up to about 225 people in IT. The interesting thing now is that it’s not just Fletcher Allen Healthcare that I’m responsible for, but also for the strategy for Fletcher Allen Partners. We had an IT governing council that we’ve kept, to help manage the governance of all the activity. And 99 percent of the agenda is system-wide work, as opposed to Fletcher Allen Healthcare-specific.

For people who have never worked in systems before, it definitely requires a different mindset, because sometimes, you have to give up what works locally for what works for the whole system.

Chuck Podesta

You were already live on Epic for your EHR [electronic health record] at Fletcher Allen Healthcare; are you live on Epic everywhere now?

No; Central Vermont has Meditech on the hospital side and eClinicalWorks on the practice side. CVPS has Siemens on the hospital side and GE Centricity on the practice side; and then Elizabethtown has CPSI. So we really have to work things out. My sense is that we’ll move to implement Epic across the ambulatory space first, and eventually across the inpatient hospitals. And it needs to follow the strategy of clinical integration and alignment as well. You don’t want to do it either too son or too late.

How does fulfilling the requirements of meaningful use affect of all that?

It does from a timing perspective, and so does ICD-10. So you have to line that up as well. The good thing is that all the organizations—hospitals and practices—have already attested to Stage 1.

Does that mean you’ll wait until after Stage 3 to switch?

Possibly yes. My one concern is whether all the vendors can support the hospitals after Stage 3; Central Vermont is on the old Meditech Magic system. And those systems are tanks. Meditech Magic is the one system I’m worried about. I am a bit concerned that GE Centricity might sunset their product.

Is interoperability the interim solution for you?

Yes, absolutely. We have a group called VITL, and it’s a public/private partnership, and it’s the HIE for the state of Vermont. So all the Vermont hospitals have pretty much connected to VITL, as have many of the physician practices. VITL is also the state REC [regional extension center]. And we have a very high EHR adoption rate in the practices, as well; it’s something over 80 percent. So that’s moving along well. And then in northern New York, there’s an HIE called HIXNY. And we’re working with both VITL and HIXNY to use the NwHIN [the Nationwide Health Information Network, now called the eHealth Exchange]. Because I don’t want to contract with VITL and HIXNY and have two separate processes, as around consent issues. We’re looking at both policies right now to see how closely aligned they are. That’ll be the sticking point if the policies in New York and Vermont are different—doctors will go crazy. So we just want one consent process. The great thing is that VITAL and HIXNY want to work together.