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Common IT Platform Key to Iowa Alliance

September 10, 2012
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Four health systems work together on quality measurement, care coordination

An announcement in late June by four of Iowa’s leading healthcare organizations signals a trend we are likely to see much more of in the near future: competitors cooperating on care coordination and quality measurement platforms, which requires a greater level of collaboration among CIOs.  

Although not a merger, the newly created University of Iowa Health Alliance (UIHA) will be a joint effort of the more than 50 hospitals and 160 clinics of University of Iowa Health Care, Mercy Health Network, Genesis Health System, and Mercy-Cedar Rapids.

The thing that got my attention about the press release announcing the alliance was that so many of the challenges they promise to tackle involve health IT:
• Assisting members in developing performance metrics and comparative reporting to support improvement efforts, i.e. using comparative data to identify and share best practices and reduce the variations in care, which will improve quality and lower costs.
• Developing techniques and systems for improving patients’ engagement in managing their health.
• Sharing the high costs of the information systems and experts needed to analyze clinical data and convert it into information that can be used by physicians and others to improve care and better manage populations of patients with chronic diseases.
• Sharing expertise and operational costs associated with development of “accountable care” initiatives, enabling the members to evaluate and participate in new payment programs offered by governmental and commercial insurance programs.

Last week I spoke with Lee Carmen, associate vice president for information systems and CIO at University of Iowa Hospitals and Clinics, about the alliance. He said the initial focus would be in two areas: the ability to analyze clinical performance measures across a common population and sharing clinical data for referrals. “Two are Epic customers and two are Cerner, so we are looking at third-party analytical tools that can work across both systems on clinical quality metrics,” he said. “We will start using the tools looking just at our own site but will eventually use it to look across all four systems.” (University of Iowa and Mercy also are forming a more formal Medicare ACO.)

The alliance is also likely to take advantage of the statewide health information exchange, which is under development by the Iowa Department of Public Health and expected to start sharing data in January 2013. “Three of the four CIOs of the alliance members sit on the executive committee of the state HIE,” he noted.

Regarding sharing clinical data, the alliance will build a platform to ensure that data is transferred at referrals and information gets back to the referring physician. “Initially we will focus on sending CCDs,” Carmen said, “but we also want to include image transfers, especially for trauma services.”

In its early stages, the alliance will work on IT projects by committee rather than by forming an IT team external to the four existing entities. “So far we are assigning teams to work collaboratively across the systems,” Carmen said, “but it could eventually evolve into something of an independent IT service delivery team.” If so, he added, that team could provide services to a wider group of providers, especially smaller hospitals that are struggling with investment and IT staffing.

Carmen said it would be exciting to work on initiatives that cross organizational boundaries. “Iowa is a collegial healthcare market,” he said, “and it is nice to get together with these other CIOs and their IT staffs to work on how we can improve healthcare without getting too obsessive about market share.”