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Building Bridges

September 29, 2010
by Mark Hagland
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Helping MDs Cross the Inpatient/Outpatient Divide

EXECUTIVE SUMMARY

Healthcare CIOs and CMIOs have been working diligently to optimize clinical IT access and navigability across the inpatient-outpatient divide for their physicians. Given a broad spectrum of computing environments, and a shifting clinical IT landscape, every organization is ending up charting its own path in this complex area.

With 12 wholly owned hospital facilities, more than 3,300 licensed beds, and more than 3,600 physicians with staff privileges, the leaders at the Arlington, Texas-based Texas Health Resources (THR) had better have some kind of strategy to help doctors navigate their clinical information systems. Fortunately, they do. “We have a connectivity strategy we've been pursuing for several years, and we continue to leverage that strategy,” reports Ed Marx, CIO of the vast system.

There are several layers to the Texas Health Resources strategy, he notes. At its core, the system runs the EMR solution from the Verona, Wis.-based Epic Health Systems; THR offers the Epic outpatient EMR to its salaried physician groups (along with the EMRs from the Horsham, Pa.-based NextGen Healthcare Information Systems and the Westborough, Mass.-based eClinicalWorks, as additional options); and it wraps its physician portal, called CareGate, which has been in place for more than a decade, around those inpatient and outpatient systems. CareGate is also the chief point of access to the health system's picture archiving and communications system (PACS), Fuji's Synapse, and its document management system from the Cincinnati-based Streamline Health.

In addition, CareGate provides for robust, secure online communications between THR and its physicians. And beyond all that, in the past year, Marx and his colleagues have developed something called CareGateLink, which provides access to physicians not formally affiliated with the health system, but who need to interact with its hospitals or physicians in some capacity. That program has already attracted 375 physicians, and is expected to grow considerably, as is the health system's fledgling health information exchange (HIE).

Ferdinand Velasco
Ferdinand Velasco

The point to all this, Marx says, is that “You have to have a multi-pronged approach, strategically and tactically. We didn't just do a portal, but also created an HIE; and we then created CareGateLink to go beyond even our affiliated physicians. And we're implementing solutions that make things easier for physicians; it's all about improving quality of care, and making providing quality of care easier, through easier computing for physicians and improved access to data.” Adds Ferdinand Velasco, M.D., THR's CMIO, “It is important to note the [spirit of] collaboration with our physicians. We didn't just ‘do’ the portal ‘to’ them; we did it with them. And we're continually looking to refine and enhance our tools, which are their tools,” Velasco says. Next steps include adding social media tools to CareGate next year.

IT IS IMPORTANT TO NOTE THE [SPIRIT OF] COLLABORATION WITH OUR PHYSICIANS. WE DIDN'T JUST ‘DO’ THE PORTAL ‘TO’ THEM; WE DID IT WITH THEM. AND WE'RE CONTINUALLY LOOKING TO REFINE AND ENHANCE OUR TOOLS, WHICH ARE THEIR TOOLS.-FERDINAND VELASCO

DIVERSE APPROACHES

Ed Marx
Ed Marx

Very few hospital-based organizations have reached the level of complexity and sophistication of Texas Health Resources in their creation of inpatient-outpatient navigation solutions for their end-user physicians; but most hospital organizations of any size have at least begun to address the issue, as the adoption of core clinical information systems advances nationwide.

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