Not to be outdone by his neighbors at Partners HealthCare, John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, is hard at work integrating his acute facility with associated physician practices. The undertaking is a massive one requiring the build out of infrastructure and plans for ongoing support. Recently, Halamka chatted with HCI Editor-in-Chief Anthony Guerra about his plans to electronically ink the acute and ambulatory worlds.
AG: Are you running this completely or working with a partner on the IPA side?
JH: No, I’m running the whole thing.
AG: Does the fact that you are well known as a thought leader make it easier to get people to follow you?
JH: I’ve been CIO at Beth Israel for about 10 years, and everyone has their ups and downs (chuckle), but since I’m a physician and I have a decade of helping people, they have given me a lot of latitude in really overseeing the implementation of the project.
AG: It sounds like in Massachusetts you have a lot of support with different organizations. Is that the case? Do you think other states may not have that level of support?
JH: It’s amazing how Massachusetts uses IT not as a strategic differentiator for any one organization, but something that lifts the bar for the whole community. So I have no problem with going to John Glaser (Partners HealthCare CIO) and saying, ‘Hey John. How did you solve this problem?’ Everyone works for everyone else’s benefit, and that’s why we’re at 50 percent penetration of electronic health records in our state, compared to 18 percent across the country. We’re all non-profits, we’re all regionally focused, and we work really well together.
AG: What is the most exciting part of this for you? Is it pulling off the IT part, the project management or the potential for improving care?
JH: If you look at the drivers for all this, as a physician, the first thing I care about is clinical integration that improves the quality of care. Because you’re coordinating here, suddenly it isn’t just, ‘So Mrs. Smith, what meds are you on?’
Second, is the idea that you can actually achieve economies of scale. Instead of $40,000 to $60,000 per doc, which is what you typically see as implementation per EHR in this country, we’re going to get it down to $25,000. So if I can get it down to $25,000, suddenly that’s getting affordable, an alignment of incentives is possible, and you can get real adoption. And then of course the thing that is scary is that technology is only a small portion of an EHR rollout, it’s all the practice transformation, all of the organizational dynamics and change management too, and so being able to try and do that and do it with a lot of partners, and do it well, is very exciting.
AG: Who is actually going to help the docs with their workflow?
JH: A combination of internal staff — so I have hired experts who work for me directly — and the Mass E-Health Collaborative, leveraging both of their expertise will provide teams of practice-transformation experts.
AG: So you could see a doc calling a hotline and making an appointment for a transformation expert to come in and help them?