Earlier this year at the Dallas-based Methodist Health System, Pamela McNutt, senior vice president and CIO, and her team, completed a systemwide launch of its new Epic electronic health record (EHR). The go-live ran simultaneously at all of the patient care organization’s 46 facilities, with the goal to create an “integrated patient record,” McNutt says. In a recent interview with Healthcare Informatics, McNutt, a veteran CIO with 30 years of experience in health IT, discusses the motivation behind that go-live, how CIOs can help reduce physician burnout, and what innovation she’s seeing these days in the Dallas region. Below are excerpts of that discussion.
(Editor’s Note: Looking for more? You can collaborate and share best practices at the Dallas Health IT Summit in December).
What core health IT initiatives are you working on these days?
We just completed a big-bang implementation of Epic across our hospitals, teaching clinics, specialty clinics, and community and family practice clinics. We went live for all modules on April 1. The biggest reason for [moving to Epic] was that for our own health system and where we were growing, we really felt like we needed an integrated record. That was number one. Also, so many other people in the Dallas-Fort Worth region had Epic already, so physicians had experience using it.
When one EHR vendor dominates a market, is that a good thing for the healthcare landscape?
I do see it as a benefit when everyone is on the same system. While the idea is for our providers to be on an integrated record, it’s actually most important for our patients to be on one patient portal as well. Across the region, to be on one platform means that your patients and physicians are both familiar with the portal and the system. Patients in this region go from one health system to another, so it makes it easier for providers in that sense, too.
What is the state of evolution of health information exchange (HIE) in the Dallas-Fort Worth region?
Well, [most people] probably know that the HIE in this region “stood up” back when there were incentives, as it was not sustainable. So we are not connected right now to any of the Texas HIEs. We were an early connector in the one that started in the Dallas-Fort Worth region, but just two organizations actually ever joined it before it became unviable. The whole [process] is very expensive. However, in this market, because almost all of us are on Epic, and also because of direct messaging, and now EpicCare Link (Epic’s web-based service that provides access to patient EHR data), we are exchanging thousands of records every day. This exchange is happening with non-Epic providers, too.
Physician burnout has been a hot topic of late. As a CIO, how can you help reduce the stress that IT can put on doctors?
Well, back to the reason we went to Epic, we went with its foundation system, which is said to be a compilation of what the best practices are across the country. So we thought by doing that we would be giving our physicians the best experience we can give them. As far as general burden and burnout with physicians, I don’t care which EHR it is, I think physicians are frustrated by the amount of documentation they have to do. And this more to do with the government and government programs that are requiring documentation; it’s not [as much] a vendor issue. So these requirements are burdensome on providers, and we do whatever we can to ease that burden, whether it’s a tap-and-go-single sign-on with a badge, or using best practices templates.
Also, MACRA (the Medicare Access and CHIP Reauthorization Act), and the Inpatient Prospective Payment Systems (IPPS) program do directly relate to your EHRs, and frankly those are some of the sources of the documentation burdens that are currently going on. To keep up with those various reporting mechanisms, you do need your IT systems upgraded to certain levels and to keep them up to speed to be able to support those endeavors.
As a CIO, how closely do you work with your CISO on ways to continuously improve your cybersecurity strategies? Has this become more of a priority of late?
We have always had a high posture on data security, and we constantly keep in communication with our peers. Our CISO specifically keeps in communication with them, and they discuss best practices, give each other heads ups and warnings on things, and that’s when you might discover that maybe there’s a tool set that might help with particular things. I think we have become more engaged, and we are testing more with each other. So you can ask yourself, are we really as best practice as we think we are? Are you doing all you can do about intrusion protection or patching? And you can then test the waters on that. I think there has been much more dialogue around security. That doesn’t necessarily mean that we’re buying a ton of products for it, however.
What are some of the most innovative health IT endeavors that you’re seeing take place in this region?
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