Healthcare IT leaders are moving forward in a number of directions at UCLA Health, the four-hospital, 2,000-physician integrated health system in Los Angeles. As the organization advances in its work on data-sharing, on the leveraging of data analytics to support accountable care and population health work, and on patient/healthcare consumer engagement, the healthcare IT team at UCLA Health is moving forward under the leadership of Michael Pfeffer, M.D., the organization’s vice chancellor and CIO. Dr. Pfeffer, who has been in his current position—which oversees the IT support both of the patient care organization and of the research organization, in the integrated health system—for three years, continues to practice part-time as a hospitalist.
Dr. Pfeffer recently spoke with Healthcare Informatics Editor-in-Chief Mark Hagland, and shared his perspectives on the various initiatives he’s helping to lead, as well as on his work as a CIO who continues to practice as a physician. Below are excerpts from their interview.
What has been the overall thrust of your work in the past three years?
Most CIOs will say that they’re involved in many, many different projects to support the operation—EHR [electronic health record] infrastructure upgrade, cybersecurity, clinician workflow redesign, and other areas. I’m also responsible for the school of medicine, so I’m looking at areas that support research as well.
Michael Pfeffer, M.D.
What would you say have been the biggest breakthroughs in the last year, in your area?
I’d say we’ve been doing a lot of really good work on the patient-facing side, including the patient portal for our ambulatory and inpatient sides; we’ve done a lot of work with the use of cloud in terms of analytics, to allow our business analysts to create really nice visualizations in terms of data sets, and also around data governance. We’re about to do a major upgrade on our EHR platform. Also, a year now, we redid our entire laboratory system, bringing it over to the Epic Beaker system. And we’re an Epic shop overall.
Looking at the managed care/healthcare market in the L.A. Basin/Southern California, how would you paint a brief portrait of that market?
Well, I think the L.A. market is fairly unique in that there are a lot of players in the market, and a lot of insurers in the market, both, and that’s unusual. So we’re lucky in that there isn’t a single dominant insurer. That makes it exciting and challenging at the same time. In addition to all the changes going on at the policy and payment level in the federal government, that makes it quite a challenge to predict what’s going to happen. But all in all, all of the healthcare providers and insurers in the market are looking to take the best care of our patients no matter where they end up. So making sure we can exchange information among providers in real time, will be extremely important. And there’s anecdotal data showing that when you have records available, you don’t repeat as many tests or order as many procedures, when you have that information. So that’s what it’s all about, really.
That to me sounds like health information exchange or health data exchange, in the broadest sense. And how is that area working out for your organization?
Yes, that’s correct; and there actually have been some very exciting things going on in our market, in that area. Most of our exchanges occur with fellow Epic providers, and we use Care Everywhere [the Care Everywhere Network sponsored by the Verona, Wis.-based Epic Systems Corporation] for that. Epic-to-non-Epic is more of a challenge, but we’re making headway. We’ve signed up for Carequality, and we’re beginning to exchange records seamlessly between our site and other sites that don’t have Epic. And we’re also waiting for the CommonWell platform, which is basically Cerner’s version of CareEverywhere, and that would really connect the people in the L.A. Basin, no matter where they are.
How many sites or organizations are involved in all of those data and information exchanges?
In terms of Epic-to-Epic, we’ve exchanged patient records with organizations in all 50 states. In calendar year 2016, we did about 3.75 million record exchanges, Epic-to-Epic. In terms of Epic-to-non-Epic exchanges through Carequality, we’ve exchanged about 2,500 records with 21 organizations so far. That’s been after about six months so far.
And through CommonWell?
Care Everywhere is part of Carequality, and CommonWell is going to join Carequality—whose membership already includes Epic, eClinicalWorks, NextGen, athenahealth, etc.—CommonWell is going to join that large collaborative And Epic has been a really progressive player in the market. And being part of Carequality is very important, and exciting, and eliminates the need for health information exchanges, which have been struggling.
Are you participating in any accountable care organizations (ACOs) yet?
Yes, we’re in the MSSP [Medicare Shared Savings Program] with CMS [the federal Centers for Medicare and Medicaid Services].
Can you share your thoughts and perspectives on aligning data and leveraging analytics, for your ACO development work?
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