Ram Raju, M.D., president and chief executive officer of New York City Health and Hospitals Corporation (HHC), laid out a bold vision of what he referred to as “healthcare nirvana” and outlined how a fully integrated IT system will play a critical role in achieving that vision during a keynote speech at iHT2 (a sister organization to Healthcare Informatics) New York Health IT Summit on Sept. 29.
“Healthcare nirvana is my shorthand version of The Triple Aim: better health, better care, lower costs. But to that I would add three other elements--not only better care, but also better care coordination, absence of fragmentation and disappearance of health disparities,” Dr. Raju said.
HHC is the largest public health system in the country with 11 acute hospitals and serving 1.5 million New Yorkers and almost half a million uninsured New Yorkers.
Raju said a fully integrated IT system is necessary to achieve “meaningful progress in healthcare delivery.”
“Without such integration, we will never master the transition to preventive care and wellness that will improve outcomes for our patients,” he said, versus a healthcare system that is “sick care,” and “We will never achieve a healthcare system that incentivizes health rather than the treatment of disease.”
Raju outlined an ongoing effort at HHC, what he referred to as the Future State, in which the health system’s “technological innovation and integration of health data will be fully aligned with reform efforts to create a more open, collaborative and connected healthcdare delivery system.”
“The reformed delivery system is one that emphasizes prevention, prioritizes the reduction of hospital readmissions and potentially lowers mortality rates,” he said.
Central to HHC’s Future Stage is an $800 million effort to overall and replace multiple legacy electronic medical record (EMR) systems with a single, integrated Epic system.
“When we go live we will have one unified patient record system for all of our facilities,” Raju said.
HHC built its current EHR system over the past 25 years and, according to Raju, the health system “valued innovation over standardization.”
“This resulted in a balkanized combination of eight different databases. This has greatly impeded care coordination, collaboration and the flow of health information across disciplines and providers both within and outside our system,” he said.
The Epic system will be fully installed across HHC by 2018, he said, and with the transition, HHC will be able to retire more than 90 applications that were built for the current system.
The transition also requires the Epic system to integrate with Cerner Labs software to improve the efficiency of lab results.
“They are working together to make this happen,” Raju said.
Raju also addressed eliminating the health disparities that “plague lower income and minority populations in New York City” and noted that “access and connectivity” are critical to this effort.
He outlined a number of HHC’s tech initiatives in this area, such as HHCAdvantage, which is a web-based application designed to link community-based physicians and HHC facilities.
And, Raju also highlighted HHC’s partnerships with affordable housing projects in New York City, such as the Kings County Hospital project in Brooklyn.
“Historically, we provided healthcare in a silo, disconnected from other types of assistance like housing. This is changing,” he said.
Concluding his keynote speech, Raju said a robust technology platform will allow New York’s public hospital system to build a “healthcare nirvana,” in which patients benefit from increased engagement and increased access to quality care while also improving connectivity of data and patient EMR and “eliminating health disparities, resulting in better health outcomes and less time in the hospital.”
And, Raju encouraged other healthcare leaders to think beyond healthcare.
“Don’t be territorial, we are all here to make the patients better,” he said.