Anyone who would want to make the assumption that the data analytics revolution is only occurring in large integrated health systems in large metropolitan areas in the U.S. needs to rethink, and consider what’s happening in little Hutchinson, Kansas (population: 45,000), in the south-central part of that sprawling state. There, leaders at the Hutchinson Clinic, a multispecialty clinic with 67 physicians in 22 specialties—not only primary care, but also obstetrics/gynecology, orthopedics, dermatology, and otolaryngology—are busy innovating around data analytics in fascinating ways.
What’s more, according to Robert (Bob) Davidson, the organization’s CIO, some aspects of the clinic’s demographics and operations might surprise some people. For one thing, Hutchinson Clinic physicians have 262,000 active patients, and their patients come from 103 of the 105 counties in the state of Kansas. One reason for that, he explains, is that, in addition to the two core clinic sites in the town of Hutchinson itself, as well as three other physical sites, in the nearby towns of Great Bend and Macpherson and including a walk-in care clinic in South Hutchinson, Hutchinson Clinic physicians regularly travel longer distances to spend individual days taking care of patients farther afield.
With regard to information systems, the organization’s core electronic health record (EHR) is Allscripts Touchworks, from the Chicago-based Allscripts; and its PACS (picture archiving and communications system), from Philips, and RIS (radiology information system) from Swearingen, are fully integrated with its Allscripts EHR. The organization also uses the practice management solution from Allscripts.
What’s more, the physicians at Hutchinson Clinic are currently finishing their testing period for Stage 2 attestation in 2014. They attested to Stage 1, and attested to Stage 2 for the full year of 2013. Their current attestation period will end on Dec. 31. That’s a lot going on for an IT staff of just 12, in a total staff of 700.
Davidson spoke earlier this fall with HCI Editor-in-Chief Mark Hagland. Below are excerpts from that interview.
You and your colleagues have been very active on a number of fronts. What would you say your organization’s biggest accomplishments and challenges have been recently?
We are a physician-owned clinic that’s fee-for-service today. Their production is their livelihood, they eat what they kill. And with 250,000 patients, our doctors are very busy. And our family practice doctors will see in excess of 30 patients each a day, and they fully use the functionality of the EHR. Allscripts calls their more advanced notes ‘structured notes,’ and our family practice docs use structured notes in all their encounters, so we’ve been very successful in utilizing discrete data.
Physicians are very analytic people, and it’s amazing how in the paper-chart days, they had to hunt everything down; now they have all the information available to them statistically. The biggest challenge is that, with very, very busy doctors, we’ve been able to incorporate all the technology needed to support discrete data. Some doctors have had a bit more of a problem transitioning to the computer world, but more often, in many cases, the doctors are essentially documenting as they go, and are all done when they’re done seeing patients for the day. And for example, that Dodge City patient might see two different doctors here in one day.
In the old days, in the paper world, the first doctor would keep the paper chart, and the second doctor had to go blind. Now, with the first doctor, the note is signed, the lab results are in the system, the radiology might have been read, and the second doctor has up-to-date information, and it helps that they didn’t have to call doctor number one. It all happens much more easily. And the interoperability between the systems is fantastic. And if there’s a critical radiological finding, it all happens automatically that the referring doctor is contacted.
You’re not yet part of an accountable care organization, correct?
We are not yet. We have filed for level 3 patient-centered medical home status from NCQA [National Committee for Quality Assurance]. And every one of our doctors is NCQA-certified for diabetes care.
What kind of insurance do most patients have?
Per the demographics of Kansas, we’re about 50 percent Medicare, 20 percent Blue Cross, and we probably don’t have as high a Medicaid population as some areas might have—it’s in about the 7-percent range. Everything else is commercial, mostly PPO. Blue Cross is mostly PPO. Blue Cross of Kansas has been very supportive, with incentive programs, that would… we’re participating in several value-based purchasing programs with BCBSKS. That includes patient-centered medical home program. Like our clinical quality program, which is highly coordinated with theirs.
Are you doing any data analytics or population health work?
Tons. The really great thing about the EHR and the way we’ve utilized it—we’ve been collecting discrete data on our patients for years now and that has enabled us to really look at our population. For instance, when we were certified for the diabetes recognition program for NCQA, every one of our primary care doctors qualified for DRP certification on the first run, just because of the data available and the fact that they had been using the data to manage the diabetes population very well. That was all 23 of our primary care doctors. And they were half of the certified docs in the state. That happened in 2012.
And you’re engaged in data analytics around chronic care, correct?
Yes, we use a third-party product that we acquired through Allscripts, called Precision BI.