Ten years ago, IT leaders at Milford Regional Hospital in Massachusetts, a 145-bed, acute-care facility serving a region of 20-plus towns, started to realize that it had a clear technology need: being able to integrate different sources of data, especially as its ambulatory practice was going live with its GE Centricity electronic health record (EHR) at the time.
Indeed, sending all laboratory and radiology results, and other transcribed reports to the practice’s EHR was integral, so the IT team started their search for a vendor to not only do that integration but also to look at all of Milford Regional’s other interfaces and consolidate them as well. They ended up choosing an interface engine product from Summit Healthcare, a Braintree, Mass.-based vendor focused on healthcare integration. Soon after the partnership commenced, Milford Regional went live with six interfaces in a six-week timeframe, says Nicole Heim, the hospital’s CIO. “Initially, we didn’t have an in-house interface team so we leaned on Summit to do the outsourcing of the interface development. So it was a super busy six weeks trying to get everything set up, as you can imagine.”
In a recent interview with Healthcare Informatics, Heim discusses that process, how interoperability is progressing at Milford Regional, and what else is top of mind for her as a CIO these days. Below are excerpts of that discussion.
How as the Summit Exchange platform helped your hospital’s interoperability needs?
Well at the time, GE Centricity didn’t have the capability to do all of the customization on their end, so we leveraged [Summit’s] tools to do the customizations that we needed to make the results look the best they could in the GE EHR. Summit’s team helped us make that six-week timeline, and then we went live with it.
From there, we had duplications of admission interfaces and results interfaces between our systems, and mostly at the time it was just between our internal systems, so sending data from one system to another. Then, over the next few years we looked at how we could consolidate those down and reduce maintenance costs, which we were able to realize.
[The platform] operates like a traffic cop, so it could filter out results to go to just this system or this provider, and it can make changes to the way the message is so that it displays better in the resulting system. We had to do that with GE because of the way that system works. We can send one admissions feed, and based on the location of the patient or based on the provider, we can send it to what system it needs to go to internally or what physician’s office it needs to go to on the outside.
Our physician group, the Tri-County Medical Associates, is about 100 physicians now, so we send [transactions] to those offices, and then we have a handful of other facilities that we send information to, like Reliant Medical Group, Partners, who is across the street from us and provides oncology services, and then some other independent physicians. We send a lot more outbound results and to some of those organizations, we send them continuity of care documents (CCDs) too. Inbound, we receive the CCD documents from our physician group when they refer a patient here for services, and from that practice, we receive all lab orders electronically.
That was a good project to highlight this partnership with Summit. We started with this interface engine and I was looking for a new solution to integrate these orders electronically, from the physician’s office; they were complaining that the loop of ordering lab orders and getting results was not closed, that they had to reconcile these orders to results manually, so they wanted a process to automate that.
Are you connected to the Massachusetts statewide HIE (the Mass HIway)?
We are connected and we were the first organization in Massachusetts to send live production messages to the HIway (Massachusetts Health Information Highway). We received a grant a few years back to do some work with two post-acute care facilities—a home care facility and an skilled nursing facility—so we partnered with that grant and sent those facilities continuity of care documents through the highway. So it goes from the Meditech EHR to the HIway, and then over to them. Since then we have expanded that to send the CCD to our physician group, and that goes through the HIway as well.
As a hospital CIO, what else is top of mind for you today? What is most pressing?
Plans are underway for meaningful use Stage 3; we are still in the stage of understanding the objectives, doing a gap analysis, and figuring out if we need to purchase anything to achieve Stage 3. It’s rather frustrating that some of the vendors are not there as far as being able to tell us if they are certifying their existing products for Stage 3—we have found some vendors are not doing that; they’re sunsetting their existing products—and others don’t have a viable solution to show us at this time to meet the measures. Some people think Stage 3 is going away, but we don’t have a lot of time to secure funding, purchase products, and implement it to be ready for January 1 if we don’t move forward with those decisions soon. So our team is spinning their wheels with certain things regarding Stage 3.
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