While the vast majority of educational session titles at the MGMA Annual Conference, being held this week at the Henry B. Gonzalez Convention Center in downtown San Antonio, Tex., did not explicitly mention healthcare information technology, the comments made by presenters at the conference, sponsored by the Englewood, Colo.-based Medical Group Management Association, made it clear over and over just how important the thoughtful leveraging of healthcare IT will be to success in myriad strategic and operational areas for physician groups going forward.
One speaker who did explicitly reference the importance of IT in her session’s title was Tamarah Duperval-Brownlee, M.D., M.P.H., chief medical officer at the Georgetown, Tex.-based Lone Star Circle of Care (LSCC). Dr. Duperval-Brownlee’s organization began as a single clinic caring for the uninsured and impoverished in Georgetown, Tex., back in 2002, and has since expanded to become a 26-clinic, 130-provider non-profit, federally qualified health center network serving three counties in central Texas (Georgetown is located about 30 miles north of the state’s capital, Austin). And Duperval-Brownlee titled her presentation, “The Role of Health Information Technology in Quality Improvement.”
Indeed, as Duperval-Brownlee noted, “Early investments in technology and quality initiatives [have positioned] LSCC to pilot and measure results of new care delivery models and adjust the models as needed to demonstrate improved outcomes and lower costs.” One reason her organization has been so proactive, she told her audience, is that “Our CEO, being a former investment and banking guy, saw the need for investments in IT infrastructure. We should know who each patient is,” she noted, “and shouldn’t have to ask them demographic information.” In fact, Duperval-Brownlee told her audience, the intelligent leveraging of IT is particularly critical to organizations like hers whose leaders want to provide care to the largest number of patients in their community, on extremely narrow operating margins.
Of ACOs and RECs
Other presenters acknowledged the critical role of IT as well, in different ways. For example, Robert James Cimasi, president of the St. Louis-based Health Capital Consultants, speaking in the session “Accountable Care Organizations: Value Metrics and Capital Planning,” noted the considerable costs involved in creating absolutely essential clinical information systems and analytics programs to support accountable care organizations (ACOs). In a chart titled “Cost/Benefit Analysis,” Cimasi noted that a 200-bed, one-hospital health system with 80 primary care physicians and 150 specialists should expect to spend $2 million to implement an electronic health record (EHR), and $1.2 million to maintain it, while additional costs—creating intra-system EHR interoperability, linking to a health information exchange, and developing a strong data analytics program, should cost $200,000, $150,000, and $285,000 to initiate and $200,000, $100,000, and $285,000 to maintain, respectively. Meanwhile, those costs, Cimasi noted in that slide, rise considerably for a 1,200-bed, five-hospital system with 250 primary care physicians and 500 specialists. The cost of creating data analytics alone for that larger organization should rise to $550,000 to establish and another $550,000 to maintain, for example.
Meanwhile, Jeff Loughlin, project director at the Waltham, Mass.-based Massachusetts eHealth Collaborative, and executive director of the Regional Extension Center of New Hampshire (Concord, N.H.), presented a session titled “Making Meaningful Use Meaningful and Sustainable,” focusing on bringing forward lessons being learned among regional extension center (REC) organizations as they work to help physician groups implement EHRs and connect with health information exchanges (HIEs).
In an exclusive interview with Healthcare Informatics following that presentation, Loughlin said that, in his view, “A lot of providers think that meaningful use is about checking off items on a list. But what I care about is a successful implementation and successful adoption by providers; when those are successful, meaningful use really just happens.”
Still, Loughlin readily acknowledged, there are two truly fundamental barriers right now for medical group leaders working to implement and leverage the use of EHRs and clinical information systems. First, he said, “Obviously, there are financial barriers,” and in many cases, those are significant enough that small physician practices are turning to acquisitions by hospitals—not solely because of the costs of clinical IT, of course, but that element is certainly one factor involved. “The second issue,” he said, “is the professional staffing resources behind you.” Importantly, he said, “In terms of meaningful use and all the healthcare IT issues, 90 percent of what is involved is simply change management.”