The CIOs and CMIOs from Trinity Health System, Beth Israel Deaconess, Summa Health System, and Children's Hospital of Pittsburgh share their experiences toward meaningful use and offer tips for navigating the long road ahead.
Meaningful use comes in all shapes and sizes; the healthcare leaders at Trinity Health System, Beth Israel Deaconess, Summa Health System, and Children's Hospital of Pittsburgh can attest to that. An underlying theme rippling through the campuses of these meaningful use front-runners is the fact that healthcare IT innovation is deeply embedded in the culture of the organization. For starters, these healthcare organizations implemented many of their clinical information systems years ago to improve patient care, long before the July 13 announcement of the meaningful use final rule. Another key factor of their success is the strong collaboration between the IT staff and clinicians to create effective, and in some cases transformative, information systems.
BEGIN AT THE BEGINNING
Trinity Health System's meaningful use story began literally 10 years ago with the launch of its $300 million IT overhaul, dubbed the “Genesis” project. Prior to that, the Novi, Mich.-based health system looked like a “nursery school rag carpet,” with its lack of common clinical information systems, according to J. Michael Kramer, M.D., Trinity Health's vice president and chief medical information officer (CMIO).
“When we learned that something worked really well clinically in one part of Trinity, we wanted to have the ability to have all of our hospitals have access to that best practice.” That led to a technology strategy in which all of the hospitals implement the same system in the same way, rather than each hospital implementing its own system, explains Paul Browne, senior vice president and CIO at Trinity Health.
Currently, 27 of Trinity's 47 facilities, or 63 percent of the system's staffed beds, have been woven into this less-crazy patchwork quilt. Browne makes sure that features and functions that worked well in the facility's old clinical systems are implemented in their new information system. (The Kansas City-based Cerner Corp. is the health system's core clinical IT vendor.) “We're not always successful with that, but a lot of times we are. So that has really helped push ourselves and Cerner to make the product better,” says Browne.
The Genesis project was rolled out in two phases. The first phase, from 2001 to 2004, implemented a system-wide adverse drug event alert system that uses an algorithm based on select criteria when a drug is ordered, to make sure that the medication is appropriate for the patient. Since 2001 about 90,000 alerts have been sent that have led to changes in medication. “We don't know how many times of that 90,000 someone would have been actually harmed, but what we do know is that the physician felt that what the computer had to offer was compelling enough that they should change the medication order,” says Browne.
The second phase of Genesis implemented computerized physician order entry (CPOE) and brought 20 modules, including emergency department, pharmacy, and radiology systems, online. The first hospital to go live with this new strategy was the relatively small 119-bed St. Joseph Mercy Port Huron in Michigan, in May 2003.
Trinity's leaders plan to complete their system-wide technology roll-out in September 2012-an ambitious goal for a health system of any size. Trinity's strategy leverages many factors like the complexity, size, and a hospital's readiness for change. The Mount Carmel Health System, which is comprised of four facilities in Columbus, Westerville, and New Albany, Ohio, will be the last group to be brought into the fold; its clinical systems were already quite advanced, which made integration into the Trinity system more complex.
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