In its road toward meaningful use, five-hospital Methodist Hospital System based in Houston Texas, launched the Physician Office EMR project earlier this year to encourage their physician groups to use electronic health records (EHR) by offering subsidies for adoption. About four years ago the system—save for one recently purchased hospital in Baytown, San Jacinto Methodist—began transitioning to electronic records. Besides getting their affiliated physicians online, the system is in the process of converting their hospitals to CPOE, with their first hospital, Sugar Land Methodist, going live last month. HCI Associate Editor Jennifer Prestigiacomo spoke with Methodist’s Senior Vice President and CIO Tim Thompson about the Physician Office EMR project.
Healthcare Informatics: Can you give me a little background on the Physician Office EMR project?
Tim Thompson: Over the last 18 to 24 months we looked at figuring out what’s the right program, what’s the right pricing, with the goal to assist the physicians getting to an EMR. Hopefully, we’re going to improve quality and safety by having that information available to everyone and get closer alignment among physicians in the hospital and get away from duplicative tests. And the end result of all that is improved care to the patient. So that is why we went down this road.
HCI: How much is Methodist subsidizing?
Thompson: We looked at what was affordable, what made sense, and what the market looked like, and we came up with a [plan] where we subsidize 50 percent for the solution. We can’t subsidize the hardware, so we only subsidize the EMR software component.
HCI: Can you tell me a little about your physician groups?
Thompson: There are two different groups of physicians. The PO [TMH Physician Organization] has 260 to 280 physicians. Those are physicians that are employed by Methodist. Then there is the medical staff of all of our hospitals, and that is about 2,600 physicians. We offer the subsidy to both groups. So, whether you’re owned by us or part of the community, as long as you’re on our medical staff, we offer the subsidy.
HCI: Why did you decide to go with Dell Perot Systems to host NextGen’s Electronic Practice Management suite? Was it the Texas connection?
Thompson: I’ve done this for a long time. I’ve offered physicians systems at other employers for 20 plus years. When we looked at the market and how aggressive everyone was getting and how do we staff it and how do we find someone large enough to deliver. Maybe it was a Texas connection, I met some people from Perot Systems [based in Dallas, Texas] and we had discussions. Perot was already a leader with hosting physician solutions for a number of leading physician software vendors. We knew they had the hosting capability, the help desk capability, and we knew they were large into services. At the time we got the contract, Dell bought Perot and that helped us put the whole hardware/software solution together, so it just fit together really nicely. We were really looking for someone large enough to have this experience and that’s where we landed with Dell-Perot. Perot is selling, implementing, managing, hosting, and supporting all those physicians.
HCI: Of the 2,600 affiliated physicians how many have come online?
Thompson: We just brought our first practice live at the end of June. We are currently implementing 46 physicians that are on the affiliated side, and we just began the implementation of those 280 owned physicians. It’s moving well.
HCI: What percentage of your physician network do you think will come online? What’s your goal?
Thompson: I don’t really have a goal. I wouldn’t be surprised if we have 600 or 800 physicians in the first couple years. We want as many as possible because we do think it will help. We do want to be methodical about it and provide the right level of service for all those we bring on.
HCI: What challenges did you face with implementing this program?
Thompson: I don’t think we’ve had any big challenges. Where we spent our time was in making sure we had consensus among the physician—and again, I don’t necessarily look at this as a challenge, just a reality. You have a lot of physicians that practice in a lot of specialties and finding a solution that reaches across the breadth of those specialties was probably the thing we had to focus on the most. We spent a long time, 18 months, getting comfortable with the solution, so we have the right solution for the physicians. And then we landed on NexGen [NexGen’s Electronic Practice Management (EPM)] with Dell Perot as the host. It was really finding the right partnership that we spent a lot of time on.
HCI: How did you solicit feedback from physicians during this process?
Thompson: We had a physician-led steering committee. One of our physicians here led that committee and brought in physicians from multiple specialties and from multiple facilities and did a thorough evaluation of many products and service offerings. That’s where we got the input of the physicians. If they’re not bought in at the end of the day, you’re not going to be successful.
HCI: What is the strategic plan over the next few years with the subsidy program and on your road to meeting meaningful use?
Thompson: Over the next two years it’s really getting the implementations in and making sure they’re solid and functioning and we’re providing the right level of support. We have an HIE product from Medicity that were using to connect physicians to physicians, even if they don’t have our EMR. The next big step in this is to enable the physicians to share information between themselves and the hospitals and we intend to roll that out early next year. There’s two phases of it. Today we’re pushing data to the doctors from the hospital—that’s phase one of Medicity. Phase two is enabling the physicians to share between themselves and between the hospital and push the data two ways. We’re implementing medical reconciliation in Sugar Land. We’re working on a patient portal to give patients electronic access to their medical records. I think those are the big things on our list that we really have to complete.