Atlantic Health is a New Jersey-based care delivery system comprised of Morristown Memorial Hospital, Overlook Hospital, Goryeb Children's Hospital, Gagnon Heart Hospital, Carol G. Simon Cancer Center, and Atlantic Neuroscience Institute. With thousands of beds under her purview, system vice president and CIO Linda Reed has quite a bit on her plate. Recently, she talked with HCI Editor-in-Chief Anthony Guerra about her plans for the health system, and the evolving role of the CIO.
AG: I’ve heard, even within a company like McKesson, even one that’s grown through acquisitions, sometimes you buy two applications from McKesson and they can be merely interfaced instead of integrated. Tell me about that.
LR: That’s absolutely true, because they are on different platforms, different databases. McKesson’s working on that with their 10.1 release, to try and marry things up, to put them on the same platform. But it’s absolutely true, we had an instance where, if you documented allergies in the OR application, or in the nursing application, either/or, they didn’t test through to the other.
The difficult part for our end users, and it’s always the part that you really have to be aware of, is are we causing them more work? We’re putting in these systems that are supposed to make life better for them but, in the end, we’re either creating a handoff or a work around where it didn’t exist before, or we’re creating double documentation. So, sometimes I think what we have to take a look at is, is the manual process or the manual documentation still better than putting in additional work arounds. I think it’s something we struggle with all the time. Do you put in a system with that additional work, or do you just wait?
AG: Do you have a formal mechanism in place for looking at those kinds of questions?
LR: We do, actually, we do have a system review and our end users are very much involved. They’re also very much involved with creating our technology road map. We have sessions with all of our end users — key clinical folks, key financial folks, and we all get together and talk about where the organization is going, what are the needs from a clinical or financial perspective, and then we map out what we think we’re going to be doing over the next three years. It helps us plan for capital requests, and it helps our operational folks really understand what’s coming and when. It helps us understand what to prioritize because one of the things that has been the issue is that IT has always done what IT wants to do, or IT thinks needs to happen, and then you’d always miss the target with what’s going on in the business.
AG: I’ve heard it’s hard to find the right level of user involvement when selecting a system. You don’t want too many voices but you need the right representation so people feel like they have a stake in the system’s success. Is that correct?
LR: I agree, I very much agree. I think you have to have the people who are the influencers. But I think you’re absolutely right and EMR, I have to tell you, I think the whole EMR quagmire is a very complex and ugly topic because, you probably know, there’s probably somewhere around 200+ EMR vendors out there, from very, very large, to very, very small mom and pop in a garage somewhere. The issue is that is if you have 15 physicians, you’ll get 16 different needs, and everybody wants the one that’s either done by this one, or their brother-in-law is selling an EMR. So, I think our issue is that the government said that EMRs are required, it will be good for the continuity of care, and they changed the Stark Law so that people with deep pockets like hospitals can help physicians. The problem is that I’m not always sure that we help them. Originally, I think we were very naïve, especially the CIO market, saying, ‘Okay, the Stark Laws are going to change, we can go out, we can pick an EMR, we’ll host it, we’ll do all the back end, we’ll take care of all this stuff for the physicians, and they will come and they will love it and they will love us.’
In speaking to my physicians over the last three years, that whole conversation has evolved. You start with the fact that physicians have very long memories and their memories start with every little sin or every little thing that they think a hospital provider has done to them over the years, or has not done to them. So you start off with a slightly negative perception of who you are and what hospitals can provide to them. Then you lay, on top of that, the fact that we’re telling them that we’re only going to go with one EMR and they either have to take it or leave it, and if you don’t take it, you don’t get that 85, or whatever, percentage benefit. It just makes for a very ugly situation.
Our physicians have also started to become more in-tuned to what that really means and more physicians have said, ‘Wait a minute, do I really want you housing my data?’ and, ‘Wait a minute, what if your network goes down,’ and, “Wait a minute, will you steal my patients?’ So for us, the thinking of what we’re going to offer as an EMR subsidy has changed significantly over the last three years.