Jacksonville, Fla.-based Baptist Health is one of the leading providers of healthcare in Northeast Florida and Southeast Georgia. The organization provides its acute services through a network that includes four medical centers (Downtown, Beaches, Nassau and South), the area’s only children’s hospital (Wolfson Children’s) and a number of outpatient diagnostic and therapeutic services. Heading up the IT for sizable enterprise is CIO Roland Garcia. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to talk with Garcia about all the projects in his pipeline.
GUERRA: So you’re working on getting integration with all of the AllScripts flavors that are relevant in your universe?
GARCIA: Beyond just AllScripts, to all of the EMRs that are relevant to us in the marketplace.
GUERRA: You have three “digital” hospitals, what are your plans to get the other two up to the same level?
GARCIA: We’re actually deploying a project in that area right now. The two remaining hospitals are Wolfson Children’s Hospital and our larger adult facility. So, that project is on the way.
GUERRA: So you’ve got about 25 more practices to get up on an EMR. You’re going to roll out AllScripts to those as well?
GARCIA: Correct. That’s in primary care. In addition to that, we have specialist’s practices that we anticipate rolling out EMRs to. We plan on growing in that area, so today there might be 40 practices in Baptist Primary Care. Two years from now, there might be 55 or 60.
GUERRA: What is your strategy for integrating the independents?
GARCIA: Well, we have a tool, as I mentioned, that allows us to communicate with all of these different EMR physician practice vendors’ products, or the majority of them, the more predominate ones in the market. What we’ve done is made a commitment that we will assist them in the cost of the development of the interface up to 85 percent, or a particular dollar figure that would serve as a cap.
GUERRA: And that’s the interface, not the product?
GUERRA: When you mentioned the tool, you’re talking about the Novell MediCity tool?
GUERRA: Have you had anyone knocking on your door for that integration?
GARCIA: Those that have an EMR, they want to have that interface. Especially nowadays, there’s a lot more interest than, say, a year ago. The misconception is around what information you actually exchange. If I’m a physician, I may not necessarily need to get into my practice’s EMR all of the data that is collected during an inpatient stay. So you’re going to have thousands of records potentially, all the lab work, all the dietary, all the pharmaceutical; let’s say you have a surgical patient and you have a number of different elements that make up that record.
Well, that may not be something I really want to have in my ambulatory EMR. So, there’s a relevant smaller subset of information that is of value for continuity of care. That information should be exchanged, but it’s not the moving of the whole chart from one place to the other.
Let’s say I show up in the ED and I’m a patient of Dr. Rosemont. There’s a lot of lab work and a whole bunch of stuff that’s done to me, and then I get to go home. Well, a notification is sent to my physician. And so, Dr. Rosemont can then choose to go into the Baptist physician portal and access the EMR, and through the EMR, access my record. He can always opt to look at the EMR and see the whole record of my visit to the ED or my visit to the hospital, but he doesn’t have to carry it within his architecture or his system.
GUERRA: Are any practices saying they want an EMR, but they want you to host it?
GARCIA: There are some that have said that. What we’ve done as a health system is we said, “These three vendors offer pretty good products with different variations, whether you host them in-house or you ASP it with them.” We’ve done the due diligence with the vendors. The practices are welcome to look at the work that we’ve done in evaluating the technologies. At the end of the day, however, we don’t want to be in the ASP business.
GUERRA: Which vendors did you look at?
GARCIA: Well, one was AllScripts TouchWorks, the other one was the A4 product from AllScripts, and then the third one was eClinicalWorks.
GUERRA: And you’ve decided ASP is not for you?
GARCIA: We don’t want to be in the business of being an ASP to physician practices, providing them with hosting and application solutions for their practice management or EMR.
GUERRA: Has HITECH elevated the CIO position to a new level?
GARCIA: Well, I’ve been with Baptist Health for eight and a half years. Since I came in here, I’ve reported to the president and CEO. There are a handful of executives that are part of the cabinet, if you will, and we meet every week for a couple of hours to discuss strategies and issues, et cetera. So, I’ve been part of that from day one. I’m there at the table.
I imagine that in other organizations, where the role hasn’t been at that level of visibility, there may be some change. EMRs and clinical systems do not constitute strategy nowadays. We made that commitment back at the tail end of 2003 when we decided we were going to deploy EMRs from our facilities. And so today, I don’t view that as a strategic component of what we do. Strategy lives in the areas of applying technology to our business needs.
GUERRA: What is the most challenging aspect of being a CIO?
GARCIA: I think the biggest challenge for me is managing the appetite of the organization for more and more technology. We have 8,500 employees and we’re growing, so there are a lot of competing interests, if you will.
Part of our success in IT can also be working against us because we execute. We not only tell people what we are going to do, how we’re going to do it, when we’re going to do it, but the difference is that we actually deliver. That certainly has given the organization confidence in our abilities, so the trust is there.
It’s a combination of more technology being available, the confidence that the organization can deliver, and managing the multitude of needs, that’s probably the biggest challenge that I have in my organization. So I don’t necessarily have to deal with issues related to confrontations about clinicians preferring product A versus product B. What I do have to deal with is everybody wants it, and everybody wants it now.
GUERRA: So it’s people coming in and saying, “Hey, Roland, when are you going to get to my request?”