Inova Health System is a not-for-profit healthcare system based in Northern Virginia that consists of hospitals, emergency and urgent care centers, home care, nursing homes, mental health and blood donor services, and wellness classes. With such a plethora of offerings, it’s no wonder Senior VP and CIO Geoff Brown wanted to tie some of the pieces together. In fact, Brown recently contracted with GE to offer the vendor’s ambulatory EMR to local physician practices. Brown, who says Inova will take advantage of Stark relaxations to underwrite the costs, recently talked with HCI Editor-in-Chief Anthony Guerra about his plans for the future.
Inova Health System Key Stats:
Licensed hospital beds 1,725
Licensed nursing home beds 377
Hospital admissions 100,946
Total surgeries 79,886
Emergency room visits (includes Inova HealthPlex and emergency care facilities) 391,611
Home health care visits 103,417
Physicians practicing at Inova facilities 2,991
— Source: Inova Health System Web Site (www.inova.org)
AG: Let’s start with the GE deal. At the end of February, I saw it announced that you were going to offer the Centricity Ambulatory EMR from GE to the practices in your area that refer patients to the hospital?
GB: That’s correct.
AG: Let’s start at the beginning with that whole process. Were you waiting for the regulations to play out and the IRS to clarify things?
GB: Our journey really started probably a year or so before that. Our percentages pretty much tracked the national trend just over double digits and we were just starting to invest in EMRs. So we actually formed a partnership with a third-party organization that allowed us to interface those practices that had EMRs, which exchanged electronic information that was previously faxed or reports that were sent out either electronically, mailed, or patients carried them around, for example: radiology reports, laboratory results, and information.
Also we went around with imaging; we’ve got a PACS solution we implemented during that time and also medications. And so, as a result, our original plan was based around, if physician practices invested in EMRs, we wanted to exchange information with those practices. That was a small group of folks that was starting to become mature in it. Some of them were just starting up, others had been online with the middle size and larger practices, and some smaller practices had been online a couple of years. We’re experienced working with that solution set; and now this was a level of efficiency that we could add to their day; particularly those that did a fair amount of business with Inova. That was the original vision goal, coming up with a strategy on the ambulatory-care side of the world, and the outpatient side of the world and to link those practices into our system.
AG: When was that, approximately?
GB: That was in 2006. We went online with that, and we used a relationship with a firm called Novo that helped make that happen, and that has gone on well. We have several practices that we exchange data with electronically. Then the relaxation of the Stark guidelines began, that was actually in late ’06, early ’07, if I’m not mistaken. So that conversation went on, but it was for the first time that there had been an opportunity for healthcare systems to, in any way, underwrite, subsidize, or participate actively in connecting the community.
Again, one of the talks I did with our governor’s group was about the mandate from President Bush at the time, that all the facilities, all the physician practices, and all the clinics will be moving in that direction. We were all focusing on this whole thing called CCHIT certification, with educational sessions that both use internal physician committees and external community committees and educate them about what was happening at the national level, and talking about some of the local work that was being done. In fact, some of those sessions were for qualified medical education credits. So when they attended these things, they were able to get educated about EMRs. ‘What is it, and how do I prepare, what do you have to do to be ready, who were the primary vendors in that market,’ all those kinds of things.
We actually surveyed our physician community and shared with them the results of those surveys, for instance, the top five vendors to have made traction here in northern Virginia around EMR solutions. What timelines people were expected to come online, what were some of the factors that were driving it from their perspective, challenges, etc. It was a very good exercise and that all played out through late ’06, early ’07. When I say late, I mean to say second half of ’06 and early ’07.