Composed of NewYork-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork Presbyterian Healthcare System is one of more renowned organizations in the country. The system is also affiliated with two Ivy League medical institutions, Columbia University College of Physicians & Surgeons and Weill Medical College of Cornell University. Aurelia Boyer — senior vice president and CIO, NewYork-Presbyterian Hospital & NewYork-Presbyterian Healthcare System — is in charge of making sure the massive amounts of data collected and produced by the organization can be put to good use by patients, physicians and researchers. Anthony Guerra, HCI editor-in-chief, recently had a chance to talk with Boyer about her work at NYP.
AG: Portals are turning into much more than bill-pay screens. Tell me about the evolution of your portal strategy over at NYP.
AB: That’s interesting you put it that way, because we did first put up the ability to pay online and to get a lot of information, but as we were deciding what to do around patient access to the medical records, we had to consider the larger IT environment we were operating in.
First, a little background so things are more clear. We’re an interesting organization in that the hospital resulted from the merger of The New York Hospital and the Columbia Presbyterian Hospital, and we have two separate medical schools. We do not have any single governance structure across the three organizations. So, where at Hopkins you have a CIO that supports both the school and the hospital, here our governance is separate. So we have a physician organization on the Cornell campus and a different physician organization up on the Columbia campus. As the Cornell practice organization implemented a separate EMR for the physicians, not the same one we were using on the inpatient side…
AG: Can you tell me what vendor they use, the physician group?
AB: The downtown physician group has Epic.
AG: And who did you have on the inpatient side?
AB: Eclipsys. At the time we made that decision, Epic wasn’t doing much on the inpatient side and Eclipsys was having a hard time getting started on the ambulatory side. So if you wanted the best of breed, you really had to split the baby.
AG: And when was this approximately?
AB: I bet it’s at least six years ago. And so with that environment in mind, we had to figure out how we were going to have the hospital inpatient record reflect the ambulatory record. (The practice is) going through Epic’s My Chart at this point in a pilot phase; it’s not fully implemented. So, the notion of the personally controlled health record came into play in that, even within our organization, the notion of sending patients to multiple portals to pull together their information didn’t seem like the best approach for us.
Second of all, we’re looking at how the RHIO is going to unfold, and will that be a success or not, and how long would that take even if it is successful? When we saw the Microsoft approach to HealthVault, I looked at how the industry was evolving. We wanted to act in accordance with our major belief, which is that it’s the patient’s data; we felt that an approach like HealthVault is the right approach. Now, it doesn’t have to HealthVault. It could be Google, it could have been Dossia, but it’s that approach which was going to make things easier for the patients, and the patients really were the ones who own their data, not us.
AG: Tell me when you started using Amalga and why you started using that, and how Amalga and HealthVault work together.
AB: I think after we started talking to Microsoft about the HealthVault opportunity, they brought Amalga to the table. It was interesting. When we started, Microsoft saw them as separate products, and I said, “No guys. If I put the data in Amalga, why don’t you connect Amalga to HealthVault?” We did initially start with Amalga for its analytic potential, not for HealthVault, but we moved to that approach very quickly after beginning to work on both projects.
AG: Tell me a little bit more about the different vendor applications and databases you have in your environment. You mentioned one physician group has Epic while the hospital uses Eclipsys. Are we talking about multiple hospitals?
AB: Yes, for New York Presbyterian, proper, we have five inpatient hospital settings, one of which is psychiatric, and they also use Eclipsys and are fully automated, all their documentation as well as portal entry.
AG: Are all five of those hospitals on Eclipsys?
AB: Yes they are.
AG: Ok, so you’ve got five hospitals on Eclipsys. What about the other physician group?
AB: The Columbia Physician Organization is just in the initial stages of implementing Allscripts for their physician offices, and the hospital does use Eclipsys in ambulatory-based clinics that are not private physicians.
AG: It sounds like one physician group implemented Epic, and recently the second group went with Allscripts.
AG: Did you attempt to talk them into either Eclipsys or Epic to simplify things?
AB: We did not attempt to talk them into Epic. They did look at Eclipsys and consider Eclipsys as an option, but felt that Allscripts did the physician practice better.
AG: So, does Amalga help you move data between Epic, Eclipsys and Allscripts?