With T&E trimmed, just as it is in all organizations, HCI editors rarely get a chance to interview sources in person. But when our source turns out to be a fellow New Yorker, it’s time to take a cab across town for some real one-on-one time. I was lucky enough to do this recently, and have one of my best interviews of the year as a result, when I linked up with NYU Medical Center CIO Paul Conocenti. The result? An engaging look at a major medical center overhauling its IT environment to completely integrate the continuum of care.
— Anthony Guerra
AG: From what I understand, you have the medical center, which is this building here, and the medical school, which are two separate entities. How many beds do we have here, approximately?
PC: Combined it’s about 1,000 beds across the three major hospital functional centers. There’s Tisch Hospital, there’s Rusk Rehabilitation Hospital, and then there’s The Hospital For Joint Disease. Those are the three basic entities that compose the hospital stay. There are hospital clinics associated with each of the three that comprise the ambulatory component of the hospital. Then — because NYU Langone Medical Center is an integrated academic medical center governed by one CEO and Dean that oversees the three missions of clinical care, research and education — the faculty group practices, which is part of the school of medicine, is also part of the clinical care mission. And the voluntary physicians, who have faculty appointments as part of the way we operate, and admitting privileges into the hospital, are being helped with their EMR adoption through the Stark provisions. We are helping them with the EMR clinical meaningful use requirements and issues, as part of our clinical mission.
Then we have the research mission, which is governed by a chief scientific officer, who reports into the Dean; and we have a whole host of research around here, a number of centers of excellence and research. I’m overseeing both the clinical as well as the research side because there certainly are integration points around research and clinical care, especially in the areas of clinical trials and personalized medicine, and these sorts of things.
AG: We did a story on that recently, a year ago, and the predominant vendor that came up there was called Velos.
PC: And we’re employing Velos right now, we also had InfoEd and we’ve got some tissue banking software called FreezerWorks, and we’re implementing a genomic lab processing system; so all of that is going on.
On the education side, we support all the education for the school of medicine and that’s a very important part of the mission. We are developing a world-class simulation center, we’ve used some OpenSource components – I think called Sakai, advanced learning exchange, and we’ve integrated iTunes into it and are doing all sorts of innovative things around research, because all three of these things integrate with each other. And so we really are one of the few organizations in the country, really, that actually have one leadership umbrella overseeing the integration of these three missions, and so that’s one of the drivers of our integration and our mission.
AG: What’s your main inpatient system?
PC: Our main inpatient system right now is Eclipsys Sunrise Clinical Manager, and we went live with that in March of ’07. We’ve been doing CPOE for 32 years; we were amongst the first three in the country to do CPOE. And so that’s in our DNA. We just, in March of ’07, upgraded to the more advanced summarized clinical manager platform of Eclipsys, which also has an integrated ED and pharmacy system into it.
AG: So doctors come here and they’re going to do CPOE, it’s not a choice. You don’t have to fight the fight, the fight’s already been fought. What about physician documentation?
PC: We are doing all electronic physician documentation. We just went live this past week, actually, where all of our medical records are totally paperless. We’re a fully paperless organization on the floors during care, we’re doing electronic notes; that’s in the rollout phase, probably 50-60 percent there. That’s the objective for by the end of year, that we’ll be paperless even during the stay.
So we’re paperless in our medical record department. It’s totally converted, digitized, so there’s no more paper records from a medical record point of view. What’s left of paper is scanned in to a new electronic medical record system which is integrated into our clinical system, so all of the signatures and documentation gets tracked.
AG: There is still a huge leap to be made for everybody between scanned in PDF-type stuff and discrete data …
PC: Without a doubt. We are now 70 or 80 percent fully codified and only about 30 percent of that is actually paper which comes in from other sources. During their stay everything is electronic, with the exception of a few physicians who are still doing progress notes on paper.
AG: The other ones are actually typing in their notes?
PC: Yes, absolutely.
AG: Do you think that is the result of the natural societal move towards the Internet; that they’re used to typing now? It’s hard to live your life without typing anymore; it used to be very easy.