Saint Clare’s Health System — with four Northwestern New Jersey hospital campuses — is one of the largest employers in the area, with 3,500 total employees, over 700 volunteers and a medical staff of over 700. In April, the system began a major transition, as it was acquired by Denver-based Catholic Health Initiatives (CHI), the nation’s second largest Catholic health system. Recently, HCI Editor-in-Chief Anthony Guerra had a chance to chat with CIO Richard Temple about how the transfer will affect IT.
AG: Now, in your system, you’ve got four hospitals and you have an integrated database for all patient records?
RT: All the clinical information is in one database and all our financial information is…we have a clinical data warehouse, we don’t have an enterprise-wide data warehouse, we have financial data sitting in one place; the Cerner data warehouse, we have a merit system we run there, what we call Power Insight, which is basically Business Objects, Cerner side on steroids. We run our reports off our clinical database. So, we really do have a CDW on the clinical side and we have easy access. We’re not lacking for information. Trying to get the information out in as efficient way as possible is sometimes a challenge. But the information is there and we have the tools to extract it.
AG: Is CHI trying to do that same model on a much, much larger scale? You mentioned their data center in Colorado. Are they trying to have all their hospitals with a single data repository?
RT: It’s being discussed.
AG: That would be quite a project. And then your data, which now is one database for four hospitals on the clinical side, would essentially become part of their larger data that could include data from 40 hospitals, or whatever the case may be.
RT: CHI does have a couple of deliverables that we have to use on a regular basis, that they use for loading into a giant data warehouse. CHI does have a data warehouse. It’s mostly claims-like data, but it’s a pretty robust data warehouse and they do all manner of different reporting on that. They do outcomes reporting from that; they do for the Healthstream Survey; there’s a lot of different things they do, based on the data that we send them. So they’ve got a pretty nifty business intelligence system that they’ve created. All the hospital systems throughout CHI are required to send in a periodic file that can comprise a lot of demographic and claims-data history.
AG: How do you think, personally, your job is going to change?
RT: It will definitely change because I’m going to be involved much more at a national level than I was. The notion of what we’re trying to do here is to be able to centralize. Centralization makes people nervous. We’re trying to create a single IT department with tentacles in the different markets, and that’s going to require standardization. That’s going to require normalization; it’s going to require building and standardized policies and procedures that apply across the board, and it’s going to mean that certain people are going to have to jump on some national bandwagons for certain things. So there are going to be impetuses to do things that we wouldn’t have had before.
We’re going to be part of something bigger that opens up a lot of doors to us, to be able to tap in and do things, but part of that is that we have to be able to, if possible, be part of what CHI has deemed to be the CHI standard.
AG: It sounds like in your voice that you’re pretty excited about this, probably professionally; this may open some doors for you and give you a bigger stage on which to show what you can do. Is that accurate?
RT: I would say I am excited about it.
AG: Is there any degree of that things are on hold, or are you full steam ahead and, if so, tell me about some of the major initiatives you’re working on.
RT: We’re not really taking on any new projects at this point, but we do have a lot of project irons in the fire, and we can continue to move forward with those. Even as we go through this very transformational change to become part of CHI, and the secondary change to become part of CHI’s one IT structure, we still have a department to run, we still have our customers that we have to make happy, and we have a shop that has to continue to provide excellent service. At no point can we run away from that, even as we have these external factors that are buffeting us right now.
We have a number of different projects that are close to fruition right now — one of the big ones is from Thomson, which is called the MData project. What that involves is allowing physicians to access information from the Cerner system to their PDAs or smart phones. It also has a desktop solution that can act as a downtime solution during the relatively infrequent times the server is down. We rolled it out a few months ago, but there were some bells and whistles that we didn’t’ have with it and, not having those bells and whistles meant that we weren’t getting the kind of physician adoption that we wanted. Now we’re about to include those bells and whistles — vitals, radiology, results, some things like that, and that’s going to be a very exciting development for our physicians, because it’s really going to improve their quality of clinical life while they’re at Saint Clare’s. I think physician alignment is something that we all really are focused on right now in this very tight market. There is one more differentiator, if you will, that will make a physician want to refer more patients to Saint Clare’s — because they’ve got a good environment from which they can practice care.
AG: So this is a portal strategy? You’re basically opening up your system to the physicians so they can access it?
RT: Physicians have always been able to access our system. What they’ll be able to do, through the MData solution, is they’ll be able to see information from Cerner on PDAs. I’m going to make up a word here — it’s the PDA-ification of Cerner and, part and parcel to that is a desktop downtime solution that we have as a backup. That’s not the driver for us to do that, but it’s a nice bonus.
AG: Are you making moves to further facilitate that physician integration by leveraging the relaxation in the Stark Law?
RT: We’re talking about it.
AG: You also mentioned that you have no shortage of data. How are you making the right data available to the right clinician at the right time?
RT: We are working pretty aggressively in that area, and one of the challenges that we historically had — and, quite frankly, pretty much any organization has to varying degrees — is that you may have three or four different reports that are, supposedly, reporting on the same set of parameters, but give you very different numbers. Why is that? Because people are pulling the data from different systems to call their reports, or they’re interpreting data fields differently.
What we’re trying to do is really migrate to a single source of truth through which we are able to report. That single source of truth means there really is no ambiguity and no opportunity to provide numbers that are, in any way, lacking in clarity. We also want to be able to use the business intelligence capabilities of these types of systems to turn data into actionable information and to, quite frankly, hold people accountable for making sure they’re providing the kind of care they’re supposed to.
Some of the tools we have on the clinical side allow us to make sure that our providers are being compliant with core measures; they’re making sure we’re doing the right thing at the right time. We have a lot of different tools that we can check. We’re really starting to do a lot of very powerful things with our clinical information system. We’ve always been strong on the patient accounting side, but we want to get stronger yet. We have a workflow engine that hangs off our Series system and allows us to produce some very interesting dynamic reporting in terms of productivity and other such things. We’ve really gotten our arms around this.
Another one of our big projects is Clinical Nursing Compass, which is a system that the advisory board at Washington D.C. is marketing and that’s going to allow us to track a lot of very key nursing metrics, actual versus budget, it will allow us to track overtime, it will allow us to track hours per patient to see if they appropriate. It’s going to be point and click so you don’t have to dive through reams of data to get where you have to go. You point and click and there’s the next visual representation of what you need to know, and you can drill down on it. So that’s another big one, we’re going to be going live on that in a few weeks. So, a lot of what we’re really trying to do is bring actionable, drill-downable information directly to the person who needs to hold those individuals accountable.
AG: You mentioned that you’ve got McKesson and you’ve got Cerner — it sounds like a best-of-suite approach. Tell me about the data flow between those two main systems.
Part III Coming Soon