A year and a half ago UMass Memorial Health Care Associate CIO Karen Marhefka and her team embarked on what was dubbed the Cornerstone Project, a six-year, $100 million program to create interoperability among seven different IT systems: the organization’s ambulatory electronic medical record (EMR) from the Chicago-based Allscripts; its inpatient EMR, the Soarian system from Siemens Healthcare (Malvern, Pa.); its perioperative system, Picis (Wakefield, Mass.); its enterprise master person index (EMPI) and information exchange solution, from the Chicago-based Initiate Systems (now a part of IBM, Armonk, N.Y.); its clinical portal, from dbMotion (Pittsburgh, Pa.); its health information record management system, from Hyland (Westlake, Ohio); and a yet-to-be-determined emergency department system. Marhefka recently explained to Healthcare Informatics ’ Associate Editor Jennifer Prestigiacomo why Worcester, Mass.-based UMass, a system of five hospitals and more than 800 physicians, decided to build their own Frankenstein IT system.
Healthcare Informatics: Can you give me some background on the Cornerstone Project?
Karen Marhefka: UMass Memorial Health Care Center started three years ago by hiring our Senior Vice President and CIO George Brenckle to come in and bring in our patient information platform into the 20th century. We had been a Meditech shop for everything within the hospitals for 20 years and didn’t have a lot of capital money to upgrade those IT platforms. George started the process by researching the vendors out there and primarily focusing on our main HIS (Health Information System). Through a pretty exhaustive process, the team came to the conclusion that Siemens Soarian was going to be our main HIS for all the hospitals within our system. We came to the realization that this was going to be great for our acute care business and revenue cycle, but it really didn’t answer the specifics for what we need on an outpatient side. Our ambulatory HIS with Allscripts was already in implementation. As time went on, our IT and clinical leadership made a decision to pull in some other things that had been in the request bucket, but also bring in some talent that is going to help us pull all this stuff together, and that was how Cornerstone was born. He brought on-board myself and my colleagues Richard Cramer and Robin Sodano to glue all this stuff together. Essentially, Cornerstone is seven IT projects. The fact that it involves seven different vendors has everybody nervous, as that means a lot of interfacing and integration. We were very careful with choosing vendors that don’t have hard edges on their “picture frames,” but puzzle pieces. So they’re very good at interoperating with other vendors, hence the name Cornerstone. It’s really caught on and folks are loving the fact that they don’t have to remember seven different vendor names and don’t have to worry about how they’re all going to connect up so that it appears to be one system platform.
HCI: What was the strategy when choosing all these different vendors?
Marhefka: It was definitely about ease of implementation. They had to have a really good track record with implementation. The best product out there for what they represent, and certainly cost was a factor, too. Plenty vendors out there like the Epics and the Eclipsyses will tell you they can give you everything in one package, but you lose the best of an ambulatory system that way; you lose the best of an acute care system that way. And we’re definitely not feeling that using one legacy system is safer and easier and more cost effective. We feel like there are too many tools, too many smart people within our organization to work with the best of these separate systems.
HCI: When are you due to finish Cornerstone?
Marhefka: The whole thing is projected to be completed in four years. We’ve been in full implementation process for a year and a half. We’re at different stages with each of our vendors. So, we’ve actually been rolling out Allscripts for the last three and a half years. And what we’ll be doing with Allscripts in the next three to four years is adding all that cool functionality that makes it more robust. It’s a very difficult culture to bring over 900 physicians on to something. Everybody has the basics, but now we’re coming back around and putting in some of the headier functionality. Our entire revenue cycle will be transferred from Meditech to Soarian and will be going live next summer 2011. Most of our advanced clinical on the acute care side with Soarian won’t be completed till 2013.
HCI: How is the work you’re doing right now fitting into any plans for meeting meaningful use requirements under the ARRA/HITECH Act?