As Stage 2 of meaningful use approaches, it is interesting to hear from CIOs about the value they perceive they have received from regional extension centers and statewide health information exchanges. Yesterday I listened to an eHealth Initiative webinar in which Robin Stursa, CIO of the Sisters of Charity Health System, described the benefits of partnering with the Ohio Health Information Partnership (OHIP), the state-designated entity for managing both the REC and CliniSync, the statewide HIE.
The Sisters of Charity Health System solely owns four Catholic hospitals: St. Vincent Charity Medical Center in Cleveland, Ohio; Mercy Medical Center in Canton, Ohio; and Providence Hospital and Providence Northeast in Columbia, South Carolina. In a 50/50 joint venture with University Hospitals of Cleveland, the Sisters of Charity Health System also co-owns St. John Medical Center in Westlake, Ohio.
Stursa said one of the key contributions of OHIP was to get people in Ohio healthcare circles to start collaborating. “Healthcare in Ohio has always been very competitive, and traditionally people have not been looking at connecting,” she said.
As they approached Stage 1 of meaningful use, each individual health system was facing a scarcity of resources, and IT was being asked to do more with less. “We have been on a dead run to meet stage 1, begin working on ACOs, ICD-10, and the list goes on,” Stursa said. “We have been able to lean on the Partnership to help us move forward.” It has trusted experts that she can rely on to interpret regulations, and share best practices as well as what she calls “least practices.”
“What I mean by that is sometimes you want to meet the measure with the least amount of effort," she explained.
“One of the things that keeps me up at night is thinking about where my data is going. But if I send my data through the HIE, it helps me sleep better,” she said. The Sisters of Charity expects to rely on OHIP for help with public health reporting and transitions of care in Stage 2.
Cathy Costello, regional extension center project manager for OHIP, said that when her organization started four years ago, there were so many questions from providers about how to proceed with EHR implementation to meet Stage 1. She said that Stage 2 is complex enough that it is “going to require same concerted effort.” Providers are not sure how to exchange records, and it is up to us to raise that bar in terms of the way physicians are educated. It is going to take the same round of education that we did in stage 1, using specialist societies to show people how it can be done in smooth way without taking them out of their work flow. Fear of the unknown rather than not wanting to do it is the roadblock.”
Costello said that although the Ohio Department of Health does not require providers to report public health data through the state HIE, it is highly encouraged. The HIE has been working on immunization reporting, syndromic surveillance and electronic lab reporting, Costello says. The ongoing transmission of lab data to Ohio’s disease reporting system is the most complex process and has required the most back-room work on the part of the HIE and hospitals. The setup currently involves 13 reportable conditions that make up 85 percent of reportable labs, she said. The plan is to make reporting on 10 to 15 more reportable conditions electronic in the next five to seven years.
Dan Paoletti, CEO of OHIP, said physician offices and smaller hospitals might struggle with the requirements that 10 percent of transitions of care are done electronically. CliniSync is offering a variety of options, including Direct secure messaging, to help clinicians meet that measure.
He added that CliniSync is linked through the Direct protocol with HealthBridge, the other HIE in the state. The next phase of interoperability is to move results such as lab or radiology results back and forth. “We are going to pick that project up in the first part of the year.”
In response to a question from the audience, Paoletti reminded listeners that despite the recent announcement about a Stage 2 extension, the start date for Stage 2 remains the same. “We just get a extra year of Stage 2 before going to Stage 3. And he reminded listeners of the larger picture: “We have a unique opportunity to not just check a box, but to change how we care for patients and transition care. For independent providers, we want to ensure the technologies they use can talk to each other,” he added. “We hope we can be that link.”