Health information exchange networks are on the rise as more healthcare providers and organizations look for advanced ways to share medical information in a safe and secure manner. David Perez, vice president and CIO of Eisenhower Medical Center in Rancho Mirage, Calif., shares seven considerations that hospitals should be mindful of before launching an HIE.
Eisenhower collaborated with RelayHealth to create a HIE for its affiliated physicians, a collaboration which has resulted in nearly 180 of Eisenhower’s 250 admitting physicians now having online access to hospital results and a secure clinical messaging system to offer patients. The health system expects that physicians who have electronic health records will use the HIE to demonstrate meaningful use and obtain government incentives.
1. Have a marketing plan. The goal of launching an HIE is not only to provide efficient and safe electronic access to patient health information but also to connect as many physicians across as many care settings as possible. Doing so ensures hospitals are providing a full continuum of care to as many patients as possible. "What we learned as an early adopter launching our HIE is that hospitals have to make sure they have a marketing plan in place to get the word out not only to affiliated physicians but also employees, patients and the community," Mr. Perez says.
Initially, Eisenhower employees went door-to-door, visiting physicians' offices to raise awareness about its HIE, which is designed to connect the health system’s hospital, primary care clinics, urgent care clinics and affiliate physician practices with Coachella Valley’s residents. In an effort to more aggressively market the connectivity initiative, Eisenhower also started reaching out to local TV stations and newspapers for added coverage about the community network.
2. Hold forums for face-to-face discussions. Holding forums gives physicians, other healthcare providers and the public a chance to ask questions and have a clearer view of what your hospital's HIE initiative entails. Mr. Perez says when Eisenhower hosted a total of six forums to explain its HIE mission and the necessity of physician and community participation, a good number of attendees came prepared with questions on how the HIE will be paid for, what the HIE exactly is and what the implications will be for other area providers, for example. The last three forums covered the integration of electronic medical records with the HIE on the heels of Eisenhower’s announced plans to subsidize a percentage of EMR systems for physician offices.
"There was definitely overall success in having these forums," he says. "Initial questions from attendees included why our organization was launching an HIE, how it was going to be paid for and so on. Then we started explaining how physicians won't need paper results or faxes because they can electronically receive and forward on patient information. Once we started fully explaining what this meant for the physicians and community, it really started taking off."
3. Don't underestimate the power of word-of-mouth marketing. Mr. Perez says once the word got out through the media and forums about Eisenhower's HIE, word-of-mouth marketing among physicians and patients helped the initiative gain more ground. "It was amazing to see the power of the community as they were hearing about the HIE," he says. "Patients were talking to their friends and communicating with their physicians about their desire to be a part of Eisenhower's HIE. In turn, physicians called and asked us about it."
Eisenhower has also relied heavily on key physician stakeholders to promote its HIE to their patients. "We have some key physicians who are reputable with their own peers and patients," Mr. Perez says. "We approached two of our largest physicians groups, presented information about the HIE and asked for their support in promoting our community connectivity initiative."
4. Show physicians the benefits of an HIE. HIEs can offer a wide spectrum of services and applications — including online billing, test results delivery, e-prescribing and secure messaging — that can allow providers and healthcare organizations to better connect to patients and each other. Hospital leaders are likely to obtain physician buy-in and support more successfully if they demonstrate the multitude of clinical and administrative efficiency benefits that can be reaped from joining an HIE.
"We knew most of our affiliated physicians at the time did not have actual electronic medical records in their offices, so we wanted to provide them an opportunity where they were still actually able to connect through their Internet browser," Mr. Perez says. "We told them they could connect electronically with patients and with pharmacies for electronic prescriptions, both features which the physicians really liked."
5. Make sure hospital staff members are on board. It is absolutely essential hospital leaders ensure their front-line employees — physicians, nurses, IT support and others — are up-to-date and knowledgeable on how the hospital's IT infrastructure operates from the onset. Mr. Perez says this includes making sure operational processes, such as electronic ordering and result systems, are in place and pertinent staff members are trained on how to use the new connectivity technology. Not doing so can result in weakened productivity and confusion, especially if patients know more than they do about how to use the connectivity services.
"A hospital's front-line staff has to be prepared operationally, so this means hospital leadership have to do a better job of informing them of what the HIE is, what it does, what it's providing to patients and how it works," he says. "Healthcare organizations sometimes fail to communicate how these processes work to those key employees, and if doctors are affected, patients will be affected too."
6. Understand the risks and costs involved with launching an HIE. Be aware of the upfront costs involved in launching and funding an HIE long term. Having the support of the governing board and being inclusive on the decisions being made are crucial to ensuring an HIE launch with minimal surprises. Mr. Perez says Eisenhower decided to pay for 100 percent of the upfront costs tied to launching an HIE, even though the organization wasn't sure at the time what its immediate financial return on investments would be. The upside of an HIE investment is that the connectivity network requires minimal staffing resources and eliminates the need for infrastructure — for the patient, hospital and doctor office — beyond access to the Internet, eliminating large capital outlays.
"The challenge in everyone's mind is understanding the costs that are involved," Mr. Perez says. "CIOs need to make sure they have the CEO and administration's support because this is a long-term commitment to the organization's bottom line. Even though we weren't sure of our ROI or if we were going to even see any ROI, our CEO still felt launching an HIE was the right thing to do to connect the community and provide better care for our patients."
7. Set goals to achieve through the HIE. Hospital leaders would benefit greatly from setting in place goals to achieve, whether those goals are related to how much money is saved, clinical outcomes or rates of patient or physician satisfaction. "My goal is to connect as many people in the community and physicians to our HIE," says Mr. Perez. "I would love a 100 percent, but 80 percent of both would make me very happy."
Continuing, Mr. Perez says one goal he has his sights on achieving is increasing the enrollment number of active physicians on staff. "Even though we have around 400 physicians on staff, only approximately 250 of them are truly active, meaning they admit patients to the hospital or send patients to the hospital for outpatient services," he says. "Out of those 250 physicians, our goal is to connect 200 to our network. Right now we're at about 180 registered doctors on the HIE."
Learn more about Eisenhower Medical Center.
Eisenhower collaborated with RelayHealth to create a HIE for its affiliated physicians, a collaboration which has resulted in nearly 180 of Eisenhower’s 250 admitting physicians now having online access to hospital results and a secure clinical messaging system to offer patients. The health system expects that physicians who have electronic health records will use the HIE to demonstrate meaningful use and obtain government incentives.
1. Have a marketing plan. The goal of launching an HIE is not only to provide efficient and safe electronic access to patient health information but also to connect as many physicians across as many care settings as possible. Doing so ensures hospitals are providing a full continuum of care to as many patients as possible. "What we learned as an early adopter launching our HIE is that hospitals have to make sure they have a marketing plan in place to get the word out not only to affiliated physicians but also employees, patients and the community," Mr. Perez says.
Initially, Eisenhower employees went door-to-door, visiting physicians' offices to raise awareness about its HIE, which is designed to connect the health system’s hospital, primary care clinics, urgent care clinics and affiliate physician practices with Coachella Valley’s residents. In an effort to more aggressively market the connectivity initiative, Eisenhower also started reaching out to local TV stations and newspapers for added coverage about the community network.
2. Hold forums for face-to-face discussions. Holding forums gives physicians, other healthcare providers and the public a chance to ask questions and have a clearer view of what your hospital's HIE initiative entails. Mr. Perez says when Eisenhower hosted a total of six forums to explain its HIE mission and the necessity of physician and community participation, a good number of attendees came prepared with questions on how the HIE will be paid for, what the HIE exactly is and what the implications will be for other area providers, for example. The last three forums covered the integration of electronic medical records with the HIE on the heels of Eisenhower’s announced plans to subsidize a percentage of EMR systems for physician offices.
"There was definitely overall success in having these forums," he says. "Initial questions from attendees included why our organization was launching an HIE, how it was going to be paid for and so on. Then we started explaining how physicians won't need paper results or faxes because they can electronically receive and forward on patient information. Once we started fully explaining what this meant for the physicians and community, it really started taking off."
3. Don't underestimate the power of word-of-mouth marketing. Mr. Perez says once the word got out through the media and forums about Eisenhower's HIE, word-of-mouth marketing among physicians and patients helped the initiative gain more ground. "It was amazing to see the power of the community as they were hearing about the HIE," he says. "Patients were talking to their friends and communicating with their physicians about their desire to be a part of Eisenhower's HIE. In turn, physicians called and asked us about it."
Eisenhower has also relied heavily on key physician stakeholders to promote its HIE to their patients. "We have some key physicians who are reputable with their own peers and patients," Mr. Perez says. "We approached two of our largest physicians groups, presented information about the HIE and asked for their support in promoting our community connectivity initiative."
4. Show physicians the benefits of an HIE. HIEs can offer a wide spectrum of services and applications — including online billing, test results delivery, e-prescribing and secure messaging — that can allow providers and healthcare organizations to better connect to patients and each other. Hospital leaders are likely to obtain physician buy-in and support more successfully if they demonstrate the multitude of clinical and administrative efficiency benefits that can be reaped from joining an HIE.
"We knew most of our affiliated physicians at the time did not have actual electronic medical records in their offices, so we wanted to provide them an opportunity where they were still actually able to connect through their Internet browser," Mr. Perez says. "We told them they could connect electronically with patients and with pharmacies for electronic prescriptions, both features which the physicians really liked."
5. Make sure hospital staff members are on board. It is absolutely essential hospital leaders ensure their front-line employees — physicians, nurses, IT support and others — are up-to-date and knowledgeable on how the hospital's IT infrastructure operates from the onset. Mr. Perez says this includes making sure operational processes, such as electronic ordering and result systems, are in place and pertinent staff members are trained on how to use the new connectivity technology. Not doing so can result in weakened productivity and confusion, especially if patients know more than they do about how to use the connectivity services.
"A hospital's front-line staff has to be prepared operationally, so this means hospital leadership have to do a better job of informing them of what the HIE is, what it does, what it's providing to patients and how it works," he says. "Healthcare organizations sometimes fail to communicate how these processes work to those key employees, and if doctors are affected, patients will be affected too."
6. Understand the risks and costs involved with launching an HIE. Be aware of the upfront costs involved in launching and funding an HIE long term. Having the support of the governing board and being inclusive on the decisions being made are crucial to ensuring an HIE launch with minimal surprises. Mr. Perez says Eisenhower decided to pay for 100 percent of the upfront costs tied to launching an HIE, even though the organization wasn't sure at the time what its immediate financial return on investments would be. The upside of an HIE investment is that the connectivity network requires minimal staffing resources and eliminates the need for infrastructure — for the patient, hospital and doctor office — beyond access to the Internet, eliminating large capital outlays.
"The challenge in everyone's mind is understanding the costs that are involved," Mr. Perez says. "CIOs need to make sure they have the CEO and administration's support because this is a long-term commitment to the organization's bottom line. Even though we weren't sure of our ROI or if we were going to even see any ROI, our CEO still felt launching an HIE was the right thing to do to connect the community and provide better care for our patients."
7. Set goals to achieve through the HIE. Hospital leaders would benefit greatly from setting in place goals to achieve, whether those goals are related to how much money is saved, clinical outcomes or rates of patient or physician satisfaction. "My goal is to connect as many people in the community and physicians to our HIE," says Mr. Perez. "I would love a 100 percent, but 80 percent of both would make me very happy."
Continuing, Mr. Perez says one goal he has his sights on achieving is increasing the enrollment number of active physicians on staff. "Even though we have around 400 physicians on staff, only approximately 250 of them are truly active, meaning they admit patients to the hospital or send patients to the hospital for outpatient services," he says. "Out of those 250 physicians, our goal is to connect 200 to our network. Right now we're at about 180 registered doctors on the HIE."
Learn more about Eisenhower Medical Center.