Health IT has moved from a phase of adoption to a process of optimization. Now that healthcare organizations mostly have their EHRs in place, they are trying to use the systs in the most optimal way and maximize their investments.
This has been the case at Marion (Ind.) General Hospital. In the acute care setting, Marion General Hospital has been using MEDITECH's EHR since 2003, and it was around 2007 when hospital leadership started looking at system optimization.
Emmanuel Ndow, CIO of Marion General Hospital, spoke with Becker's Hospital Review about the hospital's EHR optimization efforts.
Editor's note: Interview has been lightly edited for length and clarity.
Question: How has Marion General started upon its optimization phase of EHR use?
Emmanuel Ndow: Certainly the EHR we put in does a lot for us, but it's not perfect in every area. We started our journey and first looked at MEDITECH to see do they have in development plans forthcoming. We found it takes a long time for them to really enhance some of their products and give us the maximum efficiency we need. We decided to branch out and look at other organizations like [health IT vendor] Iatric Systems. Iatric got our focus because they were very good in the MEDITECH space.
We decided to purchase one of their systems called MobiLab. MobiLab basically gets the lab and phlebotomy to go and get blood specimens. If a stat lab gets ordered in the emergency department, a lab technician gets notified immediately with their handheld device that there's a stat lab, and they can head over there right away to get a blood specimen. They use the same device to scan a patient's arm band to make sure it is the right patient and that the order stays with the right patient.
It allowed for the lab staff to be more distributive, instead of being centralized and getting everything to come to the lab and sending out staff to draw blood. It allowed [lab staff] to be in many different areas and still have a way to receive communication.
That helped with staff productivity, patient safety and patient care all around. We still right now don't have a way to do that just using the EHR system, so that's why we still had to branch out and look at vendors like Iatric.
Q: Are there other vendors out there that offer all the functions you're seeking so you don't have to use a third party?
EN: There are, but even though they may offer some areas in some space, they don't necessarily offer [services] in every area, or every department the hospital uses. There are some things MEDITECH does very well. But that doesn't mean there aren't other areas that MEDITECH is lagging on. Every vendor you look at, whether Epic or Cerner, there's no vendor that has every area perfectly and maximized to the highest efficiency. You'll always need other vendors and other systems that improve efficiencies. It's just unrealistic to expect EHR vendors to do everything for every area.
Q: What other components have you added to boost your EHR investment?
EN: We purchased another [Iatric] product called CareContinuity. It's an online backup system. We are able to send real time HL7 messages from our MEDITECH EHR to CareContinuity. CareContinuity is online and we send data to Iatric's server farm.They keep up to at least 90 days worth of recent data, so if our MEDITECH system ever went down, our clinicians, providers and nurses are still able to get on the web, log on to the CareContinuity site and see patient medical record information.
This is very important because as we move away from paper and putting all of these electronic forms together, when the system goes down and if we don't have some kind of backup way of pulling up recent information, then providers and nurses are walking blind trying to determine what to do with the patient.
We've been able to use this a few times. It's there for business continuity and even for situations where we had to take the system down for scheduled maintenance.
Q: How did you have these conversations with fellow executive leaders to gain their buy-in for the projects?
EN: It's an easy conversation to have with executives, and the reason is that we usually invest in big systems — EHRs and picture archiving and communication systems and so forth. What we've come to realize is even though it's a great system, sometimes it doesn't necessarily touch on highly increased productivity. Right now we're getting physicians to document online, which didn't really make them a lot more productive. They keep complaining to us that this is making them less productive because they're spending a lot more time trying to document when in the past they could just scribble on a piece of paper.
When we go in and talk to executives about these other vendors, we talk to them specifically about improving productivity, improving patient safety.
Q: What are your IT focuses for the upcoming years?
EN: For the next five to 10 years, we are certainly looking at some newer [EHR] products that are becoming much more web-based and user friendly. We're looking at the mobile type of tech and being able to get to a zero client type of environment. For quite some time everyone has gotten very used to navigating around the web and doing different things. Vendors are all trying to move their apps to that space because it cuts down tremendously on training. It makes it easier to use and much more familiar, and then makes it a little more portable, moving IT to the mobile space and away from client desktops.
In conjunction with that, also we are certainly looking at security and looking at systems that will make sure we are prepared for these types of moves because when you starting putting things on the Internet, there's a lot more exposure out there.
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