Asked What are the IT hot button priorities for your institution? the top three selections (readers could pick three of 18 possible choices) were electronic health-record systems, 57.9%; inpatient clinical IT systems, 45.5%; and ambulatory clinical IT systems, 36.6%.
The second tier of selections was topped by clinical communication infrastructure/links to physicians, 29.7%; physician-practice-management systems, 25.5%; and PACS/diagnostic imaging, 15.9%; followed by upgrading financial applications (e.g., patient accounting and general accounting) 14.5%; developing data warehouses, 11%; and enabling patient access to selected data via the Internet, 10.3%.
All other choices garnered less than 10%.
For Daniel Martich, chief medical information officer at the University of Pittsburgh Medical Center, an integrated delivery system with 20 hospitals and 400 physician offices, the rollout of a massive clinical integration project is a hot topic. Martich will be giving a report on progress and lessons learned from the project this week at the Healthcare Information and Management Systems Society convention in Orlando, Fla.
Eight years ago, the challenge Martich faced when he first came to UPMC was an upgrade and integration of 120 or so different clinical applications across the health system. Cerner Corp., Kansas City, Mo., was the dominant vendor of inpatient clinical systems at UPMC hospitals while Epic Systems Corp., Verona, Wis., was the chosen vendor of the EHR used by UPMC faculty physicians. Integrating the two main systems with each other proved problematic.
As it turned out, neither vendor wanted to play in the sandbox with the other very well, Martich says. So the next thought was, pick one or the other. At the time, Martich recalls, Epic had yet to complete an inpatient installation, so Cerner got the nod, but the decision to switch EHRs met with resistance from the faculty physicians, so the idea of an enterprisewide vendor was scrapped.
After selling the board on the idea we were going to have one vendorand that was our interoperability solutionwe had to go back to our board, hat in hand, and say culture trumps everything, Martich says.
After bringing in consultants to advise UPMC on its tech alternatives, the hospital system chose dbMotion, based in Israel, as its integration provider. The $84 million project was announced in late 2006.
UPMC launched its first systems integration pilot earlier this month with physicians and nurses in two ambulatory-care settings and the emergency departments of two hospitals. The system creates a customized view for UPMC providers of a patients medication information, allergies, laboratory results and problem lists, tapping the EHRs of the pilot facilities, plus laboratory results from Quest Diagnostics, the ambulatory providers main laboratory source, and demographic information from five different registration systems used to identify the existence of medical records on that patient throughout the UPMC network.
If someone was in the ED, it will show they were seen (earlier) on particular dates and times and at a particular care setting, Martich says. So far, its gone reasonably smoothly.