Editor's note: The following is an edited excerpt of a full transcript of an Oct. 12 editorial webcast, “Making the Connection,” conducted by Modern Healthcare.
IT experts on issues they faced in getting their systems' components to mesh
The panelists were Dr. Steven Heilman, vice president and chief medical information officer at Norton Healthcare in Louisville, Ky.; David Muntz, senior vice president and chief information officer at the Baylor Health Care System in Dallas; and Jim Younkin, director of information technology at the Geisinger Health System in Danville, Pa. In an exchange moderated by reporter Joseph Conn, the panelists discussed strategies to best use information technology to link together the disparate components of their healthcare organizations with the goal of sharing clinical and financial data. The webcast was sponsored by Elsevier Gold Standard. Per editorial policy, sponsors are not involved in the development or publication of editorial content.
Joseph Conn: I wanted to allow the panel members to have an opportunity for about the next five minutes or so to ask questions amongst themselves ... So with that, I wanted to talk with Steve a little bit and ask him if he has anything that he found of interest of his colleagues here.
Steven Heilman: I meant to ask Jim a question. We're getting started in our health information exchange initiative and how to get connected, and I just want to see if there are any big lessons learned as he was heading up his network and getting out there and getting it open to everyone?
Jim Younkin: Yeah, that's a great question, and I'll tell you there aren't any easy answers. The answers are simple, but not easy. I would say that the biggest challenge is probably setting up your governance structure to ensure that all of the members of the community are coming to the table on equal footing, and it can be a challenge, especially if you have larger health systems that are used to having a lot of power. And ensuring that your governance is set up in such a way that even the little guy has a voice at the table and they can ensure that the information that they're sharing is being protected and not used for any kind of competitive advantage.
David Muntz: This is David. I also have a question and that is how you dealt with the issue of privacy and also consent?
Younkin: That's a question that a lot of HIEs are addressing differently. Our legal counsel at Geisinger required us to err on the side of caution and being conservative, so we are using what is known as an opt-in model where patients actually have to sign an authorization form allowing their health information to be shared. So without the patient opting in, clinicians can see that their patient has received care at a particular facility, which is kind of directory information, and if they don't have the authorization, they can at least call and say, ‘Hey, I saw there was a visit there, can you provide us with—you know, fax something over to us?
Conn: Does Norton subsidize IT for affiliated physician practices, and, if so, how much to date or how much per year? And I presume you're trying to leverage if you're doing that—leverage the meaningful-use money. And how is that working out?
Heilman: You're correct. We are currently rolling out, like I say, the new electronic medical record for all of our enterprise, and so with that we are offering a subsidized solution to physicians, but we're still early in the phases, so we have not determined what that subsidy is going to be at this point. In our marketplace, it's a fairly competitive market. Most of the physicians are already employed or affiliated with organizations at this time, so we're having to put some long-term view in this in terms of how this is going to look over a period of time, and what happens when Stark relaxation kind of goes away.
Conn: For Baylor Healthcare, do you have any EMR system that you're planning to use?
Muntz: The answer is yes, but it's a little more complicated than just a single system. The fact is that we use a particular vendor's offering and our own practices, and that's been very successful, and I should say that, by the way, about 65% of our physicians are primary-care—the rest are specialists—and so it's a little tougher when you get into the specialist community to be able to modify the templates to make sure that we're collecting all the data. ... But what we know when we get to the community is that you cannot be successful if you only offer one package to all physicians, and so we're picking out what we think are the most popular packages in the communities, and then what we're offering is a templated version of—or Baylor templated—version of those to the physicians who are interested in participating. And the advantage to us is that we're going to be able to exchange data more easily, we'll be able to offer more assistance to the physicians as they are setting up their practices and have questions about what is necessary.
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