Former KPMG and Accenture consultant Luis E. Taveras has had his share of global and national IT challenges but his latest project may be among his most complex.
The 54-year-old chief information officer at Hartford Healthcare is leading a multi-year, $200 million overhaul of the hospital network’s information technology systems, a project with far reaching goals beyond just adopting new gizmos and gadgets.
Taveras says they are building a “next generation IT environment,” that will attempt to link together all hospital and physician practices under the bourgeoning Hartford Healthcare umbrella.
The goal, Taveras says, is to not only improve care coordination and communication but allow doctors and physicians to do a better job of keeping patients healthy.
The strategy is part of a broader national effort to reduce health care costs and improve quality by shifting the traditional role of hospitals from strictly caring for sick patients, to managing patient populations through preventative treatment to keep people healthy and out of the emergency department.
“Information technology isn’t just a way to improve the health care system, it is a way to transform it,” Taveras said. “We are shifting from managing sick care events to managing a health care system where we are really trying to keep people well. Analytics will play a major role in that transformation.”
Taveras said the IT overhaul is in its infancy as Hartford Healthcare is just starting to search for a vendor. The task is so complex it won’t be completed until 2017 at the earliest. It is especially challenging considering the significant growth Hartford Healthcare has experienced in recent years affiliating with other Connecticut hospitals and buying up physician practices, many of which are operating on different IT systems.
Hartford Hospital, The Hospital of Central Connecticut, MidState Hospital and Windham Hospital all fall under the Hartford Healthcare banner, along with a myriad of behavioral health, home care, rehab, senior care, and clinical lab facilities.
Now comes the hard part of trying to integrate them so providers at each location can share patient information. That should reduce costs and improve quality, Taveras says, by arming physicians with a patient’s entire health history, allowing docs to make better informed decisions. That, in turn, should reduce errors, duplicative testing and encourage better health monitoring.
When the system is fully implemented, patients sent to multiple Hartford Healthcare facilities will go through one registration process and receive a single bill. They will also have one electronic medical record that follows them, Taveras said.
That means everything from finance to billing and even pharmacy departments will have to share a common IT platform so information can be centralized and standardized.
Hartford Healthcare is also going to incentivize physician practices not owned or affiliated with the network to adopt its IT system, Taveras said, so Hartford Healthcare can avoid any gaps in care.
Hartford Healthcare already operates its own health information exchange, so it will need to link in all affiliated and unaffiliated providers once they share a common IT platform.
But the sharing of medical records is only the tip of the iceberg. The real challenge — and potential game changer for health care delivery — comes in using patient medical data to predict future illnesses and more closely monitor patient behavior.
As providers get wired on the same IT platform, Hartford Healthcare will create a data warehouse to do preventative care analytics, Taveras said. The goal is to particularly focus on patient populations with chronic illnesses like diabetes, asthma or cancer, who tend to make the most hospital visits and cost the health care system the most money.
The data warehouse will allow Hartford Healthcare to track when chronically ill patients are due for a physical or eye exam, and when they need to renew a prescription.
“The goal is to not wait for the patient to present but to proactively get the patient to receive preventative treatment,” Taveras said. “That will reduce healthcare costs in the long run by keeping patients more healthy.”
John Halamka, the chief information officer at Boston’s Beth Israel Deaconess Medical Center and a national technology expert, said health care reform is requiring health IT systems to be used in much different ways because the focus is on wellness and quality care rather than episodic sick care.
The federal government is also pressuring hospitals and other medical care providers to adopt health IT systems that meet certain “meaningful use” standards by 2015, Halamka said.
There are several stages of meaningful use, each with different requirements like electronic prescribing, tracking key clinical quality measures and sharing information with providers and patients electronically.
Institutions that comply with the mandate are eligible to receive temporary Medicare and Medicaid incentive payments. Hospitals that don’t comply, however, face payment penalties, raising the stakes and leaving providers little choice but to make the investment and enhance their health IT capabilities.
“It’s not just about an electronic medical record anymore,” Halamka said. “Now you must understand everything about a patient and share the data with all providers with the goal of trying to figure out what care you can provide to prevent them from getting sick in the future. It’s a whole new realm of health IT.”
Halamka said the move to integrate providers under similar IT platforms can be a significant management challenge, because physicians have different needs and desires when it comes to technology.
Any change can also negatively impact productivity, as providers require time to get used to new systems, which can reduce the number of patients they see in a day.
“The key is to create a guiding coalition of interested stakeholders so you can get over dissatisfaction that occurs and cement change into the culture of the hospital,” Halamka said. “You need to listen to the clinicians, understand what their requirements are, and implement a system that is responsive to their needs.”
Taveras said he is aware of the turf wars that could play out so he will be flexible in creating IT templates that cater to different specialties, but also feed into one, compatible database structure.
“The way a pediatrician works is different from a cardiologist so you must create a template that works best with their workflows,” Taveras said.
