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Cleveland Clinic Works To Eliminate Tech Redundancies

Posted on March 1, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The Cleveland Clinic has relied on its EMR for quite some time. In fact, it adopted Epic in the 1990s, long before most healthcare organizations were ready to make a bet on EMRs. Today, decades later, the Epic EMR is the “central data hub” for the medical center and is central to both its clinical and operational efforts, according to William Morris, MD, the Clinic’s associate chief information officer.

But Morris, who spoke about the Clinic’s health IT with Health Data Management, also knows its limitations. In an interview with the magazine’s Greg Slabodkin, he notes that while the EMR may be necessary, it isn’t sufficient. The Epic EMR is “just a digital repository,” he told Slabodkin. “Ultimately, it’s what you do with the technology in your ecosystem.”

These days, IT leaders at the Clinic are working to streamline the layers of additional technology which have accreted on top of the EMR over the years. “As an early adopter of Epic, we have accumulated quite a bit of what I’ll call technical debt,” said Doug Smith, interim chief information officer. “What I mean by that is multiple enhancements, bolt-ons, or revisions to the core application. We have to unburden ourselves of that.”

It’s not that Clinic leaders are unhappy with their EMR. In fact, they’re finding ways to tap its power to improve care. For example, to better leverage its EMR data, the Cleveland Clinic has developed data-driven “risk scores” designed to let doctors know if patients need intervention. The models, developed by the Clinic’s Quantitative Health Sciences group, offer outcome risk calculators for several conditions, including cancer, cardiovascular disease and diabetes.

(By the way, if predictive analytics interest you, you might want to check out our coverage of such efforts at New York’s Mount Sinai Hospital, which is developing a platform to predict which patients might develop congestive heart failure and care for patients already diagnosed with the condition more effectively. I’ve also taken a look at a related product being developed by Google’s DeepMind, an app named Streams which will ping clinicians if a patient needs extra attention.)

Ultimately, though, the organization hopes to simplify its larger health IT infrastructure substantially, to the point where 85% of the HIT functionality comes from the core Epic system. This includes keeping a wary eye on Epic upgrades, and implementing new features selectively. “When you take an upgrade in Epic, they are always turning on more features and functions,” Smith notes. “Most are optional.”

Not only will such improvements streamline IT operations, they will make clinicians more efficient, Smith says. “They are adopting standard workflows that also exist in many other organizations—and, we’re more efficient in supporting it because we don’t take as long to validate or support an upgrade.”

As an aside, I’m interested to read that Epic is tossing more features at Cleveland Clinic than it cares to adopt. I wonder if those are what engineers think customers want, or what they’re demanding today?

Hospitals Using Tablets to Improve EMR Access

Posted on February 18, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Some high profile hospitals are turning to tablets as a way to give physicians better access to EMRs when they’re walking the halls.  Using tablets is seen as a way of working around desktops’ limitations in making better use of EMRs’ capabilities, according to MedPageToday.

For example, back in 2010, the University of Chicago School of Medicine issued tablets to all hundred 15 internal medicine residents. After a year, three quarters of residents reported tablets help them finish tasks more quickly and spend more time on direct patient care.

In another example, the Cleveland Clinic is pilot testing the use of tablets with a few sectors of its workforce, such as its rapid response teams. Using tablets, clinicians can look up patient data on the way to the patient was crashing and be better prepared when they arrive.

In yet another instance, the University Of Pittsburgh Medical Center is testing the use of Windows tablets with cardiologists. The medical center has developed special software allowing physicians to jump between different mobile apps without having to reenter patient information to do their work.

These are just examples of how hospitals can turn mobile devices into effective extensions of the EMR, said David Collins, senior director of mHIMSS, the mobile wing of HIMSS. “If you can spend $300 on a tablet and issue these to providers so that they’re more mobile, it’s really a minimal cost for the payoff,” Collins told MedPageToday. Although, John Lynn makes a pretty good counter argument for why IT admins prefer the more expensive Windows 8 tablets over iPads or Android tablets.

These are just a few early examples of how hospitals can use tablets to make access to patient data simpler. Over the next year or two expect to see far more examples of tablet use in hospitals, as it’s become increasingly clear that they can help enhance the use of clinical data, on the spot when clinicians need it.

Cleveland Clinic Expands Access To EMR Information

Posted on June 12, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The Cleveland Clinic is stepping up patients’ access to their medical information by providing secure online access to most of the data stored in their medical files.  The newly-available data will be accessible through the Clinic’s existing patient portal, MyChart, according to EMR Daily News.

Currently, patients who use the Clinic’s MyChart app can view a limited list of data , including their after-visit summary, medications list, allergies, immunization records, preventative care details, laboratory results, and radiology reports. If they want to see any more of their information, they have to get a hard copy of their patient record.

However, the new MyChart EMR offers patients access to just about every type of information doctors can see, including pathology records, x-ray reports, physician notes and lists of current health issues doctors use  to describe a patient’s health status. It will also offer access to recent concerns and known diagnoses.

This marks the most recent of several steps the Clinic to expand patient access to their medical records. Earlier this year, EMR Daily News notes, reports associated with medical images including MRI, CT, ultrasounds, and mammograms were made available online through MyChart. Starting this month, the Clinic will start automatically releasing pathology reports to patients through MyChart, though there will be a delay which gives the patient a chance to have talked to their doctor about the report prior to seeing it.

The EMR system is expected to be fully transparent to the patient sometime next year, Clinic leaders say.

Expect to see a series of announcements of this kind, folks. Increasing healthcare data transparency is clearly on everyone’s agenda, and though leading organizations like the Cleveland Clinic may be at the forefront, what they’re doing is likely to become the standard for hospitals and clinics in the not-so-distant future.

Cleveland Clinic Brings Epic Smarts To NY Hospital Practices

Posted on May 13, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The Cleveland Clinic is going the consulting route, this time around by working with the physician and specialty practices for a New York hospital to bring Epic up to speed.

Glens Falls is a 410-bed nonprofit which began implementing the Epic EMR in early 2012. The New York facility has 3,000 employees and 28 regional locations.

Apparently dissatisfied with its internal knowledge base on the subject, It’s now contracted with the Clinic’s MyPractice Healthcare Solutions (MPHS) to help deploy and optimize its rollout, reports the Cleveland Plain Dealer.

Among the Epic products installed at Glens Falls is “MyChart,” offering a clinical and billing records portal for patients, according to the Plain Dealer.

The Cleveland Clinic has had Epic in place for more than 10 years, making it one of the first healthcare systems in the country to install the vendor’s product. Having learned from that experience, Cleveland Clinic MPHS now brings project management and implementation expertise to other facilities.

I think this is an interesting business model for the Cleveland Clinic, and I’d be curious to see what other consulting agreements it has put into place. (So far I wasn’t able to turn up any others but my guess is that they exist.)

It seems to me that hospitals who have tamed Epic — Kaiser Permanente comes to mind — might very well go into this line of business, as the need is great. Not to mention that if I were making a decision as to who I’d hire to wire my medical practice into my hospital, a successful institution would have a very strong pitch to make.

Can any of you readers share other examples of hospitals/clinics who are turning their Epic experience into a consulting revenue stream?