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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?

Hospital Partnerships May Help With EMR Costs

Posted on October 29, 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.

Nearly three quarters of hospitals surveyed in a recent study by health IT vendor Anthelio plan to find partnerships while retaining ultimate ownership of their facility. And among the to-do list items more than half need to pull off is implementing their EMR.

The survey, which was conducted between August and September 2013, used an e-mail questionnaire which was sent out to community-based hospitals and health systems with up to 500 beds, according to a report in Health Data Management magazine. The researchers received responses from 135 community hospital executive representing 123 community-based hospitals.

Seventy-four percent of respondents were looking for partnerships that didn’t involve giving up their independence, while only 9 percent were considering consolidation with a hospital system. That’s a huge dip from last year, in which 41 percent were willing to consider consolidation.

Of the group, only 40 percent have completed and are operating EMRs. Most of the remaining 60 percent have bought an EMR, but have only partially implemented it. It seems very likely that those who haven’t finished their implementation are hoping to leverage their partners’ IT resources to get the job done more quickly and effectively.

Of course, there are other expensive items on hospital executives’ plates, including the transition to ICD-10. Researchers found that 39 percent of respondents have spent or anticipate spending less than $100,000 on the ICD-10 transition, 40 percent will spend $100,000 to $499,000, 13 percent will spend $500,000 to $999,000 and 9 percent will spend more than one million, Health Data Management said.

Take these two forces alone, and it’s clear why hospitals are willing to give up some of their independence in exchange for financial and operational support from a partner. Toss in the need to have a decent bargaining position in a post-ACO world, and the idea of partnering up looks even more attractive.

Still, it’s a risky strategy. To be honest, I’m skeptical that a partnership can deliver these benefits the way executives would hope. In fact, my guess is that a partnership or merger would make an EMR implementation more difficult to coordinate, not less. I suppose we’ll have to wait and see what actually happens.