NETTING IT OUT

The MedStar Health community-based network of healthcare facilities has committed to providing seamless secure communications among physicians, other healthcare staff, and patients. Further, the organization is implementing a technology solution which will allow it to provide proactive care notification and reminder to patients when services are due in regards to chronic conditions. The technology to support both efforts is from Kryptiq, an Oregon-based provider of interoperability and workflow connectivity solutions for the healthcare industry.

This interview with Dr. Peter Basch, MedStar’s medical director of ambulatory clinical systems, looks at how MedStar plans to take advantage of these technology solutions to provide even better care to their already award-winning services.

BACKGROUND ON MEDSTAR HEALTH

MedStar Health is a $2.9 billion non-profit healthcare organization and a community-based network of seven hospitals and other healthcare services in the Baltimore-Washington region. As the area's largest health system, it is one of its largest employers, with more than 23,000 employees and 4,600 affiliated physicians.

Committed to Excellence

MedStar Health displays a commitment to excellence through its patient-first philosophy that combines care, compassion, and clinical excellence with an emphasis on customer service. This commitment has been recognized through multiple awards:

IN HEALTHCARE. Five MedStar Health hospitals are ranked among the best in the nation in the 2007 edition of “America’s Best Hospitals,” issued annually by U.S. News & World Report. These hospitals were cited for excellence in a total of 6 out of 16 specialty areas ranked by the magazine in its yearly review of approximately 5,500 hospitals and medical centers. Of all the hospitals reviewed, only 173 were of high-enough quality to be ranked in one or more specialties.

IN COMMUNICATIONS. Margery Zylich, assistant vice president for operational communications and special projects for MedStar Health, was honored with the 2007 Pinnacle Award by the Washington/Baltimore Chapter of International Association of Business Communications, a global organization that supports advances in the field of business communication.

The IABC Pinnacle Award recognizes excellence in business communications tied to achieving business results and demonstrating business ethics.

One of Zylich’s accomplishments is the MedStar Health Employee Survey process she created. The survey has been a key facilitator in driving organizational performance by using data to drive culture change and improve overall employee engagement.

IN INFORMATION TECHNOLOGY. For the fourth consecutive year, MedStar Health has been recognized as one of the nation’s 100 Most Wired Health Systems, as determined by the Hospitals & Health Networks’ annual survey. MedStar Health was the only health system in Maryland or Washington, D.C., to be named Most Wired.

MedStar Health’s commitment to information technology is clear; senior leadership recently approved a four-year, $150 million IT strategy. “This strategy, which builds on the progress and IT investments made over the past several years, will lead to a fully integrated, system-wide electronic medical record,” explains Catherine Szenczy, MedStar Health senior vice president and chief information officer.

COMBINING THESE AREAS TO REACH OUT TO CUSTOMERS. MedStar Health is now beginning the implementation of a communications initiative that will allow medical personnel across its healthcare facilities to easily communicate and collaborate on treatment. Even more, patients—the customers—will be included in this collaborative communications to keep them as active participants in their own ongoing healthcare.

We spoke with Dr. Peter Basch, Medical Director of Ambulatory Clinical Systems for the MedStar Health network, who is committed to using IT to “operationalize organizational processes across the enterprise.” Dr. Basch sees IT as an infrastructure to attain network-wide goals, such as quality improvements. He is spearheading an ongoing project to integrate MedStar’s current electronic health records system, Centricity Physician Office EMR from GE, with the CareManager and Connect IT solutions from Kryptiq to provide new collaborative communications capabilities.

USING COLLABORATION TECHNOLOGY AND PRACTICES TO IMPROVE HEALTHCARE

Dr. Basch acknowledges that, “as a collection of hospitals, clinics, and practices, we provide very good healthcare. But as the goal of ‘good’ moves to ‘great,’ and the bar is raised about what is considered best practices, the abiliy to provide better healthcare without communicating with all our partners in our network was a daunting—no—impossible task.”

One of the projects that Dr. Basch helped begin several years ago was to introduce full electronic health records for ambulatory services, his area at MedStar Health. Having electronic records implemented helps in establishing common terminology as well as appropriate structured information, such as medications and problem lists.

“The electronic health records allowed us to look at information in a more coherent and organized way, and also to appropriately share this information with each other, colleague to colleague,” explains Dr. Basch. “So, if a patient goes to a cardiology clinic at one of our facilities, and then goes to another clinic in a different facility within the same system, the physicians would have the same view of the patient info. That consistent view would help ensure better and safer care for the patient.”

Sharing Information via ad hoc “Conversations”

Prior to implementing electronic medical records, information was shared among healthcare providers in a more ad hoc manner. “Sometimes, although not always, physicians would send copies of records to colleagues. Sometimes we’d rely on the patient to let the physician know who he has seen and what the physician did for him. A lot of information was passed by talking to colleagues—just picking up a phone and calling a colleague for clarification. Conversations are still very useful, but we’re usually too busy to make the calls as often as we’d like,” admits Dr. Basch.

ELECTRONIC MEDICAL RECORDS (EMR) MANAGEMENT FROM GE. The electronic medical records solution that Dr. Basch assisted MedStar Health with implementing is Centricity Physician Office EMR from GE. “I first learned about it as a long-time user of the prior product (Logician, later purchased by GE). I used it for 10 years. I guess I was a pioneer in using electronic medical records.” The same product had been selected independently by one of the network hospital’s department of medicine. “Slowly, over the years, we’ve extended its reach to other practices. Then, this past year, our CIO and CMO thought we should take a step back and think about addressing a need for improved IT for the ambulatory serivces enterprise-wide.” The project to extend the EMR across sites was approved as of July 1, 2007.

Dr. Basch explained, “We wanted to use something we were familiar with, our physicians were comfortable with, and would help us in our journey from good to great healthcare.”

Currently, MedStar Health is in the process of implementing Centricity within most ambulatory services across the enterprise; the project should take three years to complete.

EXPANDING TO PATIENTS AND PROACTIVE HEALTHCARE. In evaluating what the EMR system offered, “we recognized pieces that Centricity didn’t provide: bidirectional secure connectivity with patients and the ability to look at our patient population in groups proactively rather than just episodically as individuals.” Dr. Basch wanted to add registry functions, such as the ability to identify all patients in one geographic area who are due for cancer screening updates. “The best medical records systems can bring you up to date on a patient when you are with the patient—when the patient has come in for a visit,” he explained. “You can then see that the patient is due for this, that, and the other. But the best EMR won’t tap you on the shoulder to tell you that people need attention if they don’t come in to see their physician. So we are able to provide good reactive care, but not proactive care.” MedStar Health understands that providing proactive notification and monitoring of patients’ health was a win/win for both the medical network and for its patients.

Kryptiq’s Solutions

Knowing that there was a need for a higher level of information analysis and communications, Dr. Basch was attracted to a set of solutions from Kryptiq. This Oregon-based provider of interoperability and workflow connectivity solutions for the healthcare industry provides a large number of applications for managing healthcare organizations, but two of the company’s products seemed particularly relevant to MedStar Health’s needs...