Cardiovascular Business - January/February 2009 - (Page 23)

“You want instant access to all data at all times and you can only get that if all systems are integrated into one system.” Tom Lonergan, executive director of Hoag Heart and Vascular institute, Newport Beach, Calif. doesn’t offer specialists. In addition, with the hospital system the group would enjoy connectivity to a large number of primary-care physicians employed by the hospital. This group represents nearly 70 percent of the cardiologists’ referral base. “The decision has divided our group,” Sobal says. “Some people are willing to make the trade-off of less functionality, cost advantage and more connectivity to the primary-care physicians. Others are willing to pay more to get a system designed for the specific needs of cardiologists. And still others say both options are unacceptable. They’d rather wait to see if the hospital system improves its functionality or if something else comes along.” Nevertheless, the group’s board appointed an IT task force to study the issue and make a recommendation regarding when and how the group should implement an EMR. Most everyone associated with the group agrees an EMR is inevitable. Those who support immediate action point to the efficiencies gained from consistent and easy access to information. It is evident that the current system will not be able to handle the changeover in 2011 to the new ICD-10 codes, of which there are nearly eight times more than the outgoing ICD-9 codes. Sobal says the pace of change in healthcare would put them at a disadvantage if they could not quickly adapt to it. The more time that elapses while trying to make the decision, the longer an EMR implementation will take. “Even if the group makes a decision today to move forward, the selection, preparation, implementation, and optimization will mean that it will not reap the benefits of EMR maturation until 2011 or later,” he says. Sobal believes that ultimately their referral base will drive the decision. Most primary-care physicians have said that their lives are easier when the specialists they refer to are on the hospital system, he says. Center of Excellence In its quest to become a Center of Excellence, Hoag Memorial Hospital Presbyterian in Newport Beach, Calif., has many issues to address, particularly with respect to the disparate technology and information systems. The most important aspect when undergoing change of this magnitude is to have all stakeholders—in the front-end and the back-end—understand the need to have integrated data flow, understand the plan and have total buy-in from everyone, according to Tom Lonergan, executive director of Hoag Heart and Vascular Institute. Lonergan says they planned the digital connectivity of the Heart and Vascular Institute for a year. They came up with a team-based approach and a design that made sense to everybody. For the design to make sense, the CVIS had to not only incorporate procedural data, but many other kinds of information including regulatory, inventory, scheduling, interdepartmental and more. The institute is at the five-year mark of a 10-year plan. In the beginning, it had many disparate pieces of technology, but as each piece came due for replacement, it gave Lonergan and colleagues an opportunity to install technology that fit with the integrated design plan. “We knew every component was being added as part of the strategic design,” Lonergan says. Now the institute is bringing all the technology together with a CVIS that includes connections to physicians’ offices that tie their EMR with the institute’s EMR. In the cath lab, for example, all information is input in real time into an electronic report using drop-down boxes and custom designed structured reporting. The CVIS sends the report—either in its entirety or in part—to the EMR, medical records, referring physician, billing or regulatory agencies. Typically what most hospitals and groups have is a PACS (picture archiving and communication system), but a PACS is only one piece of a CVIS, says Lonergan. The CVIS has to go beyond handling clinical data and include scheduling, billing, regulatory reporting, EMR interfacing, patient registration— everything that has data. “You want instant access to all data at all times and you can only get that if all systems are integrated into one system.” Having the right CVIS frees up management and decisionmakers from having to find, collect and process information. Rather, their time can be better spent analyzing the data and devising ways to improve operations. “In my 30-plus years, I spent so much time chasing information. My job is to provide solutions and a competitive advantage. I’m less effective if I have to do the leg work,” Lonergan says. CardiovascularBusiness.com Cardiovascular Business 23 http://www.CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - January/February 2009

Cardiovascular Business - January/February 2009 Contents First Word Electrophysiology Roundtable Forum: A Candid Conversation about Profits, Procedures and Patients Heart Failure Care Gets Boost from Technology Emerging Technologies in Peripheral Vascular Interventions Stent vs. Graft: Choosing the Best Path for the Diabetic Patient with Multivessel Disease Cardiology Groups and Hospitals Strive to ‘Connect’ Seamlessly CT Beyond 64 Slices Clinical Study Digest: Kidney Disease & PCI; Women and Valve Disease Compact Echo Systems Come Up Big in Cardiac Care News & Views Reader Resources The ACC Corner

Cardiovascular Business - January/February 2009

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