With patient engagement such a hot Stage 2 topic, it’s no wonder CIOs are looking to ramp up the pace of their portal rollouts. And Bill Byers, VP/CIO, Western Maryland Health System, is no exception. But, more than that, Byers is also looking to get his staff and community docs up on an EHR as step 1, then facilitate a robust data flow as step 2. All of which he’s doing with an eye to keeping the interface picture manageable to promote scalability, thus also increasing the chances of long-term overall success. To learn more, healthsystemCIO.com recently interviewed Byers for our Podcast series.
- About WMHS
- Running a Meditech Magic shop, 5.6.4
- eClinicalWorks on the physician practice side
- Working Dragon into the documentation process
- Going down the patient portal path
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If you look at all the physicians in our community, well over half of them that have an EMR are using eClinicalWorks.
Just setting that up with eClinicalWorks is challenging enough, much less having to do that with all the different vendors that we have in our community so, indeed, the simpler we can keep it the better.
… from my informal discussions with the community, it’s something that I think is going to generate a lot of interest. There seems to be a lot of people that would like to have this kind of access …
Gamble: Hi, Bill. Thanks so much for joining us today to talk about your work at Western Maryland Health System.
Byers: Thank you.
Gamble: Why don’t you start by telling us a little about the organization just in terms of the number of beds and what you have in the way of ambulatory and specialty care, things like that.
Byers: Western Maryland Health System is located in Cumberland, Maryland. It’s a 275-bed hospital that recently opened in November of 2009. We also own an 88 bed resident nursing and rehabilitation center about 12 miles away in Frostburg, Maryland. In addition to being a trauma center, we offer services in oncology, interventional cardiology, open heart orthopedics, we have a nuclear cancer center. We do radiation. We just opened a wound care center in an observation unit in the past 12 to 18 months.
Gamble: When you said that it opened in 2009, this was a new facility? What did it take the place of?
Byers: Yes. Actually, in April of 1998 there were two hospitals in Cumberland that came together to form Western Maryland Health System. We had Sacred Heart Hospital and Memorial Hospital. They were both almost 250-bed hospitals each and formed Western Maryland Health System, and we operated as a two hospital system for about 11 years until we opened the new facility in 2009.
Gamble: So it’s just more convenient to have more services in one location?
Byers: Well, it certainly is more efficient to have all the services in one location. We were doing a lot of transports of patients back and forth depending upon the service that they needed, and it’s just a much better service we can provide to our community.
Gamble: In terms of physicians, do you have both owned physicians and docs who refer into the system?
Byers: Indeed we do. We have probably over 50 physicians that we employ in one fashion or another. We have almost 20 hospitalists that are part of our employed physician group and then, of course, in the community about another, depending upon how you count it, 80 to 100 providers in our community that also work with the hospital.
Gamble: Let’s talk a little bit about the clinical application environment starting with the hospital side — you’re using Meditech?
Byers: Indeed we are. We are Meditech Magic shop. One of the hospitals, Sacred Hospital, is Meditech Magic starting back in 1992 and, when we formed the health system, one of the first decisions we made was to standardize both hospitals on the Meditech platform, and that’s been very successful for us.
Gamble: What version are you on right now?
Byers: We’re under their Meaningful Use version. We’re on 5.64 and making plans for the next revision to get in line for Meaningful Use Stage 2.
Gamble: What about ambulatory, what EMR are you using?
Byers: A little over two years ago, we went out with both our employed and our community physicians and we had a fair where we brought in a couple of different vendors where we reviewed the offerings and as a group. We came to decision to go forward with eClinicalWorks, so now we’re on their version 9 platform. We’ve been live with the ECW EMR for our providers now since, I guess, a little over a year. We started rolling out the EMR in January of 2011 and, at this point, we have completely installed the EMR for our employed physicians. If you look at all the physicians in our community, well over half of them that have an EMR are using eClinicalWorks.
Gamble: That makes things a little easier.
Byers: Yeah, it does, and one of the things that we do is we interface our results from the hospital to all of our eClinicalWorks practices, so that’s an added advantage, plus we were able to leverage the pricing that we got as a bigger organization with lots of physicians. We were able to extend that pricing through a deal with eClinicalWorks and Dell to provide the community providers with essentially a turnkey solution, a turnkey EMR that they could deploy and be very compatible with. So, while we don’t actually do the installation, we have extended the deals. We have two physician support analysts that have helped out some of our community providers that are using eClinicalWorks to leverage some of that knowledge. We also host user groups, or the clinicians, and the front office folks, so that we can share lessons learned and different ideas on how to better use the system.
Gamble: Are you happy with the adoption rates you’re getting?
Byers: Yeah. I think overall if you add eClinicalWorks and the other vendors at this point we’re, I don’t have an exact number for you, Kate, but well over 70% of our community providers or all providers in the community have deployed some sort of EMR in their practice so, yeah, I’m rather happy with that percentage.
Gamble: Yeah, I mean as you would imagine that’s an issue that we talk to CIOs a lot about and, if there’s a case where there is one specific vendor that they can get a lot of these physicians on, obviously it just makes life easier, and it does seem to drive up those adoption rates somewhat.
Byers: It does and I will be honest. As I mentioned, we have these clinical results interfaces that go back to our eClinicalWorks EMRs. We want to expand that so that we can have information flow more readily across a continuum of care. Just setting that up with eClinicalWorks is challenging enough, much less having to do that with all the different vendors that we have in our community so, indeed, the simpler we can keep it the better.
Gamble: Right, definitely. What are some of the other projects on your plate? Are you doing CPOE at this point?
Byers: Well, we are actually live with CPOE in our ED. As you can imagine, Meaningful Use is something that’s very important for us organizationally and we were looking to where we can get the biggest bang for our bucks. The ED was certainly the first place we looked. In addition, the providers that staff our ED were actually anxious to use CPOE, so it was just a natural fit from a clinical perspective as well. We are also deploying real time documentation for our hospitalists using Dragon Medical Edition and we’re getting ready to roll that out to our ED providers this summer, probably in July, and that pilot with our hospitalists is going quite well.
We’re in the process of deploying 3M’s Computer-Assisted Coding and we’re reviewing the possibility of even being a Meditech beta site for the Nuance 3M Computer-Assisted Physician Documentation system that is being rolled out later this year. Now, of course, there are other things. I think today is actually the go-live for our new homecare software — called Maestro from Meditech — and we’re in the beta stages now testing with our select employees for rolling out a patient portal for the use of our patients to access clinical data.
Gamble: Now, with the patient portal, how will you handle the rollout? I know that is something very important in Stage 2.
Byers: We don’t really have a steering committee, but we just had a group of people that met to discuss the portal, and the group of, I guess it was 20 or so people, they will be the very first users to experience live data in our portal. We’ll get some feedback from that group and hopefully shortly after that, perhaps in June, expand it to our employees and get their feedback with a mid- to end-July expected rollout to our community. We’re kind of taking it slow, but the portal, at this point, is basically ready to go live. We just want to do it in a thoughtful fashion.
Gamble: Would you ever foresee having a group of superuser patients give you feedback?
Byers: Well, one of the suggestions yesterday from our CEO, which I thought was excellent, was not only should we sign up for it as employees, but we should encourage our spouses and basically elicit their feedback as to how usable it is, how easy it is to get logged in, an account setup, that kind of thing. That will probably be the group you just referred to, which I think is an excellent idea, not employees but yet someone who we can get some very good feedback from and not make it completely public until we get some of that feedback to us.
Gamble: It provides a different perspective. They might notice things employees won’t.
Byers: Yeah. So we’ll see how that goes. Like I say, we are, as of next week, going to roll it out to the group that just met, and then, probably at the beginning of June, to expand it to employees. We’re very close to actually having that completely live. We’re very excited about it.
Gamble: Yeah, it’s definitely a plus for patients, as we see them get more engaged. It’s a nice selling point to have that.
Byers: It is and, at least from my informal discussions with the community, it’s something that I think is going to generate a lot of interest. There seems to be a lot of people that would like to have this kind of access, so I’m just glad we’re able to do this now.