Phyllis Teater, Associate VP/CIO, Wexner Medical Center at The Ohio State University
When you achieve something accomplished by less than 100 out of more than 5,000 U.S. hospitals, you’ve hit the healthcare IT big time. What’s even more impressive for Wexner Medical Center at The Ohio State University is all four of its hospitals achieved HIMSS Analytics Stage 7 designation at the same time. To learn more about the organization’s IT journey, along with the career of its CIO Phyllis Teater, healthsystemCIO.com recently caught up with the Columbus-based executive.
Chapter 3
- The Epic installation — lessons learned so far
- “It felt like we were planning the D-Day invasion”
- Breaking down business and clinical intelligence
- Empowering patients with portals, Stage 2 concerns
- The pursuit of personalized medicine
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BOLD STATEMENTS
The amount of resources, attention and energy that we had to spend on the training process far exceeded anything we’ve ever done before as an institution.
… it takes the vision of your institution — that they are based, and wanting to be even more based, in data-driven decisions …
We want to be sure that the way we provide the information — that we think makes sense from a workflow perspective — matches the expectations of Stage 2, and we’re not sure that it does.
Guerra: Before we jump on a few other issues, I just want to touch on the Epic installation. A lot of your colleagues, CIOs out there, are either implementing Epic, hoping to, planning on, or dreaming about {laughing}. Can you share anything that you have learned, pitfalls to be avoided, etc?
Teater: It’s the most functionality in the history of our institution we have ever gone live with on the same day, and it was pretty much the broad breadth of everything from every registrar, every scheduler, everybody was doing something different starting on that day. The amount of resources, attention and energy that we had to spend on the training process far exceeded anything we’ve ever done before as an institution. It even exceeded the expectations we had going into the project.
We trained 14,000 people in eight weeks. We had about 1,000 people a day going to training classes all over Central Ohio. We did not have enough classrooms even on our university campus because, of course, the students were in session, so we couldn’t use classrooms that had some of our 50,000 Ohio State students in them.
The logistics related to, I mean, just take for instance training materials. Getting the training materials for 1,000 people printed and sent to the right location across 27 training rooms all over Central Ohio was a logistical nightmare. Let alone transporting the trainers and telling people where to park and, I mean, just the sheer magnitude of that coordination effort was, I think, the biggest task we undertook as part of the installation.
Guerra: It sounds like a military operation of that size {laughing}.
Teater: We felt like we were like planning the D-day invasion, frankly. We joked quite a bit about that.
Guerra: You channeled Eisenhower.
Teater: Yes {laughing}.
Guerra: Well, so that’s nice to have on the résumé.
Teater: It was a fascinating experience. We just had some wonderful people here that helped to lead that for us. We would not have been successful without them.
Guerra: Let me touch on a few things that were in the release I read about the Stage 7 announcement. Just a few things from some quotes, and you can expand on them. “Outstanding clinical and business intelligence” — certainly that is something I’m hearing more and more from every CIO I speak with. “We got lots of data. What are we going to do with this stuff?” Obviously, you’re doing some good things in that area. What can you tell me about it?
Teater: First, I think, it takes the vision of your institution — that they are based, and wanting to be even more based, in data-driven decisions so, without that vision for an institution, there isn’t want or need to transform your data into actual information. I think that we have had that, and we have been working very hard to advance that vision, so that we, as an institution, understand our data, and it can help us to make forward-thinking decisions. In our environment, we have statistics and metrics and dashboards and score cards and all of the things in a BI environment that one would expect to see, and they are used.
We see them in meetings, people open up meetings with them. We see some pretty significant usage for research, which is special to us as an academic medical center where we can provide data and analytics to support everything from individual research studies and grants, to the way that we look at enrollment in clinical trials. We utilize the data from our electronic medical records to drive the data that we see in publications that come out in all sorts of peer review journals. It’s really building that adoption over time and being able to have the organization have faith and have the vision to utilize that data to make decisions.
Guerra: It sounds like you are proponent, a believer, in patient portals, empowering patients. Tell me what you’re doing in that area?
Teater: We have Epic’s MyChart product, what’s called OHSU MyChart, here. We have over 32,000 patients that are utilizing that patient portal. We use it, we believe, to empower patients, and we do see in our patient surveys that they feel better connected to their care through the use of that product. The functionality we’re using today – we are looking actually to expand, but the functionality we’re using today include secure messaging with your physician in their office, so with the caregivers, any of the caregivers, at that office. We do set-up specialized workflows for offices to help them manage the influx of patient messages.
We also allow patients to refill prescriptions. They can see their current med list and order referrals where appropriate. It does get routed to the appropriate clinician at the practice who is licensed to refill that prescription and then, of course, through our interface with pharmacies that can send the prescription directly to the pharmacy, so the patient with one online interaction can get a message back within minutes, sometimes that their med is ready to be picked up. We also do provide some proxy functionality for families of patients to help manage some of their information in the chart. You can see your scheduled appointment. You can review results, lab results and some other results, but primarily lab results, as patients look to manage some of their chronic conditions.
Guerra: I read that some people were troubled by some Stage 2 proposals around patient engagement, patient empowerment, basically the hospital having to provide information to patients within a certain period of time. Does that sound familiar to you, and does any of that concern you?
Teater: Yes, I think some of it is concerning. We want to be sure that the way we provide the information — that we think makes sense from a workflow perspective — matches the expectations of Stage 2, and we’re not sure that it does. For instance, we have some kinds of results where we have deemed, clinically, that releasing them quickly to a patient could cause alarm, could cause some patient reactions that we would like to help them with.
We have some different processes for some things. For example, we do not release drug testing results because of the security issues. It’s a very small portion, but some of the Stage 2 metrics will get at that, and we’ll have to make some decisions about how — and I’m sure there will be some in the comment period from the industry — those things match up with the best patient care that you can give.
Guerra: One other area that was mentioned was personalized health. Can you talk about what you’re doing in this area?
Teater: Personalized medicine is a focus here at Ohio State. We have an institute for personalized healthcare that is making some advances in this area. We have done some things early on to help with this. This is still largely, I would say, a research issue. It has not advanced so much because of many of the issues surrounding it as the standard of care for patient populations, but it’s starting to get there. We have some clinics that are doing this kind of work, either testing or genetic counseling, that are using Epic. We are doing some on the front end with some of the care processes that help folks have even more of an integrated record, so that part of their care is being documented in Epic, where appropriate, also.
We are in a partnership with Coriell that is allowing us to move information, really a first trial, related to genetic testing back and forth between our electronic medical record, Coriell and then our information warehouse, which is a research tool that’s used by our researchers. What is the best flow of information between entities as you look to really bring that genetic information to bear on the point of care? We’re doing some research there and understanding that and designing some new flows of information that may help us to get it done.
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