Maureen Hetu, CIO, Lourdes Health System, Chapter 3

Being CIO of a two-hospital system within the massive Catholic Healthcare East superstructure presents opportunities and challenges for CIO Maureen Hetu. On the upside, her facilities are able to afford advanced technologies they would never have been able to obtain on their own, while, on the challenge side of the equation, dotted-line governance and having “multiple” bosses means going out of one’s way to keep everyone informed. But those are challenges she’s taking in stride as Hetu works to deepen the usage of Siemens Soarian clinicals at her hospitals. To learn more about her HIT journey, healthsystemCIO.com recently caught up with the long-time executive.

Chapter 1

Chapter 2

Chapter 3

• HIE work with Novo/Medicity/Aetna
• Is all healthcare, like politics, local?
• BYOD strategies

LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED

Podcast: Play in new window | Download (10.9MB)

Subscribe: Apple Podcasts | Spotify | Android | Pandora | iHeartRadio | Podchaser | Podcast Index | Email | TuneIn | RSS

BOLD STATEMENTS

We’re in so many geographic areas that if you think about it, it probably doesn’t make sense that we’d get a lot of clinical value out of having an HIE just for our patients. The power really comes in being able to share data within our local markets, with the local providers, so that they can get a complete picture of the patients’ healthcare across the continuum.

Just from a philosophical perspective, I can’t imagine that a National Health Information Network is useful to intercede and improve the healthcare of a specific individual.

So from our perspective, the data is secured and it’s protected, so we’re not seeing that as being a significant security issue. I’ll tell you — it took us years to get our security folks to that point but, at this point, we’re not seeing that as being an issue.

Guerra: You mentioned that CHE has Siemens and Meditech products. Is there any attempt to get data flowing between those two? Do you have any situations where there are two hospitals – you have two hospitals in Lourdes — near each other that are each on a different product?

Hetu: I don’t know that we’ve actually come across it yet. Although we do recognize, from a Catholic Health East perspective, that we do need an HIE. There was conversation originally about getting all the CHE hospitals to a single HIS platform because we’d like to be able to aggregate and normalize the data. It would be very powerful if we could get to that point. The investment to do that is monumental and given, all of the Meaningful Use deadlines, we can’t necessarily take that on at this point. Catholic Health East has already recognized the need to develop an HIE strategy, and it’s moving down that path.

Guerra: Let’s talk a little bit about your work with Novo, which was acquired by Medicity which was acquired by Aetna. Do I have that right? J

Hetu: That was an interesting path, wasn’t it?

Guerra: Yes — follow the company. Should we refer to it as Novo? I guess it wouldn’t make sense to refer to it as Aetna.

Hetu: No. Either Novo or Medicity.

Guerra: Okay. So tell me about your work there and how that builds on or supplements what you’re doing with Soarian.

Hetu: Sure. Actually we invested in what was then Novo Innovations several years ago. It was part of a physician alignment strategy. So we recognized that we had physicians who were sending patients to us, and we were looking for an opportunity to make their lives easier and, perhaps, they would ultimately see us as being a more convenient provider and feel comfortable sending more patients to us. So we were looking at a strategy that would align us with the docs, anticipating that if we could easily integrate our clinical data back into their EMRs, that might be a useful strategy.

Interestingly, what we found though is, at that point in time, and we’re probably (I want to say it might have been three or four years ago) we did not find many takers in terms of physician practices. There were not many of the private physician practices in our market who had actually deployed EHRs. It was only the very large specialty groups that had even implemented them at that point in time. So we integrated with a very large urology group. We had inquiries from a cardiology group at the time, but then they decided they needed to replace their EMR. So although I had the product — we actually sent a significant amount of data into the product, laboratory results, radiology, all the transcribed documents — I didn’t see a lot of physicians take advantage of it.

The other area where we used it was actually participating with the Camden Coalition in their health information exchange. So that became our mechanism to integrate data externally. We haven’t necessarily integrated any data into our EHR at this point, but it at least gave us the capability for any other physician practices that needed it. We were at the point that we were ready to participate in the HIE, that we could more easily take our clinical data and participate.

Guerra: Are there any HIE talks coming out of the CHE brain trust over there? You’ve done some work with Medicity, that’s one of the major vendors in the HIE space. Do you say, “Maybe we can use these guys for a larger HIE initiative?” Is any of that talk happening?

Hetu: I think CHE went through and did another RFP looking for an HIE vendor. At this point, I’m not sure if they have actually reached a final selection or are ready to publish who their final vendor will be. But they very definitely see themselves creating an HIE. I think, at this point, we all recognize that all of the regional healthcare corporations of the local ministries will participate in HIEs in their demographic market. So Lourdes participates with the Camden Coalition. St. Francis is participating with an HIE called St. Michaels in Newark. But CHE is looking for a mechanism to more easily support that.

We’re in so many geographic areas that if you think about it, it probably doesn’t make sense that we’d get a lot of clinical value out of having an HIE just for our patients. The power really comes in being able to share data within our local markets, with the local providers, so that they can get a complete picture of the patients’ healthcare across the continuum.

Guerra: That’s definitely true. When we think about that, we wonder about the value of the NHIN, that national network they’re trying to build. If all politics and all health is regional, what are your thoughts on the NHIN and some of the work ONC is doing around that?

Hetu: I have to say that I’ve been so consumed locally with all the initiatives that I haven’t been following it very closely. Just from a philosophical perspective, I can’t imagine that a National Health Information Network is useful to intercede and improve the healthcare of a specific individual. But you could see the benefit of being able to aggregate the data and being able to identify and impact the population health. But other than that, I’m probably not in a position to comment.

Guerra: First organizations have to get their houses in order, before they can think about integrating with other entities, right?

Hetu: Right. The other challenge is getting the docs all deployed and getting all of their records within an electronic health record. The reality is that the physicians that are part of the larger group sometimes have the ability to do that because they can get the capital to invest, but some of the smaller practices really struggle with that. The incentive has helped, especially for the physicians who qualify for the Medicaid incentive. It’s a little bit richer than the Medicare incentive but, even so, it’s still a challenge. Most of these private practices don’t have the wherewithal or the talent of a local IT organization that they can go out and easily deploy and  manage and support these technologies.

Guerra: As a health system, do you ever do any underwriting? When Stark was very popular did your organization do any of that Stark underwriting for EMRs?

Hetu: We analyzed it and brought it back a couple of times. But there are so many physicians and so little capital that it just turned out not to be an affordable strategy for us.

Guerra: Right. Do you know if a lot of the small practices in your area have taken advantage of any of the RECs out there to help them understand the products and some implementation issues?

Hetu: Yes, absolutely. I think that the New Jersey Regional Extension Center has been very active. I know that they’re reaching out to the individual physician practices. We’re starting to see a lot of them participating within the Camden Coalition and the HIE. I think that in New Jersey, it seems to be a very positive force that has helped the physicians.

Guerra: In terms of the physician alignment, do you find a lot of requests from physicians, both the employed and the independents, who want to be able to look into the hospital records on their own handheld devices?

Hetu: I see a lot of physicians walking around with iPads. I see physicians with their smart phones, and Soarian does support that. So they can access the portal and be able to view results from their iPhone or smart phone, from their iPads. They can actually write orders from their iPads, not necessarily from their iPhones. We’re deploying an app that will let them view the radiology images, the PACS images from an iPad or an iPhone. I think that there is a cool factor to doing it on your phone. I don’t know how effective it is though, just given the screen size and the amount of data that you’re trying to present to them. But an iPad or a tablet type of device, I’m starting to see a pretty significant concentration there.

Guerra: So you haven’t found any major security issues with someone using their own iPad to access Soarian?

Hetu: We’re not sending any data to the device and there is a significant amount of security in getting access to the portal. So from our perspective, the data is secured and it’s protected, so we’re not seeing that as being a significant security issue. I’ll tell you — it took us years to get our security folks to that point but, at this point, we’re not seeing that as being an issue. They’re coming in securely through our portal accessing the data, but we don’t store anything on the device.

Chapter 4