Joan McFaul, VP/CIO, Glens Falls Hospital, Chapter 1

To most insiders, Epic’s installation in the ambulatory facilities of an organization with a different inpatient system augurs ill for the incumbent. But according to CIO Joan McFaul, that’s not necessarily the case. She said Epic and Cerner are coexisting peacefully, at least for now. To learn more about what the future might hold for Glens Falls’ application environment, and to hear about McFaul’s other projects at the health system, healthsystemCIO.com recently caught up with the New York state CIO.

Chapter 1

• About Glens Falls
• Cerner inpatient, GE Centricity for sched/reg, MPI
• Epic selected for the practices
• “We’re coexisting at the moment, and it’s working well … “
•  Bringing docs into the selection process

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

Podcast: Play in new window | Download (11.5MB)

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

BOLD STATEMENTS

It turns out that there are organizations, although they are few and far between, that have both Epic and Cerner installed and have done so successfully. UPMC is one organization I can point to. It didn’t necessarily mean that we were going to go one way or another. As a matter of fact, we’re coexisting at the moment and it’s working well.

… we’ll ultimately make a decision on: do we stay with this and optimize two, possibly three, vendor environments or do we look to consolidate? Those are the questions that we have on a daily basis so we’re continuing to evaluate that.

many physicians find the whole EMR a challenge because it does impact their productivity. It is always changing, and so you want to try to point out all the benefits that you possibly can to help them make it an easier thing to swallow professionally and personally.

Guerra: Good morning Joan. I’m looking forward to talking with you about your work at Glens Falls Hospital.

McFaul: Thank you, good morning Anthony.

Guerra: All right, let’s start by talking a little bit about the actual hospital. Tell us the size, the scope, if there are any ambulatory owned entities, physician make up, that type of thing.

McFaul: Well, we’re the largest hospital or health system between Albany, New York and Montreal, Quebec, Canada. We have 410 licensed beds that are typically occupied in the mid-200 to high 200s. We have an emergency room that’s seasonally very busy. This is a big tourist area up here, so we run about 55,000 or so visits per year. We have most every specialty represented. We operate 18 physician practices ranging in size but, again, covering most every specialty. We do most things here. We have a very sophisticated and advanced cancer program. We have rehabilitation facilities. We have a behavioral health unit, and those are all in addition to most of your common service lines.

Guerra: So you get busier in the summer, right?

McFaul: Right, that’s correct.

Guerra: Yes, not much going on there in the winter?

McFaul: Well, no {laughing}. We still seem to maintain a fair amount of patient activity in the winter but the summer, between the end of June and the beginning of September, the uptake is pretty significant, especially in the emergency department.

Guerra: Okay, so 18 specialty practices. Let’s talk a little bit about your application environment on the clinical side first. What do you have going on in-patient and then tell me if you rolled anything out in those 18 practices?

McFaul: On the in-patient side, we have Cerner CPOE, and also we use Cerner in our pharmacy lab and radiology practices. On the physician practice side, we have recently completed a roll out of the Epic product and we are looking…

Guerra: Uh-oh {laughing}.

McFaul: We are looking to also implement that very soon in our behavioral health program, moving down into rehab and into our ambulatory cancer center program.

Guerra: Okay, you know why I said uh-oh?

McFaul: Yeah, I do.

Guerra: Uh-oh for Cerner {laughing}. It’s not good if I was the rep with that account. That would not be news that made me jump out of bed in the morning.

McFaul: Yeah, right.

Guerra: When did you go with Cerner? When did you put that stuff in?

McFaul: The CPOE was put in in late 2007, and we do use some portions of their scheduling and registration, but in a very limited fashion. We also have GE Centricity in our revenue cycle. We use that mostly for sched-reg, also our master patient index. Those are the three big applications that we have Cerner, Epic and GE.

Guerra: I know you’ve been there almost three years, which means you arrived about 2009, Cerner was in for about two years at that point. When was the Epic project selected for the ambulatory?

McFaul: It was approved by the board in December of 2010. We kicked off the project in early 2011 and started the roll out in February of 2012.

Guerra: You were there not too long before. What product was in the practices? Was Cerner in the practices?

McFaul: No. We evaluated Cerner for the practices. The practices were paper, except they did use Medent for practice management, so for billing.

Guerra: Okay, so you come in and it’s on paper in the practices and you look at Cerner and you make a decision not to go with Cerner but to go with Epic, correct?

McFaul: Well, I would emphasize that this was not Joan McFaul’s decision.

Guerra: {Laughing}.

McFaul: We went through a pretty painstaking process of involving as many people as we possibly could, and we evaluated what we considered to be the top vendors for an organization that would service Glens Falls Hospital or an organization like Glens Falls Hospital. We evaluated six options and among them were Epic and Cerner and GE as a matter of fact. When push came to shove, the group that was making the decision decided on Epic for the practices.

Guerra: Do you have to give them some context when they’re making that decision, so they know that there may be some loss of integration by not going with Cerner?

McFaul: Well, I think the decision was not made in complete isolation. Clearly, we had a lot of administrators involved in the final approval for Epic in the practices. But I will say that what we were setting up was a pretty competitive situation. It turns out that there are organizations, although they are few and far between, that have both Epic and Cerner installed and have done so successfully. UPMC is one organization I can point to. It didn’t necessarily mean that we were going to go one way or another. As a matter of fact, we’re coexisting at the moment and it’s working well.

Guerra: Okay.

McFaul: Although not as well as it can {laughing}.

Guerra: {Laughing}. So I still think I know what’s going to happen, but maybe my giggling was a bit presumptuous. Maybe Cerner’s hanging around for a little bit. What can you tell me – obviously, you know what I’m getting at, but what can you tell us, what can you tell the listeners and the readers about living with the two systems as they are and as the CIO, what’s working and what makes you say, “You know what, maybe this isn’t going to work”?

McFaul: I will tell you this. That both Epic and Cerner are great companies. We’ve had a good partnership with Cerner, in terms of a business with a lot of integrity, and the same with Epic. Ultimately, the decision is going to be what is best for the organization? What can we afford? What’s our long-term plan and how does that situate us now for the future? So as we are going through and evaluating those options, we’ll ultimately make a decision on: do we stay with this and optimize two, possibly three, vendor environments or do we look to consolidate? Those are the questions that we have on a daily basis so we’re continuing to evaluate that.

Guerra: Would be difficult to sell a system change to those who had just learned Cerner a few years ago?

McFaul: I think that whenever you’re going to make a change that affects physicians, you have to involve them in the discussion and in the strategy and in the decision. We have a very strong CMIO here who’s been very active and in touch with the physicians. We have a strong physician leadership that has been involved from the beginning. There’s no such thing as standing still. It’s not like you’ve selected a system and it never changes. Quite the contrary, it changes all the time, and it changes not just in look and feel, it changes in functionality. When you’re talking about a change, you might be talking about a change that is within the current system that you have or you might be talking about a change going to a different system. The question is where’s the biggest benefit coming from, and what’s the best thing for the organization. I think physicians are important customers. They’re critical and we’ve had a very good response on our install in the physician practices and word travels.

Guerra: Right, so it builds confidence in your department and it lends weight when you start making suggestions or giving advice, or however you want to put it.

McFaul: Or putting forth what we think should be evaluated.

Guerra: Recommendations, right.

McFaul: I think that the people who have been involved in IT here over the last few years have built up a lot of credibility. I think that when we put forth what decisions need to be made, it’s taken seriously. I believe that, and I think most people here would agree that it is taken seriously. I think many physicians, not all, but many physicians find the whole EMR a challenge because it does impact their productivity. It is always changing, and so you want to try to point out all the benefits that you possibly can to help them make it an easier thing to swallow professionally and personally.

Chapter 2