Of the many skills required to be an effective CIO, perhaps the most important is the ability to learn from past experiences and apply that knowledge going forward. At Trinitas Regional, Judy Comitto is leveraging the lessons learned from the organization’s CPOE go-live to facilitate an easier path for rolling out physician documentation. In this interview, Comitto talks about how Trinitas hopes to benefit from voice recognition and document imaging, and how IT leaders are working to balance the need for discrete data with the burden on clinicians. She also shares her thoughts on Allscripts going private and discusses her work with Jersey Health Connect.
Chapter 2
- Managing interfaces
- CIOs working with in-house counsel
- Doing storage with Dell in the cloud
- Allscripts going private? “The whole thing makes me very nervous”
- “It was the world that moved faster than they did”
- NJ HIMSS and the power of local networking
- The state of HIE in NJ
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
Podcast: Play in new window | Download ()
Subscribe: Apple Podcasts | Spotify | Android | Pandora | iHeartRadio | Podchaser | Podcast Index | Email | TuneIn | RSS
Bold Statements
The only tricky part about it now as opposed to then — although of course, we have the same concerns 20 years ago — is the security piece and the responsibility we have for the vendor. That is now very awesome and requires a real knowledge of what the requirements are and how we stay on top of it.
On the acute care side of it, the product they have is pretty strong. We’ve been able to work with it and I’m hoping that whoever buys the company will in turn see the value and be able to do what they haven’t been able to do yet — integrate it with an ambulatory product so that they can compete with the Epics and Cerners.
We are doing a lot to try to get scholarships out. We use funds for scholarships and that grows every year. I think that’s really worthwhile and it benefits the New Jersey-Delaware Valley and the whole east coast, bringing professionals or having them trained appropriately.
We’re sending a lot more data. Some of the HIEs are just sending lab results. We would have had that done two years ago, frankly, but because we’re doing demographics, allergies, all results, CCDs — that’s a big bite.
What’s nice about it is they offer other modules, and if hospitals who are part of Jersey Health Connect want other things, they can just go and contract with them. So there’s a wide variety of options available out there depending on where you are with your strategy and your electronics.
Guerra: We talked about a lot of different products and there are different products within the Allscripts suite of products, so a lot of interfaces, I’m picturing. Tell me about your interface situation and the kind of team you have working on that and the engine if you’re using it, and just the challenge that may present. On paper you have a flowchart of all these applications and the arrows going here and there, but it’s not that easy putting it together and keeping it all aligned, correct?
Comitto: Absolutely, and this is where I’m going to drive this back to Hyland and their product OnBase, because we didn’t just sign for a document imaging system. We were signing for a product that will be integrated directly in Sunrise, at least for chart deficiency, and the burden then does not fall on medical records, so we’re beginning to remove some of those road blocks that they encounter in the chart. There is a tight integration, and that’s included in the agreement. The agreement took us a very long time because we needed Allscripts’ commitment and we needed Hyland’s commitment. We needed to get all the correct wording in the agreement that all of this would be taken care of. Once we signed the agreement, we actually had our work plan at that point, because we’d done so much of the analysis by paralysis early on, and it takes us a long time nowadays because we do integrate everything.
So any agreement is heavily integrated and heavily interfaced. How do we do that? We’re fortunate that for Sunrise, I have staff that will create the interfaces on our side. Of course we need the vendor on the other side to do their side of the HL7 interfaces. But also, Allscripts has the open database that they’re pushing that allows outside vendors to write into the product, which is what Hyland will be doing, and I believe they have done this at other Sunrise sites already. That will be helpful, but we’ll need something called ObjectsPlus programming, which we will have done for our product in order to make that happen. So it will reside within the work areas that the physicians are in at the time. They’ll be able to review the medical record’s deficiencies, finish it in Sunrise, and it will then populate in OnBase.
Guerra: I was just thinking that you must have spent quite a bit of time with the hospital’s legal team to work on all these contracts.
Comitto: Yes, it is a big process. I will admit that. I do a lot of it early on myself, and they do the final reviews and either the in-house counsel will review it or they will send it out to a counsel who specializes in these areas.
Guerra: Things are moving so quickly. We get to the point probably, I’m sure, where you have to make sure legal is up on some of the nuances of integration and the key technology issues that they may not even know about.
Comitto: That’s correct, and that’s why they do use outside counsel from time to time.
Guerra: So they use lawyers that specialize in healthcare IT?
Comitto: Yes.
Guerra: Wow, that’s a good niche these days, huh?
Comitto: I would think so.
Guerra: I’ll start grooming my three-year-old for that.
Comitto: I was just going to say you’re planning to go back to law school now, right?
Guerra: I’ve had enough school. I have to make money now, Judy. My wife wants me to stop spending it and start making it.
Comitto: There you go. And then enjoy it.
Guerra: Enjoy it, right. So that’s good. You’re very busy, a lot of work with that stuff. Anything else on your plate that comes to mind?
Comitto: Don’t you think that’s enough?
Guerra: I think that’s enough for the morning, but what are you doing in the afternoon? That’s the key question.
Comitto: Of course there’s the usual maintenance. In any institution, things become obsolete; operating systems become obsolete. Upgrades are required. So we’re busy on that. We’re also in the process of a very big RIS-PACS upgrade, and along with that, we’ve now changed our storage and we have signed an agreement with Dell and they will store it in the cloud.
Guerra: And this Hyland product you talked about is cloud-based, so you’re a cloud fan.
Comitto: We are a cloud fan. We’ve been a cloud fan for a long time under many different names, going back 20 years ago.
Guerra: Remote hosting?
Comitto: Yes, and outsourcing. Remote hosting, outsourcing, cloud — they can call it what they will.
Guerra: Right, we’ll take it.
Comitto: Yeah, to make it sound like something new and different, right?
Guerra: Right, you handle it on a server somewhere else. That’s what it’s called, right?
Comitto: Right. The only tricky part about it now as opposed to then — although of course, we have the same concerns 20 years ago — is the security piece and the responsibility we have for the vendor that we deal with. That is now very awesome and requires a real knowledge of what the requirements are and how we stay on top of it.
Guerra: Then you bring in legal again to talk about that contract.
Comitto: That too.
Guerra: Right. Let me ask you about Allscripts. The latest word we’ve been hearing out there is that they’re accepting bids to go private. So companies go public, companies go private, and everybody thinks going the other way is going to solve all their problems. What are your thoughts about Allscripts possibly going private?
Comitto: Well, the whole thing makes me very nervous, of course. And then with MyWay, I have to go talk to a doctor here, and I’m not sure he knows or even heard the announcement. So it is a little nerve-racking and we think that on the acute care side of it, the product they have is pretty strong. We’ve been able to work with it and I’m hoping that whoever buys the company will in turn see the value and be able to do what they haven’t been able to do yet — integrate it with an ambulatory product so that they can compete with the Epics and Cerners.
Guerra: That’s right.
Comitto: I think those are the chief competitors out there, but they’ve really taken a fall from where they used to be as Eclipsys years ago, that is true. But again, it was the world that moved faster than they did.
Guerra: Yeah, and you just hope that if it gets bought and goes private, that whoever’s doing the buying, as you said, is doing it for the right reasons and not because they think they can extract more money out of the client base.
Comitto: That is true. That would be a problem, of course, for the customers that they still have. But we’re going to wait and see, and hopefully we’re all happy with the results of that and we move on.
Guerra: What if nothing happens? What if it just stays public? Do you deal with it day by day? Is that sort of how you’re handling it?
Comitto: My biggest concern is customer support and development. Those are the two important things once you’re on. So if the product is not going to be developed any further, that’s a big issue, and if no one can help us with our day-to-day problems, certainly we would have enormous problems. I think someone is going to want to buy them. I think that the software can do it, perhaps with more guidance, different guidance, or the same guidance. I’m not sure exactly what kick in the butt it needs, but they still have loyal customers and people who are heavily invested in the products themselves.
Guerra: But you need to know as a customer that it is getting the same R&D attention that your competitor health system’s product is getting; that your product is not going to sit in a 2012 time-lock while they move forward, right?
Comitto: Yes, and I think that’s going to be somewhat recognizable just for the fact of what they need to do for Meaningful Use Stage 2 and 3. Without that, we could have sat back for a couple of years busy with all of our other projects, but this is going to be readily apparent if they’re not ready.
Guerra: Yeah, good point.
Comitto: So it’s going to come forward very quickly.
Guerra: Right. I just want to talk a little bit before I let you go about New Jersey HIMSS. I saw you last week at the conference, it was a pleasure. You are on the board, correct?
Comitto: That’s correct.
Guerra: How long have you been on the board?
Comitto: About three years.
Guerra: Three years. Okay, I just want to talk a little bit about why something like that is worth your time in general, for other CIOs listening. Just give me your thoughts about getting involved with local HIMSS chapters — what the benefit is to you and then how you might compare your activity with New Jersey HIMSS with your activity with the New Jersey National, I don’t know if you’re involved other than just going to the yearly show or CHIME.
Comitto: That’s interesting. I think all of those organizations are vitally important to healthcare IT nowadays. As for NJHIMSS, and by the way, we partnered with Delaware Valley HIMSS as well for this particular conference, is that you can’t always get all the people in your facility to go to these big national conferences. Money is tight for travel right now. So this gives us an opportunity to bring some folks out.
And obviously, as you can see, it grows from year to year. There’s been well over 700 or even close to 800 people, last I heard, from last week — I don’t even know what the total count was — that did attend this and we had over 90 vendors. So there is great interest in being able to be local in your regional area, so those sales folks that had tables were able to talk to the people in their sales territory, versus national HIMSS, where it’s everyone, everywhere and international I guess, which is good for corporate.
But for the individuals coming to these meetings, people know each other. There’s a lot of networking and a lot of education. I think that the breakout sessions were really very pertinent and very excellent. We spent a lot of time pouring through those tracks, making sure that we picked the right presentation. We will let people know whether we believe their presentation needs to be adjusted. We want it to be vendor agnostic when they do a track now. So there is a lot of work going on.
Also, we are doing a lot to try to get scholarships out. We use funds for scholarships and that grows every year. I think that’s really worthwhile and it benefits the New Jersey-Delaware Valley and the whole east coast, bringing professionals or having them trained appropriately. New Jersey HIMSS does a lot in that respect — a lot of mentoring at the local academic institutions goes on. It is a big commitment by a whole lot of folks here in New Jersey and we’re a very active chapter.
Guerra: Well, I thought it was an excellent show and I enjoy it every year.
Comitto: Yeah, and I’m hoping each year it gets better.
Guerra: I have a feeling it will. It’s a great group of folks.
Comitto: Yeah, so we’re working on that. I’m also a board member for Jersey Health Connect, which is one of the four HIEs in New Jersey, or HIOs, as we’re calling them now.
Guerra: I wanted to ask you a little bit about that. I’ve heard different evaluations of the HIE situation in New Jersey from a lot of things going on to a pretty big mess in terms of I guess competing entities and whatnot. But what can you tell me about the New Jersey HIE situation?
Comitto: Well, I’m not going to talk about the political part of it. I try not to get too involved in that. However, we’re working on getting Jersey Health Connect standing so that our members are sharing information. We’re at 20 hospitals now. We had two or three sign on just in the past couple of weeks. We’re a pretty big entity. I’ll tell you where Trinitas is right now. We’re in test mode so our interfaces are out there and we’re going to test it, and we should be ready to go. We are having some problems with CCD with our vendor, so once we get that corrected, they’re not major issues. We’ll be ready to send CCDs as well.
So what I think might make us different than a lot of other states — and I won’t talk about specific HIEs, but states — is that we’re sending a lot more data. Some of the HIEs are just sending lab results. We would have had that done two years ago, frankly, but because we’re doing demographics, allergies, all results, CCDs — that’s a big bite. So that’s happening and we’re very, very pleased with how we’re moving along. Could it have been faster? Probably. Do we have time and resources to make this our only priority? Absolutely not.
Guerra: No.
Comitto: So one hospital moves faster, and then one falls back. We started fast and we had some issues and we fell behind. That’s how it goes with any of these projects. It’s not scientific at best. So yes, we’re pleased with where we’re going. Now the state has been changing their mind from time to time as well. That hasn’t stopped us from trying to get ourselves up and operational. We do have some of our hospitals up and operational. Atlantic Health is up and exchanging data with physicians, as is JFK. And I’m not sure about Barnabas and St. Peter’s, but I believe they’re up there. What we haven’t done —and they’re all in testing — is we haven’t started exchanging amongst the hospitals themselves and that’s going to happen in the next couple of weeks.
It will be in test, so at least we could see how this all looks. So we’re really excited. The vendor we’ve chosen, Relay, we have an agreement with them about functionality we will offer through Jersey Health Connect. But what’s nice about it is they offer other modules, and if hospitals who are part of Jersey Health Connect want other things, they can just go and contract with them. So there’s a wide variety of menus, so to speak, of options available out there depending on where you are with your strategy and your electronics.
Guerra: Well it sounds like you’ve got your hands full, but you’re doing great stuff.
Comitto: We’re trying our best.
Guerra: That’s good.
Comitto: Yeah.
Guerra: All right, Judy, that’s about all I had for you today.
Comitto: Okay, great. We’ve talked about a lot of different things and it’s always a pleasure speaking with you.
Guerra: Always a pleasure, and I hope to see you again soon.
Comitto: Great, absolutely.
Guerra: Have a great day. Thank you.
Share Your Thoughts
You must be logged in to post a comment.