Like many organizations, Community Hospital Anderson is working to figure out the best way to increase patient engagement. For Joey Hobbs, that means going beyond just building a portal; it means reaching out to patients through social media to build brand awareness and loyalty, and then taking the next steps. In this interview, the newly-minted CIO talks about the benefits of being part of a large network while still having autonomy, the importance of timing when it comes to scheduling major projects, and his plans with Meditech Client Server. He also discusses how leading the Meditech implementation helped him to rise through the ranks at CHA, and what he learned while attending CHIME CIO Boot Camp and earning CHCIO certification.
- About CHA
- Affiliation with Community Health Network — sharing data but not the same system
- Participating in Indiana HIE
- Meditech in the hospital, Epic in physician practices
- Facebook & Twitter as the starting point to get patients engaged
- “It’s a multi-year strategy. You can’t just build a portal.”
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It’s a lot easier to accomplish things at a different pace in a single hospital facility than a large network. It’s nice to have the advantages of the large network but still have the ability to go at our own pace.
You try to be a little more sensitive to that over the years. Especially with all the changes, you’re going to have to take an upgrade at least every year to meet all the federal requirements, so you try to plan it as sensitive as you can with what options you’re giving.
We’ve been feeding results for at least 10 years to the IHIE. It’s been a successful program, and from what I understand, a lot of other areas are trying to model a system in their areas around what we’re doing.
Once you get these systems, and especially if the system has all the data tied together, I think it makes it easier for you to be able to do add-ons that pull efficiencies that you don’t necessarily get out of a single system.
I think we’re like everybody else in trying to figure out this patient portal strategy and trying to figure out patient engagement and what’s going to work best. The biggest concern is always how to keep the data safe, and once you figure that out, now how do we take it and make it effective.
Gamble: Hi Joey, thanks so much for taking the time to speak with us today.
Hobbs: No problem, thanks for having me.
Gamble: Let’s start off by getting some information about your organization. Tell us a little bit about Community Hospital Anderson.
Hobbs: We’re an affiliate of a larger community health network that’s based out of Indianapolis. We’re a licensed 204-bed facility; we run more around 145 beds with an average census are in the high 80s. We also own and operate five long-term care facilities around Madison County and additionally have a research center as well as a cancer center. We’re a Meditech hospital. We have Meditech Client Server — pretty much everything from the business side of the world through all our clinical applications.
Gamble: What system are you affiliated with?
Hobbs: Community Health Network, which is five hospitals, including Community Heart and Vascular Hospital (formerly The Indiana Heart Hospital). They also have affiliations now with Westview and then Howard Community Hospital out of Kokomo.
Gamble: How is that set up — does each of the hospitals have a separate CIO?
Hobbs: All of the affiliations are a little different. The network itself has a group of hospitals that has a CIO; that’s the network CIO. We are a non-owned affiliate, so we still have our own board. Our CEO reports to our board. I’m the CIO there, so we have the autonomy to operate what system we want to operate. So while we share lots of data within our network, we don’t share the same systems as the other hospitals in the network.
Gamble: I would imagine there are certainly some advantages to having that type of model.
Hobbs: It’s a lot easier to accomplish things at a different pace in a single hospital facility than a large network. It’s nice to have the advantages of the large network but still have the ability to go at our own pace as we want to.
Gamble: So there’s not that pressure for you to go off Meditech and on to a different system — you have that autonomy?
Hobbs: Yes. Our board makes those decisions. Back in 2005, we did share systems with the network and our product was sunsetted by GE before we had it installed. At that time our CEO made the decision to run an integrated system, so our facility made the decision to move to Meditech while the rest of the network made the decision to continue down the GE path at that point.
Gamble: What version of Meditech are you on right now?
Hobbs: We’re on Client Server 5.6.5 right now, with plans to move to 566 in the April-May timeframe.
Gamble: With 5.6.5, are you where you need to be for Meaningful Use? How are you situated with that?
Hobbs: We actually were ready to attest for Meaningful Use in 2011, but based on the guidelines or recommendations of AHA, we held off to attest until government fiscal 2012. So we’ve attested to year 1; our 90-day period was October 1to December 30 of 2011 (government 2012) and we have received those funds. We’re in the midst of our year 2 of stage 1 right now and we’ve received state money for years 1 and 2.
Gamble: Okay. And you said you have plans to go to 5.6.6 in the spring?
Hobbs: Yeah. Meditech just called me the other day; they’ve had to hold off a little bit for the government to make the final ruling so that they can code all the changes. So they pushed back our go-live a month or two, but with the change of only needing to do 90 days instead of a year for stage 2, it shouldn’t really be that big of a deal because we can wait later in the year to accomplish the 90 days. And we’re still working on a lot of the things that we know are coming that we don’t need a code change to be able to accomplish.
Gamble: So when Meditech wanted to push you back a month or so, was that something where you said, ‘okay, that gives us more time to do other things,’ or was it something where it threw off your strategy a little bit.
Hobbs: Honestly it wasn’t a big deal for us, because we were slated to go March-April, closer to April, and now we’re slated to go April-May closer to April. So for us we were already in the later part. It probably did affect some people a little more. Our staff is used to taking an upgrade every year anyway. So as long as I don’t make it in the middle of summer, they’re usually not too upset with me.
Gamble: Right, that’s true. I’m sure that a big part of it is timing because I imagine that it’s a lot of long hours from everyone.
Hobbs: When we went live with Meditech we did it over holidays because we had a February 1go-live. So throughout our build and everything, you had Thanksgiving, Christmas, and New Year’s, and you take holidays away from people. You try to be a little more sensitive to that over the years. Especially with all the changes, you’re going to have to take an upgrade at least every year to meet all the federal requirements, so you try to plan it as sensitive as you can with what options you’re giving.
Gamble: Certainly sometimes it’s beyond your control, but I’m sure you still feel terrible when you have to tell people, ‘listen, it’s all hands on deck right now.’ I’m sure that’s a really tough spot to be in.
Hobbs: Yeah. We’re blessed with a good staff that’s understanding and enjoys what they do, so it does make it a little easier. But I think more of the guilt you have about feeling bad is internal versus what they necessarily feel.
Gamble: Sounds like parenting.
Gamble: As far as HIEs, what are you doing in that space? I’m not sure what the HIE picture looks like in Indiana, but what is your involvement or what are your plans for that?
Hobbs: Actually, Indiana has one of the most advanced HIEs in the country.
About 10 years ago, the major health systems in the Indianapolis area formed the Indiana Heath Exchange, so we’ve been feeding results for at least 10 years to the IHIE. It’s been a successful program, and from what I understand, a lot of other areas are trying to model a system in their areas around what we’re doing. So any physician can get faxed reports by signing up and there’s nominal fees if they want to have those go electronically into whatever system they have.
We have an exchange set up within our own network where we publish lab and radiology results, cardio results — things of that nature. We’re not at the CCD stage yet, but obviously by 2014, everybody’s going to have to be there. So we’ll be there either through IHIE or through some local exchange that we’ll run within our own network.
Gamble: Now that you say that I do remember I’ve heard that about Indiana, that it is kind of a model state for HIEs because it’s just such a tricky thing with 50 states that have very different needs. It’s encouraging to see that the model can work if it’s implemented the right way.
Hobbs: Yeah, and even then it goes beyond just the 50 states because Indiana itself has, I believe, four actual HIEs. So the main IHIE covers the middle of the state and a lot of surrounding areas. But up around the Chicago area, in Fort Wayne, and down south there are actually some other local exchanges. It ends up being more regional, so there are a lot more than 50.
Gamble: Yeah, even in little tiny New Jersey we have a few different HIEs.
Hobbs: Oh yeah, I’m sure. And I don’t know if that’s necessarily the best for what we need to get to, but it has to start somewhere.
Gamble: As far as physician practices that you’re either affiliated with or are owned, how does that work in terms of data exchange?
Hobbs: We have a unique situation. Our facility is a little different. Our larger health network owns and manages our physician practices, and they’ve just implemented Epic in the physician practices on our campus. Now we do still have some independent physicians that have whatever system they might use, but I would say the majority are on Epic now. And we have a strong feeding of data from our Meditech system to their system.
As for the independent physicians, we encourage them to get with IHIE and have that data flow directly into their system if they choose. There is a cost that IHIE does charge them; it’s significantly less than what the hospitals pay. The hospitals fund a very good portion of the operational cost of the HIE so that it’s cheap for the physicians to be able to bring that right into their records. They can make the choice to take a fax and have a staff member scan it into their system or they could do it electronically.
Gamble: What are some of the other big projects you have on your plate? Obviously the Meditech upgrade is a big one, but what are some of the other things that you’re looking at maybe in the next six months or the next year?
Hobbs: Right now we’re getting ready to do a hardware refresh on our Meditech environment as we’re hitting the five-year range. We’re looking to do a lot of things with increased reporting. We’ve actually been working on a lot of deals this fourth quarter on some surveillance-type software for infection control in the pharmacy. Once you get these systems, and especially if the system has all the data tied together, I think it makes it easier for you to be able to do add-ons that pull efficiencies that you don’t necessarily get out of a single system. That’s one of the things we’re working on.
I think we’re like everybody else in trying to figure out this patient portal strategy and trying to figure out patient engagement and what’s going to work best. The biggest concern is always how to keep the data safe, and once you figure that out, now how do we take it and make it effective. I think those will be the big projects for us in the next six to 12 months.
Gamble: You mentioned patient engagement, and the other challenge there, as some people have told me, is getting the information and getting patients engaged. That seems to be an issue that a lot of people are struggling with.
Hobbs: We started our strategy about a year ago, and for us we knew we wanted to use Facebook and social media as the start point. We hired someone to just manage our Facebook and Twitter page and to drive in more patients. And in the six months since she started, we’ve seen probably 300 to 400 new people come to our Facebook page. A lot of it has nothing to do with health at this point; it was about creating a brand and building loyalty and having people see your stuff.
So phase 2 that we’re starting is we’ve partnered with Truven Health to be able to use some of their content to create WebMD-type data on our website that we can drive patients to. There are high-definition videos and educational things. We can then drive them to our page and link back to our physicians and start to try to create some things through that. It’s a multi-year strategy; I don’t think you can just buy a portal and say, ‘okay, now come.’ So that’s why we approached it the way we did — because there are so many people on Facebook that if you can start to drive them from there, we think it will be an easier start.