Sometimes it’s the experiences that happen early in one’s career that end up having a profound impact. Long before she was a CIO, Sonya Christian had mentors who helped her understand that “the business that we’re doing is healthcare. It’s not necessarily the business of IT.” Now she is a mentor herself, and believes the onus is on CIOs to help build the next generation of leaders. In this interview, Christian discusses her top priorities for 2014 — including expanding data exchange efforts and increasing portal adoption. She also talks about the benefits of being an early adopter, how her team is looking to cut costs, and her passion for healthcare.
- About West Georgia Health
- Being an early adopter — “We have the ear of the developers”
- Balancing her team’s “competitive spirit” with a dose of practicality
- The “on-ramp” to the Georgia HIN
- Expanding data exchange beyond owned practices
- Portal education during discharge
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Because we’re an early adopter, we don’t have to wait for the other sites to get their versions of the software. Typically we get it first and then we move on without having to wait in a large slotting queue.
You have to put a good dose of practicality with that, and then make sure that your competitive spirit is not setting you up for something that you can’t deliver.
Not only will we be able to send and receive to the offices and hospitals that are using us for an on-ramp, but we’ll be connecting with other regional HIEs in the State of Georgia, and that will expand our ability to exchange information across the entire state.
Once they’ve seen where those results reside, if there are any pending tests or pending results that will be completed after their hospital stay, it will give them that extra incentive to go and check those as well.
Gamble: Hi Sonya, thanks so much for taking the time to speak with us today.
Christian: Thank you, Kate, for inviting me to speak. I look forward to sharing our story every time I get a chance.
Gamble: Great, thank you. You and I talked about a year and a half ago, but in this industry, that may as well have been a decade ago just as far as everything that’s changed, so I’m glad we’re able to catch up. To start off, can you just give a brief overview of West Georgia Health — what you have in terms of bed size, ambulatory, things like that.
Christian: LaGrange, Georgia is located 75 miles southwest of Atlanta, and we serve Troup County and three surrounding counties in Georgia. We actually have 276 licensed beds, although we only operate 150 staff beds at this time. We have two nursing homes with a total of 250 beds. We have a standalone hospice, a home care, and assisted living complex. We have about 1300 full-time equivalents and we have $150 million net patient revenue annually. We do have an employed physician’s group that works with us that has about 12 physicians on board right now.
Gamble: Okay, so the last we spoke you were on Meditech 6.0 in the hospital. Are you still on that right now?
Christian: We are. We have actually upgraded our Meditech system to the version that’s necessary for State 2 Meaningful Use, which is actually 6.07 Priority Pack 2.
Gamble: And that upgrade is already complete at this point?
Christian: It is complete. We were the first hospital to go live with this version of the software. We were one of two what I would call early adopter sites, and we actually did that back in May of last year.
Gamble: I know that even with putting in 6.0, it was something where you were a beta site. So I guess it’s something that you’re pretty comfortable with as far as being an early adopter.
Christian: It is, and particularly with the Meditech software, I probably have one of the more experienced groups of Meditech analysts. My group has been working on Meditech since 2008 on this particular version of the software. We’ve gotten used to being first in this arena. It’s not for everybody though.
Gamble: I’m sure there are always risks involved and it really does require so much dedication and just constant communication with the vendor.
Christian: It certainly does, but with that comes some additional opportunities and rewards. Number one, we have the ear of the developers from Meditech and things that we feel are important as enhancements, they listen to that. We also have a very strong service relationship with Meditech. And also, because we’re an early adopter, we don’t have to wait for the other sites to get their versions of the software. Typically we get it first and then we move on without having to wait in a large slotting queue for upgrade times.
Gamble: That’s certainly a plus. I imagine that there also is maybe a mindset among your team of being okay with the risks, and also really wanting to be the first ones and having that kind of spirit.
Christian: It is. We feel like the earlier that we start, the better our chances of making our overall goals. And also, we’re a very competitive team. We watch what the other hospitals are doing and we do enjoy being first. It’s something that’s developed with this team I would say over the last five years.
Gamble: That’s certainly a good thing to want to be competitive, just because there are so many priorities that have to get done, and it’s nice to have that as a motivation.
Christian: It is, but you have to put a good dose of practicality with that, and then make sure that your competitive spirit is not setting you up for something that you can’t deliver. We try to walk that balance.
Gamble: With Meditech at this point, would you say that you’re in optimization mode — just trying to get as much use as possible out of the upgrade and just kind of getting your feet wet in that sense?
Christian: I would say optimization is a good description. We have been using most of the major functionality such as CPOE and medication reconciliation for the last several years. But there are some new enhancements that allow for greater exchange of data from one organization to another, and just cleaner, more streamlined workflow than some of the previous versions that we’ve dealt with, and for us, that’s the big kicker. We are going to file for Stage 2 Meaningful Use during the fiscal year 2014, and obviously boosting numbers for our statistics is important, but adding some new functionality is definitely on the table as well.
Gamble: When you talk about exchanging data within the organization, are you talking about with physician groups or physician practices?
Christian: We’re already providing information to physician groups and physician practices right now. We send labs, X-rays, pathology, and transcribed reports to the physicians in our area who can receive those into their EHR, but we also want to expand that to other hospitals and other practices as well.
Gamble: Are you connected with any official regional HIEs or anything like that at this point?
Christian: We have the West Georgia Health Information Network, which has covered the service area that we have. We are currently working to connect to the Georgia Health Information Network, and actually received a grant to help fund our connectivity to the Georgia Health Information Network. What we want to be is a qualified entity on the Network so that other hospitals and other physician offices can use us as an on-ramp to the Georgia HIN.
Gamble: What’s going to be required to get to that point?
Christian: We have to do some interfacing. The State of Georgia has chosen Truven as its vendor supplier for the query-based exchange, and so we’ll have to do an interface with our health information exchange platform, which is Medicity. And so we’ll be making the connections between those two, and then obviously as we add more physician offices and more hospitals, then there could be some of the local interfaces between our information exchange and those individual physician offices and perhaps other hospitals as well.
Gamble: I imagine that’s something that’s really ramped up in the last year or two with the Stage 2 requirements just being able to facilitate that data exchange.
Christian: We actually began our Health Information Exchange in 2010. Currently we’re sending data into Allscripts, GE Centricity, Sage and to Amazing Charts so there’s four different vendors that we’re sending information to right now. Of course we want to expand that to other vendor players that are in our service area.
Gamble: Is that something that required a lot to set up to be able to send that data to different vendors, or was it fairly cut and dry?
Christian: It was fairly cut and dry. I think the bigger thing is having a bi-directional interface where you’re both sending and receiving data from those physician offices, and that’s what we’re going to be able to do with this connection to the Georgia Health Information Network. But not only will we be able to send and receive to the offices and hospitals that are using us for an on-ramp, but we’ll be connecting with other regional HIEs in the State of Georgia, and that will expand our ability to exchange information across the entire state.
Gamble: You have both owned physicians and affiliated physicians you work with, corrent?
Gamble: And the employed physicians are using Allscripts Professional?
Christian: That is correct.
Gamble: What about the affiliated physicians?
Christian: The affiliated are using a mixture of other vendors. Some use Allscripts; Allscripts does have a large number of practices in our area that they provide the health information system for, but we also have Sage. We have Amazing Charts, GE Centricity, and there’s a larger presence of Cerner PowerChart users in that area as well.
Gamble: One of the things we had talked about a while ago was portals. I believe you had just gone live with the portal in ambulatory environment the last time we spoke, and I just wanted to talk about where that is at this point.
Christian: I would say that the adoption has not been as fast as we would like to see it, but we have had a good number — I would say probably in the 10 to 15 percent range of patients who have taken advantage of the chart in our ambulatory environment. What I will say is that we’ve really not made a huge push on the portal technology. We’ll be going live with a hospital-based portal in February, and we will be doing a more concentrated marketing campaign with it, for both the hospital and the ambulatory side as we begin to really push this. Obviously we have to meet a certain quota of users in order to claim Stage 2 Meaningful Use that either views, prints, or downloads information. And so we’re going to use an inpatient strategy of having end users log in to the portal for the first time before they are ever discharged from the hospital, and then of course we’ll be encouraging its ongoing use as patients leave the hospital.
Gamble: From a logistical standpoint, how does that work? Would that happen in the patient room with somebody helping them?
Christian: It would. We have workstations. We actually use thin-client devices in all of our patient rooms at the hospital. And as part of the discharge process, the nurse can assist the patient in logging in for that first time and show them their results, their education information for their condition — where those types of things are located, and make sure that they understand what their user name and password are. It can just be that introduction. Of course, we will still be supplementing this with printed versions of those documents as they are discharged as well.
Gamble: That’s something that I can imagine would really make a difference to actually show them how to set it up while they’re still at the hospital, just because patients they come home with a lot of paper. There’s a lot on their mind, but having already had at least that introduction, I would think that’s something that could make a difference and hopefully give a little boost to adoption.
Christian: I would think so as well. Also, once they’ve seen where those results reside, if there are any pending tests or pending results that will be completed after their hospital stay, it will give them that extra incentive to go and check those as well.