As more health systems transition to an ACO model, CIOs face mounting pressures to align with independent practices and to create an integrated platform across the system. But for those organizations that aren’t there yet, some are beginning to question whether it’s all worth it.
According to the November healthsystemCIO.com SnapSurvey, the large majority (83 percent) of organizations have either began to integrate electronically with independent providers or are soon heading down that road, and 63 percent are eyeing up — or are already on — a single EHR platform across the board. And yet still, concerns persist about the costs involved in migrating, particularly with M&A on the radar of many organizations.
“It is too much of a moving target. It is hard to spend tens of millions of dollars to have a single system when we know that there are conversations happening to merge with another organization with a different IT strategy,” noted one CIO.
Another respondent suggested that “the value proposition to standardize is not large enough to offset the cost.”
Other significant barriers in migrating to a single platform included physician resistance and the lack of resources and time needed to implement systems.
For those organizations that are forging ahead, one CIO suggested appointing a specific person or team as a physician support specialist. Other pieces of advice include the following: manage expectations, communicate often, check the business case, and, as one responded stated, “Make sure your resume is up to date.”
(SnapSurveys are answered by the healthsystemCIO.com CIO Advisory Panel. To go directly to a full-size version of any individual chart, click on that chart.)
1. Is electronically integrating with independent providers among your top 3 priorities?
- This becomes a requirement as we continue down the ACO path. Without the data integration, we’re inefficiently managing our attributed population and spending countless hours attempting to satisfy payer requirements for collecting reporting of quality metrics.
Not yet, but it will be in the near future
- Would like to have the opportunity to engage with independent providers on areas we can integrate. Focused internally right now.
- A priority but based on other issues — not top 3, with the exception of anything we need to do to keep compliant.
2. If so, what level of success have you had with EHR adoption rates?
- For the few we have done, very well.
- Many PCPs have not purchased and are waiting for subsidies from our health system. Many of those who did purchase and deploy are not using the EHRs well — and some not at all.
- It’s not one of our top 3, but we have had moderate success integrating with independent providers.
- Business plan almost completed, planning under way.
3. Do you have a single EHR platform throughout the organization, or are there plans in place to do so?
Yes, we have 1 system throughout the organization
- Leveraging community and partner connect model.
We currently have multiple EHRs, but plan to move to 1 system
- As a result of recent merger, our parent corporation has begun discussions of migration to a single integrated EHR platform for acute/ambulatory.
- We have a lot of platforms, both acute and ambulatory, which we are looking to migrate onto one over the next couple of years.
We have no plans to move to a single platform
Not sure at this time
- We currently have a “strategic” EHR through 75 percent of the system. Recent mergers and acquisitions are on different platforms. We are currently reassessing the wisdom of moving to 2 systems or building a robust interoperability solution.
4. What is the most significant barrier in migrating to a single platform?
- Cost is the most significant barrier, given the size and scope of our national health system. The cost consists of the hard dollars associated with acquisition and implementation, as well as the opportunity cost of delaying other strategic and operational initiatives so that the key resources are not diverted from the project. I question the value proposition of such an initiative on a large, national scale. By the time the deployments occur across the country, the product is obsolete.
- There is no doubt that the cost is the largest barrier. There is a sense that the value proposition to standardize is not large enough to offset the cost. There are other hurdles such as readiness and disruption which are also being looked at.
- Labor to implement.
Lack of resources/time needed to implement systems
- Cost is also a major factor.
Resistance among physicians
- Mergers and acquisitions. Given the industry consolidation, it is too much of a moving target. It is hard to spend tens of millions of dollars to have a single system when we know that there are conversations happening to merge with another organization with a different IT strategy.
- Leadership commitment.
- We have not had an issue rolling out a single platform internally and for owned physicians. We have a great integration product for those that run different platforms for orders and results.
- We have one integrated system.
- Awaiting decisions around possible affiliation.
5. Which of the following strategies are you employing to facilitate alignment with independent providers?
Regularly scheduled meetings attended by independent providers and hospital leaders
Physician support teams
- We have a staff member dedicated to this function.
Site visits by CIOs and/or other hospital leaders
- We are working with our HIE but it’s slow since they are over-obligated as well. They offer an alerting system for admissions to let PCPs know when their patients were seen by other participating providers. This will be very helpful with readmissions.
- ACO-type work committees are stressing the need to align and integrate.
- Multiple committees where this strategy is discussed.
- We are prioritizing as physicians ask. They are driven by Meaningful Use to integrate
6. For those that are on an integrated platform or are moving in that direction, what advice can you offer to CIOs who are looking to move down that road?
- None, really.
- Educate and communicate often.
- Don’t implement Soarian now.
- It’s definitely the way to go. Most effective approach.
- Policy development first; manage expectations.
- Approach as a new service line with separate team.
- Not a panacea.
- Make sure your resume is up to date.
- Check your business case carefully.
- Designate a team solely committed to that project.