Like many CIOs, Steve Stanic has a love-hate relationship with Meaningful Use. While he takes issue with patient engagement requirements and the lack of an identifier, he still believes “it was what needed to be done.” In this interview, Stanic shares his honest thoughts about the program that has helped revolutionize the industry, and discusses the biggest projects on his plate, including the migration to McKesson Paragon, and a statewide effort to create a clinical integrated organization. He also discusses his team’s five-point engagement strategy, the valuable lesson he learned during his time in consulting, and what drew him to Mississippi Baptist.
- Patient portals — “The toughest measure to hit.”
- His team’s 5-point engagement strategy
- Shifting responsibilities
- Mississippi Affiliated Network
- “We needed a strategy so we’re not always at the mercy of Medicare or Blue Cross.”
- Improving throughput — “That’s the name of the game now.”
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It’s the toughest measure to hit, and it has absolutely nothing to do with the availability, the technology, the ease of use. It has everything to do with the patient setting up an account to log on to look at their personal health information.
I think my responsibility should be to set them up an account and maybe send them an email reminder with some instructions on how to log in. To actually be measured on if they log in or not, I guess I have an issue with that.
It was becoming very competitive in the market, so we needed to have a seat at the table or a voice, whereas before you’re just at the mercy of a Blue Cross taking what they’re offering you, with the negotiations getting tougher and tougher.
This gives another option for somebody to come in and help me manage the health of my employees and to move more to a preventive end as opposed to just managing them when they’re sick.
Gamble: You talked about the portal and everything that’s going on there. I’m sure that with Meaningful Use, that’s going to be big in meeting all those requirements for patient engagement.
Steve: I will tell you, that’s probably the one we have the hardest time with, and that has nothing to do with the product, the vendor, a magic bullet. The Meaningful Use requirement that 5 percent of the discharged patients from the inpatient setting log on to a patient portal and look at their records at least one time, is the toughest measure to hit, and it has absolutely nothing to do with the availability, the technology, the ease of use. It has everything to do with the patient setting up an account to log on to look at their personal health information.
We’re actually broaching that on five fronts right now. We’re visiting patients while they’re still in the room to set them up. We’re sending them email reminders. We’re giving them patient education on how to do it through our patient interactive TV system. We’re sending letters to their houses. We’re using our home health aides, because we own part of a home health entity that a lot of our inpatients, even though they have a choice, use once they’re discharged. If they need home health services, they use us.
So we’re working on five fronts, and we have such a hard time hitting that 5 percent measure. With stage 3, it’s going to go to 25 percent, and I’ll be honest with you, I have no idea if we’re going to be successful there. I guess, to graze down a personal track here, I can’t control what a patient does a lot of times once they get out of our care, and to be held responsible for a patient taking the initiative to log on and look at their portal, it’s tough. It’s something that we don’t necessarily control and it’s hard to be measured on something you don’t control.
Gamble: Right. It’s certainly a trend we see when speaking with CIOs in all types of organizations. You can only do so much, like you said with having those five fronts. But you can’t actually go to their homes and log in for them, and that’s a tough one.
Stanic: I think that the measure should be to have that ability in place for every patient at discharge. I think my responsibility should be to set them up an account and maybe send them an email reminder with some instructions on how to log in. To actually be measured on if they log in or not, I guess I have an issue with that.
Gamble: I do not think you’re the only person who’s having trouble with that one. Now what about as far as the other components of Meaningful Use — what have you attested to?
Stanic: We’ve made two attestations. Stage 1, year 1 and stage 1, year 2. I guess they switched to years now.
Gamble: Well, it needed to be a little more confusing. And then as far as the other components, any really major hurdles or is it really just the patient engagement piece that’s the sticking point?
Stanic: That’s the sticking point. We’ve actually done really well in other areas. Our CPOE numbers are good, so I’m confident we’ll be okay, but the one that scares me is the patient engagement one.
Gamble: As far as some of the big projects you’re working on, do you have any ACO involvement or any plans do anything like that?
Stanic: Not ACOs, so much. We’ve actually formed and are working on doing a clinical integration organization. All the major hospitals in Mississippi have gotten together and formed a company called the Mississippi Affiliated Network (MAN). What we’ll do is with our physicians working in conjunction with our physician community, put together a clinically integrated organization that will actually go to employers that self-employ them at it and offer health services. But I’ll tell you, we’re in the infancy stages of that. The organization is formed, it’s incorporated. All of the hospitals, because they’re all self-insured, are taking their employees and we’re going to get a common third party administrator for all of them and do that. Kind of like what Vanderbilt has done in Tennessee — we’re working on that in Mississippi. That’s probably our biggest initiative right now.
Gamble: And so you’d be like an insurance provider?
Stanic: Right, but not in a formal way. We’ll have a product that we offer, but it won’t be so much in the traditional sense of a Blue Cross/Blue Shield or whatnot. It’s primarily focused on folks that are self-insured as opposed to laying it off on a health insurance provider.
Gamble: How is that put together? I know that you know the leaders at the other hospitals, but was it kind of just something where people just got together? How did this come about?
Stanic: We knew that we had to have a strategy so that we’re not always at the mercy of a little move of the dial at Medicare or Blue Cross moving. It was becoming very competitive in the market, so we needed to have what we called a seat at the table or a voice, whereas before you’re just at the mercy of a Blue Cross taking what they’re offering you, with the negotiations getting tougher and tougher.
Our CEO Chris Anderson came from Singing River Health System, which is down on the coast. They put a clinical integrated organization together because there’s a major shipbuilder down there that employed thousands and it was self-insured, and they said, ‘Look, we want to come directly to you to handle our health insurance needs or our healthcare needs.’ That’s kind of what the impetus was. Chris had had a lot of experience in that and he came to Baptist and brought what he did on the coast up here.
Gamble: How you think that might evolve — do you see particular programs being put into place for it things like chronic disease management or preventative care?
Stanic: I definitely see that. And this is kind of my personal opinion, but I think a clinical integration organization, like we’re putting the other one, is really run by the providers. So you have not only the hospitals, but the physicians are a huge partner in this; in fact, it can’t be done without extensive physician involvement.
So I think from a patient standpoint, it offers a better option because you actually have the providers now being measured on quality; they’re very transparent with what they provide. And although not today, not at this moment, but eventually, I think they’ll be a lot better from a standpoint of, if I’m a large organization that employs maybe 1,000 people, it gives me another option as opposed to going to like Blue Cross or just being at the mercy of a TPA. I think this gives another option for somebody to come in and help me manage the health of my employees and to move more to a preventive end as opposed to just managing them when they’re sick.
Gamble: Any other things that are kind of like a major focus? I’m sure you have several, but anything that really sticks out as something that’s really a big priority in the next year or so?
Stanic: I think that’s going to be the big focus. The other thing that we’re working on — and I think that a lot of organizations are working on — is patient throughput and length of stay to make sure that we’re being very efficient, because that’s the name of the game now. You want to make sure you’re moving your patients through the system in a prudent way, but also a quality intensive way.
Gamble: Right, and does that entail as far as like putting different measures in place or?
Stanic: We measure our length of stay every day by physician and make sure that we’re all following standard clinical care paths and things like that, so that’s going to be a big focus. It is a big focus now, and I think it’s going to continue to be a big focus. Those are measures along the way to make sure that you’re doing what you’re doing. That also kind of dovetails big into what we’re doing CI-wise as well.