Joel Taylor, SVP & CIO, CarePoint Health System, Chapter 1

When Joel Taylor sees people who are out of place and talking to someone in a completely different role, he doesn’t mind at all. In fact, he finds it to be inspiring, because it shows people are curious and willing to step out of their comfort zones. In this interview, the CIO at CarePoint Health System talks about what his team is doing to create growth opportunities in IT to make sure they’re able to retain top talent. He also discusses the multi-phased coordinated care initiative at his organization, the challenges in engaging with elderly patients, the power of organic mentoring how his team is working through data sharing hurdles with acquired physician practices, and how he’s working to make innovation part of the overall strategy, and not just “the next toy.”

Chapter 1

• About CarePoint
• Upgrading to the newest Meditech version — “Staying where you are is not a good business decision.”
• eClinicalWorks in owned practices
• Data-sharing hurdles — “They certainly don’t make it easy for us.”
• Creating a defined risk management process
• “Now it happens as a matter of our day-to-day business.”

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Bold Statements

With any upgrade, you have tremendous amount of concern with how that’s going to go, what the impact’s going to be, what’s going to break. There’s no getting around that.

Coming from a 28-year IT veteran, you find it hard to believe that a company could build a product and have a database that’s hosting that product and not have the very simple fundamental understanding of how you extract that data and provide it to a customer.

It’s being able to help the operational side of house understand the due diligence that’s necessary and the work that needs to be done so that we can properly manage and support their infrastructure.

We spent a lot of time in the beginning working with the integration team operationally and letting them know our time constraints and the places where we need to have pauses so that we can do things right. Now we’re notified with plenty of advance notice and have the opportunity to do the things we need to do.

Gamble:  Hi Joel, thank you so much for taking the time to speak with us today.

Taylor:  My pleasure.

Gamble:  So to give our readers and listeners some background information, can you just talk a little bit about CarePoint Health System — what you have in terms of hospitals, ambulatory, things like that.

Taylor:  CarePoint Health is a three-hospital, 75-medical practice, healthcare system in Hudson County, New Jersey in northern New Jersey. We have about 500 physicians at this point and are expanding to other parts of the state as we speak.

Gamble:  Can you talk a little bit about how the health system came together?

Taylor:  The ownership of CarePoint Health acquired Bayonne Medical Center back in around 2008. And then in the mid-to-late 2012 timeframe, they purchased Hoboken University Medical Center and Christ Hospital, putting us in a position where we own 75 percent of the hospitals in Hudson County.

Gamble:  In terms of the clinical application environment, what EHR system is being used in the hospital?

Taylor:  In the hospitals, we primarily use Meditech. We do have some other products like the GE Centricity, which we use for OB and pediatric activities in the hospitals, but the dominant EMR is Meditech.

Gamble:  Which version is that?

Taylor:  6.X.

Gamble:  Were these hospitals on Meditech previously or was there a migration done once they were acquired?

Taylor:  There were some migrations that took place prior to my coming on board. At Bayonne, I don’t think they had anything — at least I haven’t heard of anything. At Christ Hospital, there was McKesson, and at Hoboken there was CareVue (OpenVista).

Gamble:  And now 6.x is what you’re on — how recently did you go to that platform?

Taylor:  They went live at Bayonne quite a few years ago. Christ Hospital and Hoboken went live during varying parts of last year. December was the final install.

Gamble:  Any plans to upgrade any time soon, or is that the platform you’ll be on for the time being?

Taylor:  We are looking at upgrading to 6.15 next year. But we are in the very preliminary stages of doing a determination on value and getting pricing on that. But we do intent to do that upgrade next year.

Gamble:  And 6.15, that’s obviously is being used in some places, but I imagine it’s on the newer side?

Taylor:  It is on the newer side. I believe that’s their most current product. I don’t even know that it’s actually in general release production anywhere. I think it’s still beta in a few places. I could be wrong, but I’m pretty sure that’s the case.

Gamble:  Any concerns about going to that version or is it just something where you feel like it’s the next step?

Taylor:  Both. We always have to move forward, right? Staying where you are is generally not a good business decision, and certainly not the stance in the IT department for the most part. But with any upgrade, you have tremendous amount of concern with how that’s going to go, what the impact’s going to be, what’s going to break. There’s no getting around that.

Gamble:  Are there specific functionalities that you’re really looking at for this next version, or is it just needing to upgrade in general?

Taylor:  I think Meditech is kind of catching up to the industry with regard to user interface and moving away from a very kind of clunky and un-user friendly — to put it simply — product, and moving to a more GUI user-centric piece, and this is a step in that direction. In addition, they’ve added some modules. There’s an urgent care module that we’re very interested in and there’s a data analytics module that we’re very interested in.

Gamble:  And you’re looking at that for next year?

Taylor:  Correct.

Gamble:  What about in the physician practices, what’s being used?

Taylor:  So the physician practices are about 75 percent complete with our implementation of eClinicalWorks.

Gamble:  And are these owned physician practices for the most part?

Taylor:  They are.

Gamble:  So I guess that maybe makes it easier as far as having one system and working with one as opposed to having to accommodate different choices?

Taylor:  Oh, no doubt.

Gamble:  So that’s about 75 percent complete?

Taylor:  It will be done probably by late summer.

Gamble:  And what was the strategy as far as rolling that out, was it taking groups at a time?

Taylor:  We onboard physicians quite frequently here, so there was a very long process in working with our ambulatory operations team to figure out the best course of action. We made the decision to bring up our paper-based physicians first, primarily because of the abstraction process and the lack of data migration, they were just easy to do. With some of the other physicians, they are on other EMR products — kind of no name products for the most part.

Once we got started, we found that there were varying degrees of cooperation from these vendors with regard to data migration in what they were willing to do and how they were willing to do it, and yet, quite frankly, the lack of skills that they have in actually doing such a thing. And so moving them to the end so that we can have more time to interact with them and complete our due diligence was the strategy there.

Gamble:  Was that something that was pretty surprising just as far as that level of readiness?

Taylor:  Coming from a 28-year IT veteran, you find it hard to believe that a company could build a product and have a database that’s hosting that product and not have the very simple fundamental understanding of how you extract that data and provide it to a customer. I think there are some that have that skills set, but the issue at hand is the types of agreements the physicians entered into, where contractually the physician basically said, ‘Yes, the data is owned by the EMR and not me.’ And so we’re having to deal with that in a very creative way. I mean, obviously they can’t prevent the physician from doing business, but they certainly don’t make it easy for us.

Gamble:  That really is surprising to hear.

Taylor:  There are technologies out there to help you work around that, fortunately.

Gamble:  And so obviously, bringing on practices is something that you said that you’re doing pretty frequently.

Taylor:  Yeah, a couple a week.

Gamble:  Oh, okay. Wow, that is frequently. And I guess that’s part of the strategy just as far as continuing to grow the system and have that continuum of care?

Taylor:  It is.

Gamble:  What has been some of the challenges there, maybe possibly some takeaways for other CIOs who are doing the same thing in bringing on practices?

Taylor:  Early on, we were a small team. The team that I had here was a group of people that were from established medical practices and large medical groups that were very established, some having existed 10 or 15 years or longer, and coming into an environment where it was very chaotic and kind of like, ‘hey, I know it’s 3 o’clock on Friday, but Dr. so-and-so needs to be up on Monday. He just signed his contract.’ So it’s being able to help the operational side of house understand the due diligence that’s necessary and the work that needs to be done so that we can properly manage and support their infrastructure.

It’s also having conversations around security and meeting the HIPAA, HITECH, and New Jersey laws around data, and being able to do that in a manner where it’s done before the deal is done so that we’re never exposed from the risk side — that the risk stays with the physician until the transaction is completed. We certainly don’t want to inherit any bad decisions from a single physician that could put the entire health system at risk, financially, legally, politically, or commercially. All that good stuff.

Gamble:  When you do have those cases where there are challenges with data ownership and integrating that data, is that something that you’ve run into a lot or is it getting a little bit easier as you acquire more?

Taylor:  At this point, it’s a defined process. It’s kind of an automatic thing. We spent a lot of time in the beginning working with the integration team operationally and letting them know our time constraints and the places where we need to have pauses so that we can do things right. Now we’re notified with plenty of advance notice and have the opportunity to do the things we need to do, and it just kind of happens as a matter of our day-to-day business.

Gamble:  Right. Do you still encounter a good bit of resistance as far as physicians who aren’t really sold on connecting with one health system? Is that something that still happens?

Taylor:  We don’t really have exposure to that. They’re deciding to come to work with us, so I think they’re already past any issues they might have. Quite frankly, even our affiliated physicians are very anxious to share information with us, so not really.

Chapter 2