Customer Spotlight: So Far Away, Yet So Close…

By: Donna Carroll, Editor, The MEDITECH Community Bulletin

How one rural health system is closing the gap and placing patient data at providers’ fingertips

Located in the heart of beautiful northwestern Montana, the Health Information Exchange of Montana (HIEM) represents a family of health care providers designed to meet the needs of both community residents and seasonal visitors. From preventive medicine and routine procedures to ongoing treatment and complex surgeries, HIEM members are equipped with the expertise and the facilities to improve the health and comfort of the people they serve. And the people they serve number approximately 140,000 spread across an area of 45,000 square miles! With that large of a population in their service area, HIEM medical facilities deliver care to patients through numerous sites, namely, 6 hospitals, 12+ clinics, a long term care facility, and a home health facility.

Among the hospitals is Kalispell Regional Medical Center (KRMC) which is a member of the larger Northwest Healthcare system. KRMC is both a community hospital and a regional referral center, offering the area’s most advanced health services and medical technology. KRMC is a MEDITECH Client Server site, but they also support over 250 other applications, such as MedHOST, Formfast, Softmed, McKesson, Vista Keane, DR PACS, Kronos, LSS, ANSOS, Impac, and eClinicalWorks, just to name a few. With approximately 1800 Northwest Healthcare employees, and another 500 or so outside users connecting to KRMC for support of those 250 applications, there can be over 2000 connections accessing their network at any given time.

The myriad applications utilized by Northwest Healthcare alone, combined with the disparate health information technology in use by other hospitals and clinics in the region and the geographic dispersion of facilities makes gathering complete patient information quite a challenge for healthcare providers trying to assess, plan and treat patients effectively.

With several of the physicians working at multiple hospitals in the region, it was common for patients to be referred back and forth among the facilities. Approximately six years ago, a small group of physicians started talking about the idea of being able to exchange patient information electronically, rather than by phone and paper. Those first conversations started with the idea of having a common platform for all hospital records, but an enterprise-wide conversion to a single HIS vendor was not considered cost-effective or desirable. So, they adjusted their approach to move toward a Health Information Exchange (HIE) and sought potential solutions. After a thorough selection process, they chose the CareAlign™ Aggregation Platform from Informatics Corporation of America (ICA)and thus was born the Health Information Exchange of Montana (HIEM).

The HIEM settled on a three-pronged approach. First, they began building a fiber-optic infrastructure throughout the region to support the exchange of healthcare data across the geographically dispersed healthcare system. Next, they contracted with ICA to provide a secure, aggregated healthcare data repository to integrate vital clinical information from their legacy systems into a longitudinal patient healthcare record. And finally, they decided to expand ICA’s base aggregation platform with clinical communication, disease management, clinical workflow and forms and notes capabilities.

Kip Smith, HIEM’s Executive Director since November 2008, describes the project: “It’s going to be a very robust solution as we are bringing in Pharmacy, Radiology, Inpatient and Outpatient records. It’s a huge undertaking, but we’re getting closer. We’ve completed a pilot implementation between the two MEDITECH hospitals in Kalispell already, and are now bringing in the clinics which are on eClinicalWorks. We will also bring in 3 other hospitals, some with different HISs.”

To learn more about the CareAlign™ Aggregation Platform, we spoke with John Tempesco, Vice President of Client Services for ICA. Tempesco describes the CareAlign™ solution--a web-based application accessible anywhere with an internet connection--“Essentially, CareAlign™ takes data from the various software applications and aggregates it into a centralized data repository which is then ‘vaulted’ by each of the individual sites.” Each entity has a vault of their own data, which is accessible across the entities. Each entity can view each other’s data, but cannot modify it. This is considered a ‘view-only’ model. “The system then looks across all of the data vaults for all references to a patient and dynamically compiles them all into one view to be seen by providers,” continued Tempesco.

Not only does CareAlign™ solve the problem of data sharing amongst numerous entities, it also provides a single sign-on capability. Tempesco explains, “A very common problem in the Emergency Department (ED) is for physicians to have to log into 7-10 systems in order to get all of the information they need on patients visiting the ED. Now, they can log into 1 application and pull information from all sources. So, CareAlign™ is a combination data aggregation and single sign-on solution.”

So, how is ICA’s CareAlign™ Aggregation Platform working for HIEM? Well, Northwest Healthcare, the largest participant in the HIEM, recently won 4th place in Modern Healthcare’s 2009 IT Case Study Contest for their pilot implementation of CareAlign™. Candis Deruchia-Bunten, Director of Healthcare IT at Northwest Healthcare, wrote in the case study, “The American Recovery and Reinvestment Act of 2009 will be highly favorable to the information exchange’s initiative because it requires “meaningful use” of EHRs to qualify for financial incentives. Clearly, this would extend to streamlining patient data from disparate sources into a single, unified record. This system also adds value to long-term investments in healthcare information technology by spanning existing systems to improve the clinical value of current technology, reduce costs, increase interdepartmental communication and improve the quality of care.”

Looking forward, HIEM executive director Kip Smith outlines some of the additional benefits ICA’s solution is slated to bring to the community. “Once the initial deployment is complete within the HIEM, we expect incremental rollout of secure clinical messaging, clinical flow sheets and dashboards to enhance communication, acute care monitoring and disease management throughout the community,” he said.

As for Informatics Corporation of America (ICA), they recently won the 2009 Nashville Area Chamber of Commerce's Future 50 Award for the second consecutive year. ICA was named one of 50 fastest growing companies in Tennessee for projecting continued growth in both revenues and the number of employees over the next three years. “Given the nation’s economic uncertainty, we consider it a significant achievement to project growth and to be among this group of 50 outstanding businesses,” says Gary Zegiestowsky, CEO of ICA. “But it’s not just about growth – it’s about making a difference.” Zegiestowsky emphasizes the need for deploying systems that add value to long-term investments in healthcare information technology, saying, “By spanning existing systems to improve the clinical value of current technology, our solution helps healthcare enterprises reduce costs, increase interdepartmental communication and improve the quality of care.”

All of the patients in northwestern Montana have a lot to be grateful for due to the hard work and dedication of the physicians, a software vendor, the IT staff of Kalispell Regional Medical Center, and each of the HIEM participants. Even though their rural medical facilities may be so far away, their critical patient data is so close at hand.

To learn more about Informatics Corporation of America, visit them online at www.icainformatics.com.

To learn more about Northwest Healthcare or Kalispell Regional Medical Center, visit them online at www.nwhc.org or www.krmc.org.