Med at work
FORT WAYNE, IN – "If you're not unbelievably busy in health IT these days, you're doing something wrong," says Jeff Donnell, president of NoMoreClipboard, the personal health record subsidiary of EHR vendor Medical Informatics Engineering (MIE).
Those words are true, of course, even if one's firm is "only" focused on getting physician practices up and running with EHRs and helping them qualify for Stages 1 and 2 meaningful use incentives.
MIE is doing that. Its Web-based EHR technology has helped medical practices and health clinics across the country attest to MU and get big stimulus checks. But for the past several years it's also focused its energies on a sector that doesn't much care about meaningful use: outfitting employee clinics and occupational health capabilities at companies such as Dow, Google, Disney, Chevron, Xerox and more.
What started as a pilot project with Dow back in 2005, has "frankly become the biggest growth engine for our entire organization," says Donnell.
The clinics at these corporate behemoths have very different needs from a typical two-doc shot looking to implement their first EHR system, he says. "Some of these organizations are being far more aggressive, not only in terms of what they're doing, the timetable on which they're deploying solutions, than what you're seeing in healthcare."
Most EHR developers are focused on meaningful use and dealing with demands around ACOs, and are "understandably focused on making that happen," says Donnell.
Those preoccupations can mean they don't necessarily have the "occhealth" modules and functionality employers need to manage employee populations. On the other hand, many vendors geared toward the occupational health and safety realm, "tend to lack the clinical and patient engagement" MIE and NoMoreClipboard feature in their configurable, SaaS-based technologies.
If these clinics aren't necessarily interested in meaningful use required from a stimulus check point of view, many are when it comes to tracking quality.
"They don't apply for meaningful use, but they'll want to know where they stand, relative to the industry and best practices," says MIE's president and CEO, Bruce Lisanti. "We'll often run the information for them, and on their screens they can have a meaningful use calculator that shows where they are, relative to the different requirements."
Beyond basic clinical EHR functionality, occhealth modules could include everything from travel management related to medications and immunizations for foreign trips to OSHA regulations with regard to hearing and pulmonary functions, to more esoteric realms, such as requirements pertaining to pharmaceutical companies that may deal with lab rats and monkeys. Suffice it to say, it’s the "things you just don't find in your typical clinical system," says Donnell.
MIE tries to offer "a lot of flexibility and a lot of horsepower" to its clients in this realm, says Lisanti. He cites examples such as Disney, who "liked that it was all on our own integrated platform, where they could have it fully scaled in one facility and minimally in another." Lawrence Livermore National Laboratory, which makes use of "seven different systems that provide different functions," is another fan of the technology's fungibility, he says.
The ability to integrate clinical capabilities with everything from HR systems to corporate e-mail can be traced back to MIE's "heritage in health information exchange," says Donnell. "They got really good at interoperability early on."
The fact that it's all Web-based has appeal too for companies such as Chevron, which runs some 55 clinics around the world. "They don't want to go in and put in servers in all of them," he says. "It's really scalable for these multinational organizations."
Indeed, Chevron's dozens of clinics "range extremely in size and complexity, from large operations with eight or 10 docs in San Ramon, Calif. and Houston, to a clinic that's open a couple days a week in Nigeria that may just give shots or minimal care," says Lisanti.
Developing software that can configure from a full-service clinic that uses patient engagement and enterprise health modules, right down to bare bones functionality is just one challenge.
"If you're a Dow employee in China today and you go into one of their three clinics, everything is in Mandarin," says Lisanti. "We're operational today in six languages and we'll have another three this year. The way our system is set up, if a screen wants a word, it goes and does a table look-up, so we can adjust and make it German or French or Mandarin or whatever, fairly easily."
Language isn't the only variable when working internationally. "As you get into some of these other environments, like China, their prescriptions are very different," he says. "They may use powders and natural remedies there that we simply don't use here."
"You'll also get into some different regulations around privacy, around data management," says Donnell. "There's clearly a higher level of complexity."
Indeed, "as we've moved globally, you can imagine there's a lot of local regulation involved and we need to make sure we comply with it," says Michael Gondek MD, corporate medical coordinator for Dow.
That first trial with Dow in 2005 led to its implementation of MIE's Enterprise Health system for its employee health clinics worldwide.
"We were looking for a complete medical record plus future-looking capabilities, as we expected the world of health was going to be changing," said Gondek, who noted that Dow's focus for its employees and our retirees is "not just clinical," but has a "lot of emphasis on preventive health."
Traditionally in occhealth, offerings tend to focus on OSHA environmental health and safety requirements, and the high-level data collection related to those. "That wouldn't meet our needs," said Gondek. "We wanted a complete EHR replacement with other capabilities."
Back on the home front, other huge institutions have seen the value of working with this smallish EHR firm. Lisanti points to Texas Children's Hospital, which is "part of a huge complex that uses Epic."
Nonetheless, "we're implementing our enterprise health system for their employees because they want a wall between the employee information and the hospital information," he says. "Employees don't necessarily want the docs that run the hospital to know everything about their own personal health. We provide an environment that's secure, and all their data resides on the other side of the wall."
More and more big companies are heading in this direction, says Donnell.
"Healthcare has been elevated to something the C-suite is very concerned about," he says. Corporations are worried about cost containment, of course, and "the one cost that goes up every year, for every company, often at a double-digit rate, is cost for healthcare. Companies have said it doesn't look like the traditional health system is going to heal itself. We've got to do something about this."