Using dozens of EMRs 'a challenge'
It's fair to say Linda Shanley has a rather full plate these days. "We're a 600-bed hospital – we're two hospitals, actually: one's a rehab hospital – and right now we're going through an Epic implementation," said Shanley, vice president and chief information officer at Hartford, Conn.-based Saint Francis Hospital.
"We also have a very large PHO, with probably about 800 physicians," she added. "Approximately 200-plus are employed, and the rest are all community physicians. There are two larger groups: One is about 60 doctors, and the other is 30; all the rest are of varying sizes, from one or two physicians, up to 10."
Across all those care settings, "we have about 24 different EMRs," said Shanley.
Put mildy, "That's a challenge."
And one more thing, just to add to the fun: At the same time as the hospital's Epic switchover, "We also decided to participate in the Medicare Shared Savings Program," she said.
Long story short, when it comes to aggregation of data for this nascent ACO, "there's a lot going on."
Thankfully, the Epic implementation piece is going well. When we spoke at HIMSS14 in Orlando, Shanley said the go-live was just over a month away, and she felt sufficiently confident the launch would be smooth that she could spare a few days to visit the conference.
"It's refreshing to see how it all comes together," she said. "We're training right now, in the midst of it, and it's really been unbelievable."
As for the ACO, setting up data exchange among so many disparate systems beyond the hospital has been more of a challenge.
"Ultimately we want everybody to be on the same EMR," said Shanley. "That journey is not going to happen overnight."
In the meantime, St. Francis is getting help from Orion Health, whose Collaborative Care for ACOs suite helps with "aggregating all the data together in a traditional HIE sense," she said.
"We needed to bring more than just (clinical) data together; we needed to bring the claims data in, and we needed to have a mechanism to look at patient data and be able to manage them from a care coordination standpoint," said Shanley.
"That's the whole thing: to be able to bring every piece of data together. A lot of the docs aren't on our EMRs. We have to be able to enter data and bring together lists – and work those lists so we can affect outcomes."
Even with help from the most robust care coordination tools, though, that can be easier said than done. Shanley said one of St. Francis Care's acute challenges is "finding where all the data is.