As physician acquisitions have accelerated in recent years, many hospitals have found themselves faced with a previously unfamiliar problem, the need to integrate data from across multiple organizations. A recent article in Cardiovascular Business profiles Atlanta’s Piedmont Heart Institute and the hurdles they faced as they worked to find an effective and efficient method of data management after merging with three physician practices.
As programs face increasing pressure to use data to drive improvement initiatives, they must insure that data from across the enterprise is accessible, a feat that has proven challenging for many institutions. In the piece, the authors identified two primary strategies to manage data once physician practices have been integrated:
- First, to create interfaces to patch existing physician EMR systems into the hospital IT structure
- Second, to completely overhaul the physician IT platform in favor of consolidating all data into one system
Piedmont Heart Institute chose the latter approach, which required the purchase of a new IT system for the three merged practices. The key factor in their decision was a concern that maintaining separate systems would impede future quality and efficiency efforts, making the costly upfront investment worthwhile.
Sizing up the investment
Neither option is particularly inexpensive. The article’s authors estimate that it may cost upwards of $30,000 to build interfaces between disparate physician and hospital IT systems, not including vendor patches, software upgrades, and fixes to implement meaningful use requirements. Large institutions or physician practices may have the IT support staff necessary to build many of these interfaces in-house, alleviating some of that cost, especially if the goal is to connect only two IT systems.
This is not, however, the case for many hospitals lacking a large or sophisticated IT staff. Though it may be difficult to convince a newly acquired physician group to abandon a familiar IT to install and learn an entirely new system, running and maintaining two separate IT systems and their data repositories is unwieldy and inefficient.
Difficult to ensure seamless transfer
Given the proprietary data formats of most vendor solutions, it may be very difficult to ensure the seamless transfer of all data between disparate systems. Indeed, the Piedmont team found it nearly impossible, short of building all the necessary interfaces, to transfer data from one EMR to another.
Ultimately, the best solution they found was to manually transfer nearly one million patient records from the old physician systems to the new system. Though the human capital invested in that initiative was massive (Piedmont estimated that it took 30 minutes per patient to transfer the data to the new system), the benefit of having all the data in the same place will allow for significant data-driven initiatives to improve care.
Evidence-based protocols gaining importance
The cardiovascular service line is becoming increasingly reliant on data, and while a first step is to have all patient records in one place regardless of format, being able to leverage that information to improve quality, define evidence-based protocols, and drive efficiency is a critical next step for the service line.
As the demands on health IT increase in an era of meaningful use and accountable care, cardiovascular services are again in the spotlight, needing to find more efficient, comprehensive, and cost-conscious ways to care for patients across the continuum. This is an achievable goal through effective data abstraction and utilization but the before reaching that pinnacle, hospital must take the first step; ensuring that all patient data is accessible and clean.
More information for members
For more information on optimizing data collection and utilization within cardiovascular services, please see the Roundtable publication The Outcomes-Driven Enterprise. Within this research, we explore how to streamline accurate data abstraction, how to put data to work to support a high-performance infrastructure, and how to promote accountability among CV staff.
Share your best practices
As health care IT evolves, especially in the cardiovascular space, the role of cardiovascular services in, institution-wide efforts to bolster IT systems, including EMRs, CPOE, and clinical decision-support systems will be ever more important. To that end, the Roundtable is currently conducting research on the role IT is playing at our member hospitals. We would be particularly interested to learn how your organization is utilizing IT to elevate cardiovascular care; please feel free to email me directly at MacMillN@advisory.com if you are interested in sharing your hospitals challenges and successes in the cardiovascular IT space.