HOLIDAY WISH LISTS
is real,” he says. That entails vendor demos
and reference checks.
Sripada’s other big need is a vendor neutral archive. As Beaumont ascends the EHR
ladder, the amount of data it is accumulating grows. The hospital’s total data archive
has exceeded 2. 5 petabytes in aggregate and
Sripada says he could spend $2 million annually just to feed the growth of his indigenous systems, where data currently resides.
“Our storage costs are spiking,” he says. He’s
looking for a vendor to step in and solve the
problem. Beaumont needs a storage archive
to house not only radiology images but also
EHR and other data. State law requires him
to store patient records for 11 years, or longer
for children. But not all data needs to be immediately accessible.
He’s looking to a vendor who can offer
a repository in which access is tiered by immediacy of need, with older records being
stored in such a way that is less costly but
requiring more time to retrieve them. The
archive will set the stage for Sripada’s other
need: expansion of medical devices integrated with the Epic system. Currently, Beaumont has integrated its ICU and emergency
department monitoring devices into its Epic
system, sidestepping the need for nurses to
re-enter data from the devices to the EHR.
The device integration was a hit with the
medical staff and nurses, who are now clamoring for more data feeds. “We have a long
list of what to do next,” Sripada says, adding
that the medical staff is prioritizing its requirements. He figures that trapping ventilator and EKG data will be the next move.
Beyond that, Sripada envisions a day
when clinicians and administrators can
not only retrieve data quickly through
the EHR and other systems, but create
their own business intelligence reports as
well. “In the legacy model, I. T. would create reports,” he says. “Now we are moving
to giving users access to data.” Beaumont
has installed software from QlikTech, a
self-service data mining vendor, and hopes
to expand its use in 2013. “We need data
transparency,” the CIO says.
Name: Bill McCoy, M. D.
Title: Chief Medical Information Officer
Organization: Metropolitan Health
Networks, Boca Raton, Fla.
Wish List Items: Cooperation,
Bill McCoy understands that the future of medicine is wrapped in clinical I. T.
But his primary need for the future is not
Common Wish: Regulatory Stability
While CIOs have many particular needs for their operations, they share one overarch-
ing concern. They’d like better clarity, if not outright relief, from an ever-growing list of
federal regulations governing their operations. A better sense of “regulatory certainty”
is tops on the holiday list for Michael Krouse, senior vice president and CIO at Ohio
Health, a 17-hospital delivery system based in Columbus. The regulations in play
include ICD- 10 (postponed to 2014), meaningful use (under fire from certain Repub-
licans), and ACO payment models (reinforced in the federal health reform legislation).
“We are working hard and fast and will try to be compliant with all the regulations,”
Krouse says. “But we would hate to find ourselves in a position after doing all that
work that it doesn’t matter anymore.”
The ICD- 10 deadline, which CMS once asserted was set in stone for 2013 deadline
(then subsequently shifted to 2014), is a moving target for many CIOs—and some ex-
perts contend that the federal government has lost credibility on its pronouncements
about the regulation as a result. Many CIOs looked at the most recent postponement
of ICD- 10 with a mixture of relief and dismay—relief in that a resource-draining project
had been delayed, but dismay in trying to regroup yet another effort around compli-
For Chuck Christian, CIO at Good Samaritan Hospital in Vincennes, Ind., ICD- 10
and meaningful use Stage 2 are “on a collision course.” Reporting deadlines for meaningful use and ICD- 10’s go-live converge in October 2014, a timeline which Christian
says will be very challenging for smaller hospitals to fulfill. “The timing of the programs
is like juggling running chainsaws,” the CIO says, adding that Stage 2 ups the ante on
quality reporting requirements. “I wish that we had done ICD- 10 a long time ago and
had it in place before meaningful use came about,” he says.
Christian describes an industry in conflict over ICD- 10. “There are competing
agendas,” he points out. “AHIMA [the American Health Information Management As-
sociation] says ‘let’s get it done,’ while others say ‘slow down, we’re not ready.’ The
question is: who do you listen to?” Christian says that last summer’s delay on ICD- 10
helped his hospital, and he predicts Good Samaritan will be prepared on schedule.
“Payers are the ones that will struggle,” Christian says. “They have more customized
systems.” Thus, some claims may be rejected, or stalled, he says, echoing a common
industry concern. “If you can’t bill with the appropriate coding, or the coding is wrong,
it will negatively impact reimbursement. Just because we can produce the transactions
doesn’t mean someone else can process and adjudicate them. We will need to be able
to monitor and audit that. A lot of things are hanging in the balance.”
Other industry observers say the variety of agencies in play with federal regulations
create confusion industry-wide. “We need clarity and coordination of regulations,” says
Harry Greenspun, M.D., senior advisor health care transformation and technology, De-
loitte Center for Health Solutions. “Many agencies have responsibilities for overseeing
parts of the industry in quality, safety and mobility.” Greenspun describes the regula-
tions around mobile devices for consumers as “happening in siloes. You have the FTC
regulating the device, the FDA wanting to weigh in, and other parts of HHS pushing
consumer engagement through these apps.”
To Christian, the regulatory stability so many of his peers seek may be long in coming.
“The industry won’t ease up anytime soon,” he says. “It won’t make a difference who gets
elected. We are still in a situation where health care costs are unsustainable. Even if the
GOP repeals reform, or parts of it, we have to go back and answer the question of how to
provide broader coverage without breaking the bank of the United States.”