technology. “Cooperation with providers” is how the CMIO describes his most
pressing requirement for the future. Metropolitan Health Networks runs a provider
services network focused on adult primary
care. With 80 employed physicians, the
publicly traded company is reimbursed
through at-risk Medicare contracts. It also
contracts with hundreds of other primary
care physicians in some 200 practices.
Metropolitan is transitioning its employed base of physicians to an EHR, from
eClinicalWorks, using a vendor-hosted
version of the ambulatory software. McCoy figures all the offices will be live on
the system by the end of 2014. The practice
operates under the patient-centered medical home model, which McCoy describes
as “primary care quarterbacking.” The I. T.-rich model calls on primary care physicians
to orchestrate care delivery among specialists and uphold various quality measures
along the way.
Technology, McCoy says, is not the hur-
dle to the model’s success—getting various
external providers to cooperate and share
data is. “Some hospitals don’t want to give
up their data,” he says. “If a patient stops at
the emergency department, or gets admit-
ted for something unrelated to what we are
treating them for, we are at the mercy of the
medical records department to send us a
discharge summary,” he says. “If a patient
has been in the local hospital, we want to
see that patient in three to five days. But
it takes an act of Congress to get the dis-
charge summary.”
McCoy’s I.T. arsenal includes some
tools to enable better exchange of data. Its
eClinical Works EHR, for example, includes
a secure messaging app built into the sys-
tem. Hospitals or specialists can partici-
pate by signing up through Metropolitan.
“It is getting the person on the other end to
change their behavior that is difficult,” Mc-
Coy says. “No one has said they won’t do
it, but they are dragging their feet. They are
used to the fax machine.”
There is one piece of technology McCoy
would like to have: a vendor-agnostic piece
of software that would “push” relevant
data back to the practice from contracted
physicians. The set-up would resemble a
private health information exchange, with
data from the contracted offices being
delivered to a central repository operated
by Metropolitan. McCoy is just beginning
to investigate vendors that could deliver
such technology, with DB Motion among
the candidates. He’d like some text mining
capability built into the system, so he could
more easily scour text narratives for critical
data not captured in a discrete format.
right tests and noting all the diseases,” Mc-
Coy says. “It would be like a chart review,
which, without technology, requires a per-
son paging through the notes and reading
everything. You can’t hire enough medical
directors to do this.”
The text mining tool could even be
used in capacity with his own physicians
who dictate most of their notes on the
eClinicalWorks platform (which also has
the capacity to capture structured, dis-
crete data). McCoy says that the potential
of EHR is promising, but that the industry
needs more mandated cooperation for it
to take hold. “We are just scratching the
surface about using technology most ef-
fectively for patients,” he says. “The way I’ll
get cooperation more quickly is some sort
of stick. If the government says to provid-
ers, ‘under these circumstances, with the
