MGMA 2010 – James Corrigan (GE Healthcare)

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Ann Fishman, with Dr. Eric Fishman of EHRtv speaking with Jim Corrigan, Senior Vice President of GE Health IT.

Category: Featured, MGMA 2010, Tradeshows
Date: November 21, 2010
Views:9,542 views

Ann Fishman: Ann Fishman, with Dr. Eric Fishman of EHRTV. We are with Jim Corrigan, Senior Vice President of GE Health IT. We are at MGMA in New Orleans, 2010. Jim, thank you very much for being with us.

James Corrigan: Thank you so much to you and Eric.

Ann Fishman: The first question that comes to mind is why would GE be and then healthcare space?

James Corrigan: Look, I think the question is “Where is healthcare going?” I think we clearly see in GE that healthcare is really going to become industrialized and what I mean by that is if you look at industries like retail or finance or banking, you really see how those industries used IT to really change and enable the value chain in a way to really solve three things – cost, access and quality – and those are the same exact things that we are facing today in healthcare. Healthcare, as you all know, has really moved from more art to more science; and as that science has become more pervasive, the amount of data that is generated every single day whether it be through a device, an interview or the internet, it has become almost unbelievable for any physician to consume and then apply in a safe and effective manner. We believe IT is going to be just a great catalyst to really change that paradigm, really make that value chain much richer, much more enable to solve the problems of cost, access and quality but most importantly to take care of people. You know, I am always fascinated by my friends who are in healthcare and not just the people who sign up to be physicians but the people at the front desk, the people who are assisting the physicians and the people that issue the bills. These are incredibly committed folks who every single day are doing everything they can to get it right; but in many cases, the system just doesn’t seem to help and what I mean by the system is that of the healthcare market itself. Well, in GE, we have attacked this phenomenon with healthy imagination. We are not thinking about solving just cost or just access or just quality. We are really trying to look at it holistically and we are looking on a global scale. We are taking our learnings from India and Europe and South America and Asia and applying them here to the U.S and we are taking the fundamentals that we consider to be here in the U.S. across the pond or across the globe and it’s something that we are really excited about; and here at the MGMA, it’s our way of really kind of showing off kind of the four corners of the patient – when they first visit their primary care, when they go work with a specialist, when they enter the acute setting – and what we see is the home.

You know, I would like to quote Brandon Savage who is our Chief Medical Officer and I think you have all met Brandon a few times. Brandon has always told me “It’s not what we do at the one or two hours with a physician every year. It’s what we do the other 8,000 or 9,000 hours that really makes a difference on healthcare and really makes people have well span, not just life span.”

Eric Fishman: And we have been discussing how the products you have introduced are for physicians but it is not just for physicians; it’s for their ability to improve the care of the patients that they treat. It can be done through evidence-based medicine, it can be done through better communications with the patients. Explain to some extent how the GE product line assists in those areas.

James Corrigan: Well, I think as you both know, as great as healthcare IT has been over the last few years, we are really probably only maybe 15% to 20% penetrating. So, there’s a large percentage and if you look at just physicians in the less than 10 office space, there’s probably almost 350,000 to 400,000 physicians in that space who have had no experience using healthcare IT. They are the ones that we are really targeting with our brand new introduction of Centricity Advanced. The issue with those physicians has been how we enable the physicians to get the clinical thinking and the IT that we have been using in some of the larger practices in a way that’s easy to use, easy to install and is cost effective. Well, leveraging the architecture of software as a service, like we use in Google, is really our way to do that. We launched the product in June, CCHIT certified, ERO certified this past month; and now we are off and running with these physicians to enable those physicians to really have the ability to use that. But as physicians move from a 10-doc practice to a 25, 50, 100, 250 or a community hospital, our products are able to serve them very, very well, giving them richer reporting, richer clinical content, deeper use of portals and also making sure that we do the most fundamental thing that is used the business side of healthcare. We have to make sure that physicians can focus on the people and the patients and not worry about the administrative side, and we believe our suite of applications does that very, very well and very competitively.

Ann Fishman: The High-Tech Act states as a goal that by 2014 all patients will have a electronic health record. How realistic do you think that is?

James Corrigan: I think it’s a fantastic role. I think the reality of it really is going to be partnership you can have with physicians, as I said, making it very easy to adopt. Now, again, I know the economics are going to incent physicians both from a kind of a <<inaudible>> standpoint, but I really think the ability for that system to become a tool, something that they know that they need to make sure that they can deliver high quality care is really going to be the trick. So, I look at our physician that we have at home. She really wants to have a tool that enables her to make sure that my children, my wife, and I are taken care of holistically. She doesn’t want something that gets in her way. She wants something that is actually an aid, something that enables her to really understand what’s going on with you but also understand why you are there and to be able to quickly ascertain and leverage some of the great clinical thinking that’s out there and then apply that to you very, very effectively and very efficiently and I think that will be the thing that gets on us over the edge; and when I talk about the industrialization of healthcare, that’s exactly it. It’s our ability to convince physicians and the care delivery teams that healthcare IT really is going to be a catalyst for better care and systemically solves some of the big, big hurdles that healthcare as an industry is facing today.

Eric Fishman: In order for physicians to utilize the technology in that fashion, they need to be properly trained. The number of 50,000 healthcare IT worker shortage has been <<inaudible>> about recently. What is GE doing in order to be sure that you are ready for what I think we are all expecting to be an explosion of adoption of this technology in the coming years. How will you be training physician to implement it adequately?

James Corrigan: Well, Eric, I mean I think we are doing the basics. You know, we have been scaling up all of our install teams and all of our partners to make sure they understand our suite of products; but I think that’s just kind of the first step. One of the things that we have launched is the donation program for the community colleges that are receiving some of the incentive dollars for training. So, we are actually donating our EMR product, the software itself, to make sure they have a product that’s real and usable in the field, in the classrooms, so that when they do move outside the classroom they have real-world and application experience with a very sophisticated vendor who understands the continuing care but also with a real product, not just the textbook. We want to make sure that, as you say, these wave of people that enter the healthcare IT space on the install and support side are very, very competent. You know, one of the things that we believe is that the quality of care is so dramatically important and the quality of instruction for these healthcare providers is critical to that. So, we want to do everything we can both internally and also partnering with community colleges, academic medical centers and other places to actually have a live EMR to work with, to learn on, so they can apply those principles out in the real world. So, that’s why for us, having a standard based product, a product that isn’t so proprietary that no one else could use it, no one else can connect to it makes no sense for us. Again, back to my industrialization point – you know, that won’t scale, but most certainly, that really doesn’t show how we are trying to solve the problem holistically.

Eric Fishman: Let’s go back to evidence-based medicine, clinical decision support obviously, obviously a phenomenal benefit for patients. This is a bit of a theoretical question. Once those paradigms are put in place, it gives the payers for instance the ability to provide financial incentives for physicians to actually follow them. It may even provide financial incentives to patients that “if you don’t take the medication that has been prescribed because it’s the one that should be prescribed, we won’t pay for your care.” You anticipate the changes in healthcare over the coming years, decades, will come to pass that the evidence-based medicine will no longer be suggestions but rather than mandates, if you will, either at the physician level or even at the patient level.

James Corrigan: Again, Eric, you know, I think evidence-based medicine – any initiative that is going to give the care delivery team the right information at the right time that they have confidence in is going to be consumed very rapidly. So, whether you are someone at the front desk, you want to about to know last time that the person was visited, did they access you via your portal, what’s going on otherwise. It’s so amazing to see how forthright and how honest people are to the computer so that the care delivery team can really provide better information; but then when you move into that clinical setting during that 15 or 20 minutes of vital, vital time that a physician has with the patient, you honestly want to make sure that they know of all the demographics, all of the history of present illness, all of the sibling information. Those basic sets of data that a physician can have at the point of care are incredibly compelling for any physician. Now, when you start bringing in some of the evidence-based medicine or some of the best practices that are out so that a physician in the middle of Indiana can leverage the best thinking of a Mayo or Cleveland Clinic or Intermountain, Indiana University itself is something that we believe is going to be consumed more and more rapidly; but in order for that to happen, those standards have to be put in place – you have to have a common language, a common terminology that you can share from, that you can leverage from, and then make sure you repurpose it back at the point of care or really the point of decision making not point of care because you got to look at the whole care delivery stream.

Ann Fishman: How important are personal health records?

James Corrigan: Let’s define that a bit. So, there’s an electronic medical record which I would call a physician center. A personal health record would be something that maybe you and I would be using. Is that how you are thinking about it?

Ann Fishman: Yes, sir.

James Corrigan: So, when I look at the personal health record, I think if it’s not tied to a physician, it’s just not going to be that valuable – one person’s opinion – and the reason why I say that is because a personal health record is a great way to log things – diet, sleep, workout habits – but if that’s not integrated with your physician so that you can bi-directionally share information, I am really not sure you are getting the whole value out of that. So, whether it be any of the commercial products that are out there either at the payer level or at some of the big IT level, you just haven’t seen them take off; you know, they are in the single digit rates right now because they are not linked to a physician. Again, I think we all have stories but I think all of us we want a better way to tightly link with our physician that has security but has that bi-directional real-time information so that you can kind of create a conversation; and I think when personal health records get to that point and I think IT is a great catalyst to make that happen, you will see them start to be more widely adopted, it won’t be such a fringe type of technology and it would be something that is used on a day-in-and-day-out basis. For the people that have chronic disease which is the focus today, the people are really focused on wellness.

Eric Fishman: Jim, obviously HIEs are an important part of the accessibility of health information across the country and obviously GE has an interesting perspective on that. if you could elaborate on that.

James Corrigan: Sure. You know, HIE is really kind of comes back to my industrialization point. Healthcare Information Exchanges have been around now for probably almost 10 years and we have been leaders in that space contributing very heavily to The Hinge, kind of connectivitython that happens every year. So, I am very excited about that; and what it enables us to do is, like I said in many others, it forces us to have a common language, a common set of making sure that each portion of the value chain understands what it does and what the next portion needs. So, it produces what the next set needs to consume. We will use an example like the ATMs. So, an HIE is very similar to the way the ATM works today. I know healthcare information is incredibly personal and incredibly valuable. I think money is also something that people value very much; and anyone sticks a card into a machine and can access their balance, do a transfer and some of the very, very simple basic things that they had to do; that’s what physicians are looking for. As you move from primary care to a specialty care to acute setting, physicians want to make sure that they have the right information about us at the right time that they have confidence in. They don’t want the entire chart. They don’t need the entire of chart. They need to know the certain aspects of you that’s going to enable them to deal with your care. So, an orthopedic is much different than a primary care and is much different than a surgeon. So, HIE enables us now to standards base those transactions and share that information such that both sides of the party know what they are expecting but also know what they are producing so that they can drive more efficiency in healthcare, and again, back to my point of industrialization.

Eric Fishman: Jim, let me ask you a related question. I have been shocked at the relatively small utilization that physicians have of patient portals. Physicians pay their staff to do things that patients could be doing at no cost more efficiently – you go to the airport and everybody’s using the kiosk. What is your experience with respect to the utilization of patient portals from a physician’s perspective?

James Corrigan: First and foremost, I think every physician would love to do that. I think you have to make it easier for the patient and you are going to also instruct them of what it is that you are looking for. So, I think, again, we talked about the PHR; I think the a portal is a great first step to a PHR, and I think now the key is people are coming in to physician’s office now with the stack of paper or a thumb drive of all the research they have done on why they are there today. How exciting would it be that they would be able to transfer that information so that when the physician walks into that office, she knew exactly what that person was thinking about for themselves, their child or the people that they are caring for. So, I view portals as something that every physician wants. I think the key is how we make the consumer and the physician interact in such a way so that it’s valuable; it’s not just checking a box, it’s something that they see that they both get value of.

Eric Fishman: Do you think that the uptake in patient portals will be parallel to the uptake in electronic health records.

James Corrigan: Eric, I think what will happen is I think physicians will adopt IT because of the incentives that are there today. I think EMRs will become much more pervasive, they will be standards based, they will share information as the legislation is moving in that direction, and I think portals will quickly follow after that and I mean portals whether it be a handheld device or something that you could see in a kiosk format, and then I think you will quickly see people saying “Ah, now I want the information that the doctor has, I want the information if I have to be in one spot and I want the tools to better manage my care, my payments, my work with pharmaceuticals, my parents.” You know, these are the things I think we are going to see more and more of and I think IT is going to be a great catalyst to make that happen.

Ann Fishman: One of the executives we spoke too here said that a perfect storm is brewing and I will tell you what the factors are but the perfect storm is going to take most physicians unaware, that they are simply not prepared for the changes coming which are important regulation, the stimulus plus ICD10 plus new bundling requirement plus the probable consolidation in the industry that’s going to leave fewer companies standing. What would you say to that? What should the physician who is really not informed at this point and does not really know where to go, what is that person to do because the changes are going to be so striking?

James Corrigan: You know, I would say that opportunity is brewing. Every single industry that I have been part of always has a tipping point. I think we are about to see it in healthcare. You, me, our friends and families are demanding more and more of our healthcare providers. They are no longer these people that are not questioned. They are no longer siloed individuals that are expected to be ‘know all, be all’ because they are responsible for. They are going to be more team based. So, you hinted to accountable care organizations. We love accountable care organizations because it makes the physician, the primary care the quarter back, the coach, the general contractor of your healthcare. So, I view this as a perfect opportunity for payers – pharmaceutical companies, vendors, providers and patients – to finally work together in an efficient value chain and you are bringing back to my point which is the industrialization of healthcare. I don’t view it as a threat. I don’t view it as something to be of. I view it as something to actually look forward to as a son, as a brother and a father.

Ann Fishman: Anything to add, Jim?

James Corrigan: Well, I want to really again remind everyone that this is not a problem that’s going to be solved in a year or three. As people evolve, as healthcare evolves, as it becomes more scientific, there’s always going to be an element of arts; and I always want everyone to remember that IT can help with the science part, we can digitize science, but there will always be an element of art that whether it’s a portal, a PHR, there will always be an interaction between a trusted provider of healthcare and the patient; and if that is going to be successful, IT has to recognize that and through our collaboration frameworks, through the very, very dedicated team that we have here today and across the globe, I really think we understand them but, most importantly, because we are being very open with our customers. We understand today that providers, as you say, are in a very difficult spot, but difficult positions make unbelievably awesome opportunities and we believe as a company we can partner with them both on a product standpoint, on a financial standpoint, and also on a process standpoint. GE being one of the oldest companies in the United States, being around since that DOW was started, has lived through many industrializations and has weathered those storms and has made all of its customers very successful, and we believe healthcare is just going to be another great point for us in history to make that happen.

Ann Fishman: Jim, thank you so much.

James Corrigan: Thank you very much.

Ann Fishman: Ann and Eric Fishman from EHRTV at MGMA, New Orleans, with Jim Corrigan. Thank you.

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