Ann Fishman, with EHR TV, interviews Mark Dente, MD of GE Healthcare & Andrew Hamilton of Alliance of Chicago.
Ann Fishman: I am with Andrew Hamilton, COO of Alliance of Chicago, Hi Mark and Andrew, can you tell us about Alliance of Chicago?
Andrew Hamilton: Sure we are an organization located in the city of Chicago that provides electronic health record system and Health IT services to federally funded community health centers that serve on uninsured and under insured citizens of the city of Chicago.
Ann Fishman: In your role as COO, do you have to choose an electronic health record system?
Andrew Hamilton: Yes our organization went through a vendor selection process and I was involved in leading effort with the organization CEO.
Ann Fishman: Because I am sitting here and I see you chose Centricity Practice Solution, why was that the right solution for you?
Andrew Hamilton: Fundamentally the solution offered us 2 very important things, one it allowed us to build the screens that the clinicians and staff used to meet the work flow considerations of that organization and secondly and perhaps its biggest strength is it is an application that allows us to collect and manage data in discreet fields that we can use for reporting and monitoring performances and safety in our community clinics.
Ann Fishman: How have your physicians liked the adoption of this technology, has it been an easy transition?
Andrew Hamilton: Well as probably many in the industry would report, the transition from paper to electronic is challenging for everyone. This particular product, I think we found users of the system think it is intuitive so it is easy to use, it is easy to learn and they find that they clinical screens contain all the information that they need to document which is very important for the organization and yet we balance that with this need to bring all that data together in a structured way to look at our population as an aggregate cohort and so that is always a challenging balance when you are doing the implementation of any EHR. We think that the GE Centricity product that offered the best of both worlds, easy to use but yet structuring that data from reporting and decision support.
Ann Fishman: Mark, Dr. Denten how closely do you work with a client like Alliance of Chicago?
Mark Denten: Alliance of Chicago is a marque example of how to really out to think about the value of electronic health records and how we are going to really take care of patients going forward. We work extremely closely with Alliance and with Andrew specifically. We have a research program right now for the Center for Disease Control, the Chicago Department of Public Health and Alliance of Chicago utilizing our technology and standards. So the other theme of our show here is standards and interruptability, so it is not … it is the ability to take in information, make it available for the clinician to use but then also have knowledge management performed in that information to help provide guidance. One of the great examples we are using right now is a food born illness. Any good EMR should be able to give you the diabetic full exam protocol, right? Has it change, not going to change but if you really think of what we can add value to and why our systems is so flexible in with its enterprise data warehouse for getting this data we can get take something as transient as all the restaurant down the street might have a salmonella outbreak and these guys are seeing within 2 digits of a zip code and we want to get that data to other people so that it could be acted upon and those are some of the researches that we are doing. On the really pragmatic side with what Alliance does, they serve a population that is just what we want to do is do the right thing plus the right thing to do. When we start to think about disparity care in the role of the Alliance plays in providing that care it make us proud to be able to supportive of that.
Ann Fishman: So you are serving the dis-enfranchised?
Andrew Hamilton: Yes the uninsured and the underinsured in the city of Chicago, we are considered a safety net organization that is really caring for some of the most vulnerable populations in the city.
Ann Fishman: Well I like that a lot. Could you give us a short demonstration?
Andrew Hamilton: Sure, so just to illustrate some of the points I was talking about, you can see here I am in the chart, right on the summary page of the chart I have, right at my finger tips, all of the current problems, medications, allergies, advance directives and care alerts and reminders those are decisions support prompts that remind me as a clinician how this particular patient I need to address certain items that they are overdue for or might be having due in the near term. I can get into detail by opening these tabs up and looking at much more detail under them by just clicking, some boxes, those boxes I can move around with ease, it is a very intuitive, simple to use system and then I can also then document all of these different types of visits so a clinical studying will have different types of work flow based on the need of that patient. So there is examples there, then I am able to use these to document their care. And then when I want to look at data that I have collected at a quality level and aggregate that data I can see right here with simple indicator I have 30 diabetic patients, of those 30 they are needing hemoglobin 1C control but I haven’t done the appropriate laboratory monitoring that I had hoped to do. I can click on that button and I can get a list of those patients that are overdue for those activities so these are my 30 diabetics that I am responsible for and right here with 2 clicks of a button I know these are the folks I need to be targeting. And in a new paradigm of care, accountable care, health care reform happening it is very important that these types of systems also introduce these work flows because it is not just about the patient and the doctor anymore. It is about the system of care caring for a community of patients and that is really how powerful this tool said.
Ann Fishman: Very well said, is there a mobile application for this?
Andrew Hamilton: There is! There is I actually a version of this very product that I can access from an internet site and that allows me if I am at home taking call or if I am in a hospital round on patients in appropriately secured mobile application, consistently following all the privacy and security standards in the industry but yet allowing me to access that information.
Mark Denten: You know this is one of the technologies that we are really proud of, we have had electronic records at General Electric for a long time but this particular application had a significant input of hundreds and hundreds of used cases. This application goes from the single doc practice to… how many clinicians are actually using …?
Andrew Hamilton: Great question Mark, we have over 300 physicians, nurse practitioners, and physicians’ assistants using this system at any one given time.
Mark Denten: And we actually have customers that are even larger than that, what was interesting was that in essence is a very enterprise scalable solution, yet we have over 40 specialty technologies, specialists formats of the same technology but now they confirm their views. The orthopedic surgeons have their view, ophthalmologists will have their view, all feeding the same enterprise data warehouse that has over 25 million lives in it that we can now start not only to look in the institution that Andrew critically pointed out in payment reform but also now as we start to take care of community of patients, how do we make sure that their bench mark, right in most appropriate care and now have a data set because of what we really started almost 7 years ago, is allowing us to really optimize patient care right now. I am really proud of this.
Ann Fishman: How does this system help physicians achieve meaningful use 1.
Andrew Hamilton: Well from our perspective if you have followed closely the meaningful use I have been calling them test questions lately, things like they must be a structured problem and the structured medication online, order entry, electronic prescription of medications, all of those features are in this product in the product you are looking at here. I don’t have to use 3 different systems to do that; I can meet all of the requirements of meaningful use by this one product. And most importantly I am able to as you can see here, I can look at all the meaningful use measures and I can see that my organization currently is in alignment and has passed those test questions for stage one just by looking at this and that is very important because managing clinical adoption technology doesn’t mean give them a computer and turn it on and train them one time. It is a system that needs to be reinforced and this tool, this recording tool makes that very easy to identify your problem areas and launch some institutional interventions to fix that, to ensure the use of the technology is consistent with its design.
Ann Fishman: Very impressive, I thank you both so much; I am Ann Fishman at the GE Booth 2012, thank you.