Integrating Integrated Delivery Systems
September 2005
Aligning people, process and technology" was the mantra for Parkview Health when the Fort Wayne, Ind.-based integrated delivery system committed to improving its information technology infrastructure to unite an expanding family of care locations.
Parkview Health has electronically integrated its eight hospitals, with 774 beds, in northwestern Indiana. The process began in 1999, when the delivery system's governing board recognized a need to upgrade its I.T. and telecommunications infrastructure, says Pat Thompson, senior vice president and CIO.
"The board believed our strategic direction was to use I.T. and redefine health care in northwest Indiana," she explains. "That direction was built around integration."
At the same time Parkview Health kicked off a project to select a primary vendor in 2000, the organization began improving its telephone and local and wide area networks. Thompson oversaw the parallel tasks, with the vendor search running through 2002.
A paramount need
Many integrated delivery systems have duplicated Parkview's efforts in recent years. As provider organizations form new governance arrangements to deliver expanded ranges of care across a community or across state lines, the need to share information at all points becomes paramount.
While integrated delivery systems report different strategies for enabling enterprisewide access to clinical, financial and administrative data, they agree it can only be done with a cohesive I.T. plan. And deep pockets: the cost of tying systems together with I.T. ranges from tens to hundreds of millions of dollars.
There are more than 460 integrated delivery systems in the United States, and that number is growing, says Charles Bracken, managing director for ACS Healthcare Solutions, a Dearborn, Mich.-based consulting firm. As their numbers continue to climb, so will the need to lean on I.T.
"There is a long way to go, but we are definitely in a round of upgrades, integration and information system advancement, all since 2000," he says. "Most of the integrated delivery systems we work with are on the journey. They are committed to the next level of upgrade, to advancing clinical information systems through a core vendor strategy."
Many are on the road to fully integrating their organizations with I.T., but there are obstacles ahead.
"More integrated delivery systems are implementing I.T. than selecting," Bracken adds. "And many who are implementing have yet to aggressively pursue the operational changes associated with their goals."
How these organizations coalesce has changed over the two decades since integrated delivery systems began forming to compete for managed care contracts.
For example, the 1990s modus operandi of employing group practice-based physicians is giving way to integrated delivery systems looking for ways to tie in doctors without putting them on the payroll, says Laura D. Jantos, principal with ECG Management Consultants Inc., Seattle. That's leading to a more complex problem when it comes to implementing I.T.
Ground-up I.T. strategy
"When a physician is not on the payroll, management can't just say, `Use this system,' " Jantos says. "Management needs an I.T. strategy built from the ground up. And they need a cohesive vision and governing structure."
Parkview Health's vision was putting patient data in the hands of clinicians where they need it-hospital, office or home-in order to truly integrate the integrated delivery system. It was achieved by the decision to standardize on IDX Systems Corp., Burlington, Vt., as the core vendor.
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