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Taking on the Big Boys
Health Data Management Magazine, June 1, 2009
A Catholic integrated delivery system that owns six New England hospitals is spending $70 million on information technology so it can better compete for patients against the major teaching hospitals in Boston.
Caritas Christi Health System is paying startup costs for implementing electronic health records software for 1,300 physicians, with area payers picking up the tab for basic hardware. In addition, the system is gearing up its clinical automation efforts at all its hospitals.
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"In order to be competitive, we need to spend money on I.T.," says Todd Rothenhaus, M.D., senior vice president and CIO. The Boston-based delivery system hopes to use information technology to generate clinical data that demonstrates it offers high-quality care at a low cost, or what Rothenhaus calls "value for the health care consumer."
As the owner of community hospitals, Caritas Christi must take on powerhouses, such as Partners HealthCare System Inc., as it competes for patient loyalty in an intensively competitive market.
To help defray some of the enormous I.T. costs it faces, the delivery system will aggressively pursue Medicare and Medicaid financial incentives under the federal economic stimulus program, Rothenhaus acknowledges.
Picking up the Pace
Since launching its effort to bring electronic health records to physicians' offices in 2006, the delivery system has implemented software for 150 physicians. This year, it will add another 150 doctors. And it has set an ambitious goal of adding another 1,000 in 2010, Rothenhaus says.
The delivery system is hosting the software, from eClinicalWorks Inc., Westborough, Mass., using the application service provider computing model. In this way, physicians avoid having to invest in a server and maintenance. Doctors are accessing the software primarily using laptops linked to wireless networks.
When new CEO, Ralph de la Torre, M.D., joined Caritas Christi last year, he shortened the timeline for its automation projects in hopes of gaining a quick competitive advantage. "The goal is to have every physician integrated," Rothenhaus says. "We want to be a high-quality, low-cost competitor in the region. To do that, we really need to have exceptional data about the lives under our care."
To speed up its automation efforts with area physicians, most of whom belong to independent physician associations and practice at very small clinics, Caritas Christi hired a consulting firm, Concordant Inc., North Chelmsford, Mass., to help with the project.
The consultants have developed a 20-week implementation plan for each site, followed by four weeks of on-site support, says Janie Tremlett, senior vice president for the consulting firm.
Although the technology can theoretically be implemented in less than 20 weeks, the longer timeline means physicians can maintain a "reasonable schedule of seeing patients" during the transition, Tremlett says.
The ongoing effort includes the organization's 400 employed doctors and 900 independent physicians affiliated with Caritas Christi, Rosenhaus says.
Although independent doctors will have virtually no upfront costs, unless they purchase hardware upgrades, they must pay a monthly maintenance fee to the delivery system. Caritas Christi is picking up startup costs for the software under exemptions to the so-called Stark anti-kickback rules. Some physicians in the Brockton, Mass., area received hardware subsidies through the Massachusetts e-Health Collaborative, a coalition promoting health information exchanges. Now, hardware subsidies are available from a number of area health plans, which Rosenhaus declined to reveal.
Concordant helped the delivery system establish core data sets that it will gather to measure quality and maximize its potential to win extra payments under health plans' pay-for-performance projects, Rosenhaus says.
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