MedVirginia connects healthcare systems Bon Secours and Centra Health, as well as physician groups and a rehab facility in Richmond. It was the first HIE in the country to go online with federal agencies, including the Social Security Administration, the VA system and the military health system. MedVirginia's nonprofit affiliate holds the contract to build and operate Virginia's statewide HIE, ConnectVirginia.
InHealth also supplies managed care, disease management and operational consulting to members, including Bon Secours' accountable care organization.
Matthews did community health planning in South Carolina and Ohio in the 1970s and 1980s. He supervised strategic planning for Akron City Hospital and Summa Health System from 1981 to 1993. Then he moved to Virginia and started working with a group of healthcare systems that wanted to link their systems together to improve outcomes and begin taking financial risk for care.
Matthews sees three pillars to his overlapping companies: physician engagement, care coordination and health IT. It's complex, but "that's what got me interested in the HIE world, where there are so many disparate parts," Matthews says.
-- Ken Terry
THR's health IT prowess also helped the organization form an accountable care organization (ACO). In January, the ACO signed agreements with Aetna and Blue Cross Blue Shield of Texas. Both agreements will reward the ACO for providing high-quality care and lowering costs.
CIO and senior VP Ed Marx has a staff of 650 and an annual budget of $100 million to provide IT support to a system that includes 25 hospitals and 5,500 staff physicians, of whom 500 are employed. But Marx, who has been with THR for five years, has a role far beyond the nuts and bolts of technology, sitting on THR's leadership council with about a dozen top company leaders. He helps shape THR's business strategies and sometimes suggests options in areas where the other leaders didn't even know THR had problems, he says.
Marx says the ideal CIO role in a big organization like THR should be 90% strategic and 10% operational. But when there are fires to put out, "I'm going to jump in and help my team," he says. "So my role is probably split more like 70% strategic and 30% operations."
Because of his conviction that health IT must be grounded in clinical knowledge, Marx spends a day each month doing rounds with clinicians in a THR hospital. His senior staff members must do the same. Says Marx: "This makes you realize that you work in healthcare."
-- Ken Terry
The entire organization backed the effort, starting with financial support. "We spent easily a couple of million dollars just on bar-code medication administration," Minear says. Physicians, nurses, pharmacists and everyone on the health information management staff all had to make operational changes.
Physician buy-in was a critical part of the effort. Back in 2009, physicians began documenting their care online. Ninety-five percent of the staff now uses computerized physician order entry in the hospital, and nearly all orders are entered electronically. The key force behind adoption is a group of 40 physician champions who meet monthly. "They're highly engaged, and they make things happen," Minear says.
The biggest challenge in achieving Stage 7 was meeting "the scope of expectations," he says. Going truly paperless, for example, doesn't just mean scanning all paper into the system eventually; staff must scan it the same day the paper appears. So IT gave people scanners on carts.
Minear's background is in finance, but he shifted to IT in the early 1980s. He feels particularly lucky to be a CIO at UC Davis because it allows him to be involved in clinical care and also in research and education. "In most academic healthcare systems, those roles are still siloed," he says.
-- Ken Terry