When Schooler came into healthcare at Methodist Hospital of Indiana, graphical user interfaces such as Windows 3.1 were revolutionizing the office desktop in most fields, but hospitals were still running mainframes. "Registration, billing, and maybe lab and radiology were the only things automated," Schooler told InformationWeek Healthcare. "Everything else was manual."
Although many healthcare organizations are still struggling to switch from paper to electronic health records (EHRs), data are rich enough and decision support systems have advanced to the point that information really is helping to create better care, according to Schooler, winner of the John E. Gall CIO of the Year award from the College of Healthcare Information Management Executives (CHIME) and the Healthcare Information and Management Systems Society (HIMSS). Schooler will be recognized at the 2012 HIMSS Conference awards banquet on Feb. 23 in Las Vegas.
[ Most of the largest healthcare data security and privacy breaches have involved lost or stolen mobile computing devices. For possible solutions, see 7 Tools To Tighten Healthcare Data Security. ]
The award, named for the late John E. Gall Jr., who implemented the first fully integrated medical information system at El Camino Hospital in Mountain View, Calif., in the 1960s, honors innovative leadership in health IT.
Schooler says he won in part due to his longevity, that it was kind of his turn after 21 years in healthcare. "It's also an award that means a person has been recognized as a thought leader in the industry," he said. Schooler actually was nominated six years ago, but was ineligible because he was a member of the CHIME board then.
Orlando Health made the 2011 InformationWeek 500 list, in part because Schooler had been successful in tying together myriad, disparate information systems.
"A health system like ours literally has hundreds of clinical information systems," Schooler said. Different vendors provide systems for registration, scheduling, billing, and ancillary departments. "There are all these technologies that need to be integrated."
The flagship Orlando Regional Medical Center has Allscripts Sunrise EHR for inpatient care, which is interesting in that Sunrise is a former Eclipsys product. Eclipsys, which Allscripts acquired in 2010, was an outgrowth of Technicon Data Systems (TDS), based on the same technology Gall helped contractor Lockheed Martin develop at El Camino decades ago.
Orlando Health also works with GE Healthcare and Virtual OfficeWare to provide ambulatory EHR hosting for independent physician practices through the EHR exemption to the Stark physician self-referral and Medicare anti-kickback rules.
Over the years, EHRs have become far broader and more sophisticated than what Gall developed and even what Schooler worked on at Methodist. "What we call [EHRs] today are a superset of what we had in the past," Schooler said.
The technology might be different, but the strategy for integrating systems has not. "It all stems from getting effective workflows into place," Schooler explained. But for the first 15 years of his healthcare career, Schooler struggled trying to find technology with powerful enough analytics and interoperability to help clinicians better manage patient care.
Now, a "new level of decision support," driven by business intelligence, is moving health IT closer to what Schooler called the "endgame" of disease management, clinical analytics, and population health. "But first of all, you have to have effective data capture," he said. In other words, a system is only as good as the data that goes in. "These are very critical things to the next five to 10 years of healthcare," Schooler said.
According to Schooler, the winners and losers of health system transformation will depend on how well they input and mine their data, both in real time at the point of care and in post-care review. "We're now able to focus on what I've always called accountable care," Schooler said. Although the new concept of accountable care organizations mostly refers to bundled payments, Schooler means organizations taking responsibility for delivering quality care.
"It's all about getting the right care to the right patient at the right time," he said.
Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)