an EHR isn't really an EHR unless it addresses the challenge of integrating data from different EMRs into a comprehensive patient record and an integrated experience for the patient and the provider.
By that standard, "I don't think anyone has achieved the level of having a complete EHR," Gardia said. "Some are closer."
Baptist Health has been working toward that goal since before the advent of Meaningful Use, creating its first "fully digital hospital" in 2005 with the construction of Baptist Medical Center South, a suburban outpost of the downtown main hospital. But although that model has since been replicated throughout the system, with Cerner as the core medical records technology, today Baptist has 11 EMRs in use within its health system. That's partly a result of acquiring medical practices that previously made their own EMR choices, as well as the use of EMRs tailored to specialties that don't fit neatly into the EMR for general hospital operations. Achieving continuity care across providers and regardless of what software they use is the major challenge healthcare organizations must address today, he said.
Baptist operates a private health information exchange to merge data from multiple EMRs and exchange data with other healthcare organizations. Yet Garcia is also aware of the danger of presenting a fragmented experience -- for example, by presenting patients with multiple patient portals, each linked to an EMR associated with a fraction of their Baptist healthcare experience. Baptist recently conducted a "soft launch" of an integrated patient portal "untethered" from any single EMR. It's not yet at a stage where he's ready to brag about it or declare success -- in an interview with Becker's Hospital Review, he described it as a large software development project that his developers struggled to get right.
In addition to technology management, Garcia has taken on business leadership functions -- notably, overseeing the revenue cycle management -- the process, not just the technology -- for the hospital.
He is also playing a new product development role for a "corporate health" product called PATH (Personalized Approach To Health), created in partnership with the local YMCA. The idea is to contract with employers seeking to lower their healthcare costs and improve employee wellness. Baptist Health provides the medical expertise for the program, while the YMCA brings its expertise in behavior modification. Together, they hope to guide their clients' employees through programs that advocate smoking cessation and better exercise and diet habits.
While there are many competing wellness programs, typically sponsored by insurers, Baptist will make the case that a program anchored to the region's largest healthcare system can offer more continuity to employers that may not stick with the same health insurer from one year to the next. An ongoing record to track employees' health and encourage efforts to stay well will be a key element of the program, with Applied Health Analytics of Nashville, Tenn., providing important enabling technologies. When the system generates a recommendation to an employee, the system will track whether the employee viewed that email and took action -- for example, by scheduling an appointment.
"The challenge is how do we get [employees] engaged and accountable for their own share of responsibility for their health," Garcia said.
Overall, he said, the story of his career is about being aggressive and competitive and wanting to build something that makes a difference. "I want to build the organization so hopefully, when I leave it, it will be better than I found it."
Garcia is not a caregiver -- "I did not have that calling." Rather, "it's my calling to give the right technology to those who have the calling to put their hands on the patient and have an impact."
The impact he most hopes for is to spare some other father the pain of lying awake in a hospital bed, waiting for relief that comes too slowly, or to eliminate the delay in delivering a diagnostic that's needed before care can begin.
Has meeting regulatory requirements gone from high priority to the only priority for healthcare IT? Read Health IT Priorities: No Breathing Room, our latest digital issue.