Love Thy Vendor?

The meetings with the three vendor CEOs tipped the scale to Eclipsys, King says. "The differences in their cultures were pronounced," she recalls. "Eclipsys had more flexibility. When the CEO of their company said he is willing to commit with us, and he said it directly to our CEO, it was a clincher."

The four-year rollout began late in 2007. Among the early milestones: that a certain percentage of users will be logging in and using the clinical data repository. "A risk-based relationship has everyone's attention in the right place," says King. "We hold each other accountable."

-Gary Baldwin

Collaboration and Then Some

Catholic Healthcare West's clinical IT overhaul is taking the 41-hospital system down some tricky pathways. Among the applications that CHW is deploying is computerized physician order entry. CPOE requires a major shift in the way physicians work, which is only one reason why the technology has seen limited uptake in the industry, despite its potential to reduce errors.

Nevertheless, CHW has enjoyed physician acceptance of CPOE at some early adopting hospitals in its massive "CareConnect" initiative. At Dominican Hospital, the system's first facility to deploy CPOE in June 2006, more than three-fourths of orders were being entered electronically by physicians within the first year, recalls Dan Ferguson, MD, vice president of medical operations. That proportion has since grown in other hospitals. "It is due to collaboration by all our partners," he says, referring to CHW's two main software suppliers--Cerner and Meditech. The software suppliers offered guidance in order-set creation. In addition, Cerner facilitated discussions between CHW and Novi, MI-based Trinity Health System, another client undergoing a large multi-hospital deployment. For CHW, being able to reach out to another hospital system has helped avoid reinventing the wheel.

-Gary Baldwin

Why Physicians Balk

Compared to most physician group practices, Holston Medical Group is light years ahead in using information technology. According to several studies, less than one-fourth of medical groups have automated their recordkeeping. In contrast, Kingsport, TN-based Holston, an independent, multispecialty practice, has been using EMR technology for more than a decade. But why is Holston such an anomaly?

Holston's founder and EMR advocate Jerry Miller, MD, says it is more than cost that keeps physicians away from IT. Plagued by over-hyped and under-developed products, the EMR landscape is too complicated for many physicians to navigate, he says. "Many of the doctors are at the mercy of some IT person who comes in and says, 'You need to see this latest product.' But running a medical group is a complex business, and you need to be prudent in choosing a vendor. They need a track record and longevity."

-Gary Baldwin