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Eyeing the holy grail of the "integrated EMR," hospitals and medical groups make tough decisions when faced with hurdles to connectivity.
As vice president and chief information officer at Saint Luke's Health System in Kansas City, MO, Deborah Gash has plenty of opportunities to realize her vision of a digitally integrated clinical record—one that consolidates information from a variety of disparate systems and sources. The 11-hospital system, which includes a home health agency, has some 1,500 affiliated physicians, many of whom are eager to get onboard with Gash's vision of easily exchanged data. With an annual IT budget of about $35 million and a yearly capital budget that normally approaches $10 million, Gash has more resources than do many of her brethren who also want to share data across different systems.
Nevertheless, like many other hospital and medical group executives, Gash has had to temper the dream of widespread connectivity. When it comes to data integration, however, Gash remains a true believer. "More integration is critical," says Gash. "We won't have quality healthcare delivery without sharing information."
The hurdles to data integration are not always purely technical, healthcare executives say. They invariably involve sometimes difficult organizational politics—often around the topic of which medical department head has the most clout within the organization. Addressing technology purchasing decisions, therefore, requires a businesslike approach to analyzing the cost-benefit model beforehand. And even when data standards, such as HL7, facilitate data swapping across systems, a highly interfaced network can be costly to maintain. To make wise technology purchases and related system integration decisions requires "using data, and not just someone's best guess or dialogue at a social event," cautions Mike Maynard, the outgoing CEO at the Springfield (IL) Clinic, a 195-physician multispecialty group practice that is swimming in technology.
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