Not-So-Easy Integration

His retirement looming at the end of this year, Maynard has led Springfield Clinic for more than 20 years. The clinic now functions as what Maynard describes as a "true healthcare business, not a cottage industry," as it did when he took the job in 1987. During the early years, the clinic kept no money in reserves, and communication among physicians was fragmented at best. Since then, Springfield has quadrupled in physician members, launched its own managed care plan (the group is at full risk for 40,000 HMO lives), and opened an ambulatory surgery center with four gastrointestinal service suites and five operating rooms. It recently obtained its own direct financing to fund a major expansion of its main campus (saving 1.5% on a 30-year loan).

None of this growth would have occurred with prudent use of technology, adds Mark Kuhn, Springfield's chief administrative officer. "Before we bought anything, we analyzed the procedures we were doing, who was doing them, and where. Then we proceeded." For example, Springfield used reports from its practice management system to justify purchasing—and later expanding—its MRI suite. It also has embraced tech-heavy nuclear medicine and digital mammography. Not until recently did Springfield invest in an electronic health record, expanding its use of Allscripts software in 2004. The clinic had expanded to so many new satellite clinics (it now runs 22), the EHR technology made sense financially, adds CIO Jim Hewitt. According to Maynard, the clinic is poised to see a 3-1 return on its EHR purchase.

Due to the expense and the number of hospitals its members serve, Springfield Clinic has put direct hospital interfaces to its EHR on the back burner, says Hewitt. Instead, the clinic focused on pulling data from its other legacy systems, including registration, scheduling, and transcription. "We would like a complete repository," says Hewitt. "But we cannot interface to every hospital in the 12 counties we serve."