Physicians Turn to Online Communications

Physicians who want to communicate more easily with their patients—but aren't ready to open up an IT business in their back office—are turning to online solutions. Physicians at hospitals and private practices are using Web-based programs for a variety of tasks, such as conducting e-visits, e-prescribing medications, delivering lab results to patients, and sharing medical records with patients and their other providers—with no wiring, servers, or IT staff required. And, in some regions, healthcare organizations are partnering with their biggest rivals to make it happen.

That's the case in New Jersey, where several disparate hospitals that all use their own EMR systems are collaborating to help physicians and patients communicate more effectively.

The hospitals, all within a 20-mile radius in Middlesex County, agreed to use RelayHealth, a Web-based communication service produced by Alpharetta, GA–based McKesson. Some of the hospitals in the New Jersey Health Connect health information exchange and more than 700 affiliated doctors are already using the product, with more to follow.

It's a historic collaboration, says Frank DiSanzo, CIO at Saint Peter's University Hospital, a 478staffed bed acute care teaching hospital in New Brunswick, NJ, which plans to roll out the system to 100 of its doctors this month.

"Sharing information between these different hospitals in the area is really something that we've wanted to do for a long time, [but] we really haven't had a vendor-agnostic way to do it," says DiSanzo. RelayHealth offers doctors secure peer-to-peer and provider-patient communication and medical data sharing, plus other online tools such as virtual office visits and e-prescribing.

In the past, for a collaborative project such as this to work, hospitals had to agree to buy the same product, DiSanzo says. "And those things always started to fall apart relative to support and technology and who paid for what and how that would mesh with other proprietary technology these institutions had," he says. "So Relay, being vendor-agnostic, was an olive branch we could offer."

The main benefit driving adoption is the ability to better connect with patients in a competitive marketplace. It's easy to learn and has zero footprint, DiSanzo says. "You log on the web and, poof, you're there. No one's putting a server under your desk or asking you to back anything up," he says.

Still, some providers prefer to host their data on-site. "I counsel against that, and I think a lot of them may not know what they're getting themselves into," DiSanzo says. "I would recommend that physicians, as far as deploying EHRs in their practice, go with a Web-based software as a service model no matter what or who they ultimately purchase from."

The main reason is that IT is not most physicians' area of expertise. "You know, when you have a server there, who's going to maintain it? Are the environmental conditions proper? Who's going to do your backups? And what happens when that breaks? And who's going to restore your data? And on and on and on," DiSanzo says. "They're not used to running a little IT department. And when you look at how long they're responsible for the data they collect? That's why I would just say they're all better off adopting some kind of Internet-based software-as-service model."

On the other side of the country, in another fiercely competitive market, a similar partnership is under way. "We're reaching out to our archrivals," says Eric Saff, CIO and senior vice president of John Muir Health, a two-hospital system in Walnut Creek, CA. Saff says he never imagined that he'd be sitting at a table with his competitors, agreeing to help patients connect with physicians and to share information. "It's uncharted territory," he says.

One thing that's luring providers into that territory is that hospitals and health systems that facilitate patient access to medical records will comply with meaningful use requirements outlined in the American Recovery and Reinvestment Act of 2009 and its Health Information Technology for Economic and Clinical Health (HITECH) provision and qualify for stimulus money.

But it's not just about the money. "There's just this awesome ability to collaborate," Saff says.

At the root of why organizations come to the same table is the patient—giving them the ability to control and access their data and to improve quality and patient safety. The community has healthcare organizations that run about 20 different EMR systems that don't talk to each other, Saff says. And pertinent medical information can be lost or overlooked when patients seek care from multiple providers. Using RelayHealth to communicate and share information facilitates physician-hospital and patient-doctor communication, collaboration, and partnerships, Saff says.

In Kansas City, MO, the Web-based program is helping Saint Luke's Health System focus on physician alignment, says Deborah Gash, vice president and CIO of the 11hospital system. Doctors have access to lab results in near real time and they can access EMRs from their home or office. The ability to communicate with patients about nonurgent matters in a private and secure online format saves time and means fewer encounters and less time playing telephone tag. "It's a way to make it easier for them to practice with us," says Gash.

Physicians throughout West Michigan are using another Web-based platform that integrates clinical information with the EMR at physicians' offices. The program sends real-time laboratory, radiology, and transcribed results directly to the physician's EMR or to an electronic "dropbox" in his or her office. The eSHare Results solution is deployed jointly by Spectrum Health, a seven-hospital system in Grand Rapids, MI, and Medicity, Inc., in Salt Lake City.

More than 75 physician offices across eight counties in Michigan now receive data electronically from Spectrum Health, and an additional 70 offices are in the process of being connected. Physician practices and other hospitals can also submit electronic lab orders directly to the health system and perform other clinical recordkeeping tasks. For offices still using paper charts, Spectrum also supplies a bridge solution that allows them to begin interacting electronically.

It's an efficient method, says Patrick O'Hare, senior vice president and CIO of Spectrum Health. "We have been able to provide this information electronically, which helps our physician community become more efficient and, more important, improves patient care because the information can be accessed throughout a patient's life," O'Hare says.

Patient education is also important. "Fundamentally, it's information regarding them. It is information they should have access to," says O'Hare. Healthcare should make patients' information available "in the most relevant setting, in this case via the web, so they can be more engaged [and] take more responsibility for their health."

And that's a big selling point for physicians: that it engages patients and improves patient satisfaction, Gash says.

"There are very few pieces of patient software that get both patients and their families engaged," says Saff, and that works across facilities.

"It really is about the right thing for the patient," DiSanzo adds.