Community hospitals in competitive markets face a multitude of business challenges, not the least of which is how to increase patient referrals from local physicians. Therefore hospital administrators seek to make their facility the most physician-friendly of all the local options. Information technology is an increasingly important element in the mix of factors that can influence the “physician appeal” of any given hospital.
Community Memorial Health System (CMHS) in Southern California has turned its physician-facing information technology into an asset for physician recruitment and retention. CMHS is a community-owned, not-for-profit organization established in 2005, when Community Memorial Hospital in Ventura, California, merged with Ojai Valley Community Hospital. CMHS is comprised of these two hospitals with a combined total of 350 beds, along with 13 multispecialty family-practice health centers that are staffed by 90 physicians. The hospitals are served by 175 contracted and affiliated physicians, and a total clinical staff of 500. CMHS serves communities within Ventura County, California, which has a population of more than 800,000 people.
Seeking a competitive edge: Physician satisfaction
Community Memorial Hospital sits within a few miles of two other hospitals – one private, one public – creating a highly competitive market for both patients and physicians. Accordingly, differentiation is key; and one way CMHS has opted to differentiate itself in the eyes of physicians is to give them a significant voice in selecting physician-facing information technology used at the hospital.
Several years ago, when CMHS migrated from MEDITECH MAGIC to a MEDITECH Client/Server hospital information system (HIS), physicians balked at using the new HIS’s electronic medical record (EMR) application, complaining that it was cumbersome and inefficient. So a working group comprising IT and clinical leaders was convened to investigate alternatives. After researching the options, including replacing MEDITECH altogether, the group unanimously chose PatientKeeper, a suite of physician workflow applications that overlays and integrates with MEDITECH and other hospital-based systems.
“Our goal was to give physicians one system where they can do their entire workflow,” said Thomas Kniss, CMHS’s former information systems director, who now serves as vice president of the healthcare practice at Presidio, an information technology consulting firm. “And it was important that it be a system that physicians want to go to, not something we’re forcing them to go to. With PatientKeeper, we’ve been able to get to that point. Physicians are using PatientKeeper for orders, notes, and medication reconciliation. In fact, it’s gone so well that physicians are pushing us to accelerate our deployment timelines.
“The two other hospitals in our area made their EHR decisions without consulting with their respective medical staffs,” Kniss noted, “and we’ve heard that many physicians are unhappy with those systems. Our collaborative approach to acquiring IT has had the exact opposite effect. We didn’t impose anything on physicians; they chose for themselves, and are happy with the result.”
Significantly, CMHS has been able to protect its investment in MEDITECH by employing an “overlay” strategy for its physician workflow applications. At CMHS, PatientKeeper is integrated with MEDITECH Client Server 5.6.6 as well as other key hospital systems, including PACS, EKG, Data Express and Forward Advantage. HL7 interfaces are used as much as possible to minimize scripting. Provation order sets are directly integrated into PatientKeeper CPOE, and CMHS’s HIE can be launched directly from PatientKeeper.
CMHS insisted on using ONC-certified technology so the organization could attest to EHR Meaningful Use and qualify for federal incentive payments.