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The Hospital as the Network Hub
August 1, 2008
A growing number of hospitals and integrated delivery systems are tired of the “hurry up and wait” game involved with many regional health information organizations. So they’re taking matters into their own hands, building hospital-centric networks to share data with physicians.
“It’s always amazed me that some organizations that are part of RHIOs are not yet effectively exchanging information among their own facilities. It’s like putting the cart before the horse,” says Deborah Kohn, principal at Dak Systems Consulting, San Mateo, Calif. For broader, collaborative networks to succeed, Kohn argues, the participants must first have their own networks in place.
The hotbed of networking activity in health care today involves hospitals linking with their referring physicians, not broader RHIOs or health information exchanges, says Mark Holland, program director, health care provider research, at Health Industry Insights, a unit of IDC, Framingham, Mass.
Integrated delivery systems have struggled for more than a decade to use information technology to link their hospitals to clinics they own as well as independent physician offices, the consultant notes. “Now it’s really beginning to take hold,” he says.
Competitive pressures are forcing hospitals and their parent delivery systems to invest in networks, Holland says. They want to use these networks to make it easier for community physicians to refer patients for hospitalization.
This is becoming more urgent, he says, as fewer patients are hospitalized because of the continuing shift to outpatient care.
“Most physicians in our area admit to two or three hospitals,” notes Matt Ebaugh, CIO at Silver Cross Hospital in Joliet, Ill., just south of Chicago. “We knew that if we made it easier for physicians to access data, it would be a way to bond with them and offer us a temporary competitive advantage.”
Ebaugh believes that, ultimately, a broad HIE will serve the region, and most patients will have personal health records. But until that day comes, his 306-bed hospital is building its own network links to local physicians.
The Motivation
Hospitals seeking to improve their reputations as centers for excellence, especially for cardiology or oncology, are particularly motivated to build their own electronic links to specialty physicians, says Michael Mytych, principal at Health Information Consulting LLC, Menomonee Falls, Wis.
Exchanging data with specialists is vital to avoiding duplicative tests and providing efficient care–important steps in a hospital’s effort to dominate a local market niche, he adds.
And more of these hospitals are concluding that they can’t afford to wait for broader communitywide HIEs to take hold, he contends.
Catholic Healthcare West, a San Francisco-based organization with 41 hospitals in nine markets, has concluded it can’t afford to play hurry up and wait.
“We’ve had to move ahead more quickly than the timelines of most RHIOs,” says Eric Leader, chief technology architect. “Anything we can do to make it easier for doctors to work with us makes for a better patient care environment. When physicians realize that, they come to us.”
Some hospitals and delivery systems are taking ambitious steps to facilitate the two-way exchange of clinical data with group practices.
For example, a few pioneering doctors affiliated with Catholic Healthcare West can send data to some of its hospitals and receive information on hospitalized patients.
Others, Mytych, notes, are taking a simpler approach. For example, they’re enabling doctors to view hospital data in a read-only mode. “That’s the poor man’s HIE,” he says. “But it’s better than driving in the dark without your headlights on.”
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