Greater Portland's push to improve the health informatics field has high stakes
Photo / Tim Greenway
Dr. Jackie Cawley, associate chief medical officer and chief medical information officer at MaineHealth, at the offices of Maine Medical Partners Urology in South Portland.
Health informatics. It's not the most straight-forward term, but once you learn that it means the development, analysis and distribution of health information to help patients, it's easy to understand why it's one of the driving forces of Maine health care organizations right now.
Though it seems like modern computers have been in use forever, it actually wasn't too long ago that MaineHealth, the state's largest health care organization, was just beginning to adopt a single patient record system that would allow nurses, physicians and other medical professionals across different practices and hospitals to access a patient's records from a single file.
That was a little over two years ago.
Now, MaineHealth and several other stakeholders — including technology and insurance companies, local government officials and higher education institutions — are working on an initiative to assess the current state of Maine's health informatics field and what can be done to help foster its growth.
John Spritz is manager of Growing Portland, an organization founded by the city of Portland and the Portland Regional Chamber. He is leading a study of greater Portland's health informatics field, “Health Informatics Assessment Project,” as part of the initiative, with support from the University of Southern Maine's Muskie School of Public Service.
Spritz says the study's conclusions, which are expected in March, will be based on survey and interview responses from dozens of stakeholders, answering questions like: Who is involved with this field? What is inhibiting their growth? Is there value in having organizations cluster together?
“Most people have said it would be good to come together in some way,” Spritz says of the dozens of stakeholder companies and organizations he surveyed. How that will come together remains to be seen. “Is that a trade association; is it something more virtual than that?” he asks. “Growing Portland is interested in seeing if something [like that] makes sense for this area.”
The stakes are high not just because answering those questions could help strengthen an emerging field of work across multiple industries within Maine. Even more important is the health and well-being of every Mainer.
A major undertaking
Steven Michaud, president of the Maine Hospital Association, says the transition to an electronic health record system has been a major undertaking for hospitals. First, he says, there's a large upfront investment with technology. Then there's the implementation, which involves getting hundreds of nurses, physicians and other medical professionals properly trained and comfortable with the system. Last, there's the most important underlying issue: implementing security measures and following federal regulations to protect those records from data breaches.
But the massive project is seen as a worthwhile endeavor.
“There's a strong desire and belief that it will improve care and save money by not duplicating services if we have an electronic record,” Michaud says.
If you want a good understanding of why implementing such a system is important and how it can help improve patient care and cut operational costs, just talk to Dr. Jackie Cawley, the chief medical information officer and associate chief medical officer at MaineHealth. One of her main jobs is providing clinical leadership in the system-wide rollout of Epic, the health record software MaineHealth will use across all of its practices and hospitals by 2017.
Cawley says the integrated health care system will have invested more than $200 million over the several years it takes to implement. So far, she says, Epic has been implemented in Maine Medical Center in Portland and Waldo County General Hospital in Belfast, along with ambulatory practices in Portland, Scarborough, Falmouth, Belfast, Rockland, Damariscotta, Boothbay and Norway, and two of the system's home health agencies.
That means MaineHealth still has six member hospitals and hundreds of providers to go. Eventually, the health care system's 17,000 employees will have to be trained.
Cawley didn't provide a dollar value when asked about the project's expected return on investment. Instead, she says, the return will be seen in “improved efficiency, better patient outcomes and better transitions of care and flow of patient information.”
There are countless examples of how an electronic health record system can improve care, but there's one in particular that comes to Cawley's mind. It happened in late January.
“[Maine Medical Center] had a very sick patient who needed a lung transplant … He ended up having to go to Duke University Hospital [in Durham, N.C.],” Cawley says. Because Maine Medical had an electronic record of the patient readily available, she says, the “transplant team was able to exchange information, real time, with Duke.”
That cut hours from the patient's transplant wait time.
“It's so wonderful because it could have taken us hours to get things faxed, but it went so smooth because we were able to [share] information real time,” Cawley says.
Improving patient care is a top priority, but the adoption and implementation of the Epic software also provides MaineHealth with financial incentives. In December, the health care organization received a $9.2 million check from the federal government for saving nearly $20 million in Medicare costs over an 18-month period, all by improving efficiencies. While Epic's management system for health records wasn't the sole driver of the cost savings, Cawley says it did help MaineHealth meet its health and population goals in the Medicare Shared Savings Program.
“We have quality outcomes we are supposed to be hitting targets on so we're allowed to measure our performance [with Epic and other systems],” she says.
Attracting quality talent
Spritz, of Growing Portland, says one of the largest issues MaineHealth and other stakeholders face in supporting the health informatics field is attracting quality talent.
“That's a growing issue across America for informatics,” he says. “It's a growing, burgeoning field and there's simply not the right number of people who have the skills to fill all the jobs.”
Luckily, one of the initiative's participating higher education institutions is building a new program that hopes to solve just that problem. Spritz says it was happenstance that the University of New England was looking to develop its own program at the same time the Growing Portland initiative began looking at how to improve the field.
“The study points to them as the most exciting higher education opportunity occurring in southern Maine,” Spritz says, noting that there are other college programs throughout Maine that either directly or indirectly support the health informatics field.
However, what may separate UNE's program is how closely it will work with some of the Growing Portland initiative's other stakeholders, such as IT consulting and outsourcing firm Winxnet and health care provider InterMed, both based in Portland.
Ellen Beaulieu, UNE's vice president for academic affairs, says the companies are not just helping develop the program's curriculum, but they're also planning to enroll some of their employees in the program when it launches this fall. While the program will have open enrollment, she says it will focus on helping adults who haven't completed their degree and/or employees who may need training to improve their skills.
“They're probably going to be working in hospitals and insurance companies already,” she says. Instead of the employer training them for a health informatics position, they'll be doing that “in concert with us, so the [employees will] be learning on the job in project-based teams,” she adds. “They'll have supervision and guidance from us, and then they'll get their bachelor's degree, but they'll be in place at their [job] with a higher position.”
The program, which is being supported by a grant from the Bill and Melinda Gates Foundation, will be UNE's first competency-based program, meaning that students will have to satisfy a set number of competencies to finish the program instead of the more traditional school model where students progress by completing classes.
Chris Claudio, Winxnet's CEO, says his company began participating in the development of UNE's program after receiving an invitation from university President Danielle Ripich. Claudio, who serves on MaineHealth's board, is also involved with the Growing Portland initiative in part because nearly half of his company's business is with health care organizations.
“I wanted to be part of it to make sure it's being steered in the right direction, because we're so immersed in it, we want to provide guidance on how to create jobs,” he says.
Claudio says developing the health informatics field is important because the use of electronic health record systems is helping health care organizations achieve the Institute of Healthcare Improvement's Triple Aim Initiative: “Improving the patient experience of care, improving the health of populations and reducing the per capita cost of health care.”
“For me, it's about making our state really the very best it could be, from a population health perspective and a health care delivery perspective,” he says.
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