payers & providers midwest edition – issue of may 3, 2011

8/7/2019 Payers & Providers Midwest Edition Issue of May 3, 2011

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After years of inaction and opposition tosharing data, dozens of hospitals andhealthcare organizations in the Chicago areaare banding together to build what could

become the largest big-city health informationexchange in the country.

The Metropolitan Chicago HealthcareCouncil has chosen technology fromMicrosoft, Computer Sciences Corp. andHealthUnity to create the MetroChicagoHealth Information Exchange, potentiallyserving 9.4 million people in nine Illinoiscounties and small parts of Indiana andWisconsin.

The council said at least 66 hospitals and"major outpatient care organizations" havesigned letters of intent to participate and that70% of hospitals in the metropolitan area are

considered founding members of the HIE.Microsoft's Amalga software, backed by

some exchange services from HealthUnity,will aggregate data from participatinghealthcare organizations and provide astandardized view of patient histories at thepoint of care. Consulting rm CSC will helpwith project management and technologyimplementation.

Initially, the exchange will involve 22hospitals in nine organizations, according toTeresa Jacobsen, the councils HIE director.We want to get one or two use cases runningrst, she said.

The project will commence with linkingemergency departments to exchange clinicalsummaries and for syndromic surveillance.Later the HIE will add medication and allergy

lists, diagnostic testing results and reports inthe Continuity of Care Document format, aswell as additional elements for public health,including immunization records.

The exchange will operate on asubscription model, with the vendors takingon some of the risk.

The subscription fee will be based on thebenet each member derives, said MCHCVice President Mary Ann Kelly.

Formation of the HIE represents abreakthrough of sorts in the hotly competitiveChicago market. Several major health systemsin the area are far along with their conversion

to electronic medical records.The four NorthShore University

HealthSystem hospitals in the northernsuburbs are among just 56 facilities in thecountry to achieve the highest level on theHIMSS Analytics EMR Adoption Model, ascale developed by an afliate of the Chicago-based Healthcare Information andManagement Systems Society. RushUniversity Medical Center, Mercy Hospital &Medical Center and Swedish CovenantHospital have all reached the second-highest

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In Brief

IU Health Takes OverWhite County

Tiny, debt-heavy White CountyMemorial Hospital in Monticello, Ind.,has become part of the Indiana

University Health network. WhiteCounty commissioners and thehospital's board voted last week tomerge with the Indianapolis-basedhealth system formerly known asClarian Health.

The critical-access hospital,which opened a new, 25-bed facility in2008, was carrying $40 million in debtthat the county government wouldhave been responsible for in the eventof a default, according to the Journaland Courier of Lafayette, Ind. IUHealth takes over the debt load andalso will pay the county $955,000 forthe land the hospital sits on.

As part of the merger agreement,

White County Memorial's boardretains the right to approve anyadditions or reductions in hospitalservices. The deal also creates a "directlink" for White County patients to IUcritical care and trauma facilities inIndianapolis, the health system said.

Lawson Accepts $2BPrivatization Offer

St. Paul, Minn.-based nancialmanagement software vendor LawsonSoftware, which has a strong presencein healthcare, is being privatized. Thecompany has accepted a $2 billion

takeover offer from private equityrmGGC Software Holdings, an afliate of

both Golden Gate Capital (SanFrancisco), and Infor, an Alpharetta,Ga.-based company that offersbusiness software and services.

The offer, rst publicly conrmedin March but approved by the Lawsonboard last week, calls for Lawsonstockholders to receive $11.25 pershare in cash when the takeovercloses, likely in the third quarter, the

Continued on Page 3

NEWS

Chicago HIE (Continued from Page One)

level, as has Advocate Lutheran GeneralHospital in Park Ridge, Ill.

Furthermore, NorthShore, Rush, the

University of Chicago Medical Center andNorthwestern Memorial Hospital all use thesame vendor for their inpatient EMRs, EpicSystems of Verona, Wis. But, to date, localorganizations have been reluctant to shareelectronic records with other providers.(A few years back, family physician StasiaKahn, M.D., in far west suburban St. Charles,got so frustrated with the lack of progress thatshe formed her own group to promote EMRadoption and health information exchange,Northern Illinois Physicians for Connectivity.Several hospitals in the Chicago suburbs ofNorthwest Indiana chose to join an

Indianapolis-based HIE in 2008.)"The information has to ow with thepatient," Jacobsen said. "We have to work asa community to make that happen."The MetroChicago HIE traces its roots to alaw Illinois Gov. Pat Quinn signed inFebruary 2009, shortly after disgraced Gov.Rod Blagojevich was removed from ofce.The bill, which predated the federal American

Recovery and Reinvestment Act by two weeksallocated $3 million to the IllinoisDepartment of Healthcare and Family

Services for HIE planning.Funding from ARRA helped create theIllinois HIE Authority, which, coincidentally,held its rst organizational meeting April 27.That entity, according to Dan Yunker, MCHS'schiefnancial ofcer, is key to attractingsupport for the Chicago-area HIE from payers,including Illinois Medicaid and to connectingwith other regional exchanges for whenpatients move or travel.

Our hospitals in Chicago are responsiblefor the snowbirds who are in Naples(Florida),!Yunker noted. But with the IllinoisHIE authority just getting off the ground and

providers around the country struggling toinstall EMRs, it could be years before there'strue statewide and nationwide interoperability

Thats the biggest wild card we dontknow, Yunker said.

Still, the MCHC is optimistic about theMetroChicago HIE. "We believe that in thelong run, we will be bringing together a lot ofpeople," said Kelly.

Ascenscion To Acquire AlexianParties Enter Into Non-Binding Letter of Intent

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St. Louis-based Ascension Health has signeda non-binding letter of intent to absorbAlexian Brothers Health System of ArlingtonHeights, Ill., which operates two communityhospitals in Chicagos northwest suburbs.

Terms were not disclosed, but it isapparent that nancial considerations in achanging healthcare environment played amajor role in Alexian Brothers decision.

This partnership is a sign of AlexianBrothers Health Systems commitment toensure that everyone in the communities weserve will continue to receive the highest leveof care for the long term and strengthenCatholic healthcare in the Chicagometropolitan region, Executive Vice PresidenMark A. Frey said in a press release. A

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NEWS

In Brief

companies say. The deal represents a14% premium over the closing shareprice on March 7, the day before newsof the GGC offer rst broke, and 28percent above where the stock closed

Jan. 10, just prior to Lawson signing anon-disclosure agreement with Infor.

"Infor and Lawson will create a

rich, integrated enterprise applicationsuite," Infor CEO Charles Phillips saidin a press release.

Infor, which is majority-ownedby Golden Gate Capital, also promises"richer and deeper functionality in theverticals where the companies havecomplementary strengths," includinghealthcare.

Loyola Claims RecordFor UnconditionalKidney Donations

Loyola University Health System in

Maywood, Ill., has claimed to haveset a world record for "GoodSamaritan" kidney donations, asfive employees haveunconditionally donated kidneys tocomplete strangers. Two moreLoyola employees have givenkidneys to "casual acquaintances,"according to the health system,which is calling the group the"Seven Sisters of Loyola." Gift of Hope, a not-for-profitgroup that coordinates organ andtissue donations in NorthernIllinois and Northwest Indiana, andthe United Network for OrganSharing, manager of the national

transplant waiting list, both saythey are unaware of any othercompany in the U.S. or the worldwith so many employees offeringorgans to non-relatives.

The Chicago Sun-Timesreported that the Seven Sistershelped start the "Pay it Forward"kidney donation program atLoyola, which is trying to turn onedonation into a chain of manykidney transplants. To date, 18donors have triggered 95transplants, the newspaperreported.

partnership with Ascension Health provides uswith the resources needed to grow ashealthcare changes, as well as to strengthen

and enhance Alexian Brothers commitment toproviding healthcare in Chicago, he added.Frey and the health systems board chair,

Brother Jim Classon, cited expandedresources and strengthened capabilities toprovide healthcare and housing services of thehighest quality in their decision to joinAscension Health.

Alexian Brothers leadership and brandingwill remain intact at St. Alexius MedicalCenter in Hoffman Estates, Ill., and AlexianBrothers Medical Center in Elk Grove Village,

Ill. The organization said physicians and stashould expect few discernable changes intheir day-to-day roles and responsibilities.

Classon and Frey said the merger should,however, allow Ascension to move forwardwith plans to build a childrens hospital on Hoffman Estates campus.

According to the letter, Alexian Brotherst began pursuing a merger or partnershiptwo years ago. In the end, it was clear thatAscension Health was the best choice becatheir values and management stylecomplement those of the Alexian Brothers,Classon and Frey wrote.

Iowa lawmakers will consider legislation toshift management of subsidized mental healthservices from the county level into eight largerregions, in hopes of reducing waiting lists andcreating a more stable means of funding. Butopponents fear the bill would actuallyincrease inequalities and make futurereimbursements too reliant on Medicaid.

"One of the main things were trying to

achieve is an integrated service system forIowans including core services that arestandardized across the state so that everyIowan knows what to expect for coreservices,!one of the bill's supporters, stateRep. Renee Schulte (R-Cedar Rapids), toldIowaPolitics.com. We would also have corepayment and set standard payment for servicesfor providers so that you dont have the 99different counties paying providers 99 differentprices depending upon where they live.

The plan would attempt to even outfunding across Iowa by repealing $125 millionin mental health taxes each county imposesand replace the lost revenue with anundetermined level of state funding.

IowaPolitics.com reports that the state spends$350 million a year on mental health foradults.

Schulte says the idea is to provide anautomatic funding mechanism for basicmental health services across the state andgive counties the choice to go beyond theminimum. But the Iowa State Association ofCounties has its reservations, particularly

about the fact that the sparsely populatedwestern part of the state would be divided intjust two geographically broad regions.

A county could have their property taxesent to a region and never spent on anybodywho relates to that county, Linda Hinton,lobbyist for the Association of Counties, says.

Some lawmakers have reserved judgmenuntil they see more details. Rep. LindaHeddens (D-Ames) voted for a shell the a billthat a House subcommittee approved Mondabut isn't ready to endorse the plan any furtherthe news service reports. "I would have likedthe process where... everybody had time to

look at it and review it and have some input,"Heddens said.

Iowa Eyes Mental Health RevampProposal Would Take Control From Counties

Alexian Merger (Continued from Page One)
http://www.healthwebsummit.com/ma052011.htm


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Payers & Providers Page

With the federal governments electronic healthrecord (EHR) incentive program hitting high-gear, early signs are that it is a success.

The program for providers ling for thepayments through the Medicaid system beganon Jan. 6 in about a dozen states and hasalready distributed $37 million in payments.The Medicare system incentive program willbegin nationwide on April 18. !These payments will be awarded tophysicians and hospitals that havedemonstrated meaningful use ofEHRs through either Medicaid or

Medicare.The governments goal is tohave virtually 100% of the nationsphysicians and hospitals using andexchanging EHRs for patient data.!However, we are seeing sometrends that indicate a substantialnumber of physicians, primarily insmall medical groups, will be leftout. !

A survey conducted in early 2010by SK&A found that only 28% of solopractitioners hadadopted EHRs, while71% of physicians in large medical groups (26+

doctors) had done so. A more recent survey,conducted after the meaningful use programwas launched by the National Center for HealthStatistics (NCHS), found that while 41% ofofce-based physicians are planning to achievemeaningful use and qualify for the incentives,14% said they were not planning on qualifyingor applying for payments.!

Who are these reluctant physicians whoremain dependent upon paper records? Studiesshow them to be solo practitioners or physiciansin smaller, independent medical groups that arenot closely afliated with a hospital. They tendto be older physicians who are not comfortable

with computers or the Internet. !We cant afford to ignore small medicalgroups. About 40% of all physicians are solopractitioners or work in a medical group of sixor less. When the federal incentive programends in four years, if we have 20 or 25% of thenations physicians unable to collect andtransmit EHRs, it will be considered a failure.For example, imagine a 1,000-mile interstatehighway with a gap every 100 miles, requiringall the trafc to exit and take back roads.

Bottlenecks and trafc jams would be a way olife, commerce could not ow smoothly andtransportation costs would be high. !

Three steps in particular will help improvEHR adoption rates among small medical gro

1. EHR systems must improve their usabiWhile most EHR systems have improved steadin terms of speed and ease of use in recent yesome physicians still nd them difcult to useOne area that holds signicant potential is vo

recognition. Many older physicare used to dictating their notesAdvanced EHRs now incorpora

dictation and voice commands.2. Health information exchange(HIEs) must expand. HIEs arecurrently operating only in scattregions around the country.. It ivery difcult for physicians torealize signicant value from EHwhen they cannot send and recinformation from other physiciaand hospitals. !

3. EHR vendors must become moreinvolved with the meaningful useprogram. Vendors must become m

committed to helping physician customers me

the meaningful use standards. Too often, vendfeel their obligation is to simply get their EHRinstalled in a physicians ofce.

Second, vendors should take the time to involved in working with federal ofcials inshaping Stages 2 and 3 of the meaningful useprogram.

There will be no turning back the clock; tera of EHRs has arrived. Small, independentmedical groups face a unique set of challengewhen implementing EHRs and connecting tolarger regional networks. Our national drive tadopt EHRs and move to a new level of efcieand accountability will not be complete until

get these physicians incorporated into the newworld of connectivity.

OPINION

Small Practices Avoid EHR InstallatioChanges Must be Made to Encourage Adoption

By Brad Melis

Brad Melis is executive vice president of

ChartLogic in Salt Lake City.

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