At St. Charles Health System in Bend, Ore., our mission is “Better Care, Better Health and Better Value.” But it’s more than a motto—it’s truly the foundation for our future.

One of the cornerstones of achieving this mission is health IT. We know that getting data to the point of need is critical across the landscape – for providers, staff, administrators, payers and patients alike. With that in mind, we’re moving our IT solutions from a “best-in-breed” approach to an integrated solution model with a single vendor. With a variety of disparate systems already in place, this isn’t a quick fix. Rather, it’s a long-term investment that pays dividends in better care, health and value over time.

Big Picture Challenges

St. Charles is a non-profit, four-hospital, 359-bed system in central Oregon. We are a community-based system with two of our hospitals being critical access. We are the primary hospital provider for a four-county area bordered by the Cascade Mountains to the west and north, which creates a natural barrier of sorts. While our region remains a popular hub of outdoor activities, this geographic layout, along with a low population density, creates challenges for access to care and hospital-based services for our communities at times

Our big picture challenges in a nutshell:
  • Delivering multi-specialty care across a geographically diverse, but sparsely populated region.
  • Connecting 43 physician practices (owned and community) electronically.
  • Connecting/engaging our patients electronically.
  • Proactively addressing healthcare reform and pay-for-performance models.
  • Participating in a Medicaid demonstration activity that calls on providers to collaborate around patient population management.

To push data to the point of need, we’ve implemented a multi-pronged plan, covering our micro environment (i.e. improving internal IT solutions) and the macro environment (i.e. linking physicians, hospitals, payers and patients).

Integrating Solutions Internally

A snapshot of our system showed data management was rather disconnected. While our two critical access hospitals were still paper-based, our other two facilities had scheduling solutions that didn’t communicate well with electronic health record (EHR) components. In addition, cross-departmental information sharing was fragmented.

To address these issues, we have just implemented a single database solution to help drive system-wide synergies. McKesson’s Paragon® will help us deliver clinical/pharmaceutical, scheduling, financial and supply chain information to the right people at the right time, for better outcomes and operations.

We are also working to fully leverage an analytics solution for performance management, business intelligence and optimization of care delivery. Our advice is to clearly define your analytics end points; then select the right tools to reach them. For example, by generating regular reports on our progress toward Meaningful Use Stage 1 data collection, we elevated the visibility of the effort. The shared reporting drove collection to required levels. We also used data-driven feedback on congestive heart failure education rates to spark improvements in population health management.

In addition, St. Charles is using CPOE to drive data accuracy and efficient delivery to the point of need. Our adoption rate is 100% in our two hospitals using CPOE. The chief lesson we learned is that people do need some time to transition, but it’s essential to set a deadline for removing all paper “workarounds.”

Connecting Care Externally

Meanwhile, we’re working externally to bridge the gap between ourselves, physicians and other providers across the state and nation.

Here’s what we’ve done or are in the process of implementing:
  • We’ve established a health information exchange (HIE) to improve collaborative care. Most of our physician practices have different EMRs, so we needed a neutral platform to deliver clinical data, provider messaging and patient correspondence. Through the RelayHealth HIE, we’ve also created a community information repository, useful for patient handoffs and referrals.
  • We’re piloting a referral program between our ED and an orthopedic practice, automatically alerting specialists to the need for follow-up care. Next, we’ll expand the solution across specialties and primary care practices.

A Vision for Better Healthcare

We’ve made great progress in getting data to the points of need, but there are more dots to connect, particularly in the area of collaborative care. Our HIE currently helps physicians corral multiple data sources; next, we will use it to apply analytics to drive improved performance.

As we focus on a more patient-centric view across facilities and providers, patient engagement and population health management will get even more attention. Underscoring it all, our vision of Better Care, Better Health and Better Value will continue to be our mantra—and our long-term strategy.

St. Charles Health System has been named one of the nation’s “Most Wired” organizations for 2013 by the American Hospital Association’s Hospitals & Health Networks® magazine.

St. Charles Improves Performance using Health IT

St. Charles Health System has improved outcomes and addressed regulatory requirements with the help of health IT.
  • Moved from a best-of-breed IT philosophy to a single integrated solution that gets information to the point of need.
  • Used analytics to elevate visibility of meaningful use requirements and met data collection requirements.
  • Used data-driven feedback on congestive heart failure education rates to spark improvements in population health management.
  • Achieved 100% CPOE adoption rate at two hospitals using the solution.
 
Mary Dallas

About the author

Dr. Mary Dallas is medical director of clinical informatics at St. Charles Health System, where she leads strategic planning, development and implementation of clinical information systems for the acute care and ambulatory environments across the health system. She also is responsible for development of a community HIE and management of IT resources for the health system. Dr. Dallas is board certified in internal medicine and a licensed medical examiner. In addition to her medical education and training, she holds a Master of Science in Medical Informatics and a Six Sigma Green Belt.

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