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to link to state HIEs in Arizona and Colorado.

Going forward, the key points of the strategy include: • Initial rollout to employed physi- cians;

• The use of an enterprise chart within employed practices;

• Secondary rollout via portal technol- ogy to aligned physicians who admit to Banner Health facilities;

• Migration to HIE through interfaces directly into inpatient and outpa- tient EHR;

• Leveraging clinical content object workgroup (CCOW) standards for quick, context-sensitive access to disparate information systems;

• Interfaces with independent physi- cians on various EHR technology platforms; and

• Links from the Banner Health HIE to statewide HIEs. To manage quality and costs, pro- viders across disparate facilities and services will need to share utilization, outcomes and quality data in real time. Using this data to improve the effi ciency and effectiveness of care will also re- quire advanced analytics to continually develop and refi ne coordinated clinical protocols and point-of-care decision support. The success of any HIE or ACO endeavor, therefore, will depend on active physician participation. As frontline decision makers, physi- cians are the primary end users of medi- cal record systems. But they will only use them if they improve care and save time. Since the needs of physician users vary signifi cantly by specialty, patient population and practice circumstances, it is essential to involve physicians in customizing HIE interface design to ensure usability.

On the other hand, data defi nitions and information sets must be stan- dardized to support quality reporting, documentation requirements, research and population health tracking. So physicians must agree on common clinical procedures and documenta- tion standards. To enable physicians to develop systems that are both fl exible

and structured enough to support all HIE needs, Banner relies on: • Clinical informaticists: The ways in which IT solutions can benefi t clinical care are not always obvious, and developing applications is tech- nically challenging. Clinical infor- maticists have their feet in both the clinical and IT worlds, bridging the divide. Our team of clinical infor- maticists provides the vision to help physicians understand the potential of IT, as well as the translational skills required to help IT understand complex clinical problems.

• Leadership cultivation: In each clinical department and location, clinical leaders are identified to help promote application design and implementation. All physicians are encouraged to participate.

• Committee approach: When solu- tions cross clinical, process or IT

boundaries – as they often do – spe- cialty workgroups are convened to work through options.

• Project management resources: We use the tools and trained personnel for each rollout to ensure adherence to the schedule, good practices and communication.

Combined, all of these approaches have led to many practical solutions at Banner that make IT systems more us- able. More importantly, however, physi- cian engagement and fl exible develop- ment processes create a framework for adapting to future needs.

The technology necessary to create the HIE of the future is decidedly not plug and play. But strategies can be used to standardize the management of HIE projects. By encouraging a process for innovation, healthcare organizations will be able to adapt to the continually evolv- ing HIE and ACO environments. HMT

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go to call Stephen Jasiukiewicz at 267-513-1851 email


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