Latest / Becker’s Healthcare Podcast / Why Schneck Medical Center Prioritizes Interoperability to Remain Independent

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Why Schneck Medical Center Prioritizes Interoperability to Remain Independent · Becker’s Healthcare Podcast

• 0:00
  - Welcome everyone to the Becker's Health Care podcast.
• 0:02
  - This is Mike Cordero. I'm the senior director
• 0:05
  - of interoperability at Meditech, and I'm excited to
• 0:07
  - welcome our guest, Craig Rice, who's the vice
• 0:10
  - president and chief information officer at Schneck Medical
• 0:13
  - Center in Seymour, Indiana.
• 0:15
  - Today, we will be talking with Craig about
• 0:17
  - the importance of interoperability,
• 0:18
  - especially for independent hospitals.
• 0:21
  - We will discuss the challenges of data exchange
• 0:23
  - across health systems, the promise of TEFCA, and
• 0:26
  - Meditek's Traverse Exchange,
• 0:28
  - and how a more interoperable EHR can support
• 0:31
  - both better care and the adoption of next
• 0:34
  - generation technologies.
• 0:35
  - Craig, thank you for joining us. Hey. Glad
• 0:38
  - to be here, Mike. To get started, can
• 0:40
  - you tell us a little bit about Schneck
• 0:42
  - Medical Center, the community you serve in Southern
• 0:44
  - Indiana, and some of the unique challenges of
• 0:46
  - delivering care across your region? Specifically, how do
• 0:49
  - these realities influence the way you think about
• 0:52
  - connectivity
• 0:53
  - and care coordination?
• 0:54
  - So Schneck is a rural independent county hospital
• 0:57
  - and health system here in South Central Indiana,
• 1:00
  - and our primary service area is a four
• 1:02
  - county region. We're very proud that we're still
• 1:05
  - independent and not tied to a larger system.
• 1:07
  - And, you know, our focus and and goal
• 1:09
  - has always been to keep those decisions local
• 1:11
  - and to be able to focus on what
• 1:13
  - matters most for the communities we serve. But
• 1:16
  - being a rural hospital,
• 1:17
  - our patients receive care across a pretty broad
• 1:20
  - geography.
• 1:21
  - We're proud of the advanced care and services
• 1:23
  - that we provide for a rural hospital, but
• 1:26
  - there are always gonna be some specialties that
• 1:27
  - are only available in the major cities.
• 1:30
  - And for us, that's Indianapolis,
• 1:32
  - Louisville, Cincinnati even. And so from our perspective,
• 1:36
  - that connectivity and that care coordination
• 1:38
  - is incredibly important. When one of our patients
• 1:41
  - receives specialty care in the big city, when
• 1:43
  - they come back, whether that's through our emergency
• 1:45
  - department or through their family care provider,
• 1:48
  - we want our clinicians to have the most
• 1:49
  - complete picture possible without the patient having to
• 1:52
  - reconstruct their medical history for us. So that
• 1:55
  - reality
• 1:56
  - has really shaped the way we think about
• 1:58
  - interoperability.
• 1:59
  - It isn't nice to have anymore. It's really
• 2:02
  - fundamental to how we deliver coordinated care. What
• 2:05
  - are the consequences for an independent health system
• 2:08
  - when clinicians don't have reliable access to a
• 2:11
  - patient's complete health story? We know that we'll
• 2:14
  - never own every single component of the health
• 2:17
  - care journey. But what we do know is
• 2:20
  - we need the ability to securely exchange that
• 2:22
  - information
• 2:23
  - with other organizations
• 2:25
  - to be able to provide the best care
• 2:26
  - possible for our patients. And I I I
• 2:28
  - think back a bit over the years, whether
• 2:31
  - it's been with ACOs
• 2:33
  - or clinically integrated networks,
• 2:36
  - and the thought process was the solution to
• 2:39
  - interoperability
• 2:40
  - was to be on the same electronic health
• 2:43
  - record
• 2:44
  - or even be a part of the same
• 2:45
  - health system and and remove independence. I don't
• 2:48
  - think that should be the answer for our
• 2:51
  - clinicians to be able to provide the best
• 2:53
  - care possible.
• 2:54
  - For us, independence is important because
• 2:57
  - we wanna keep decisions local. We wanna be
• 2:59
  - able to provide
• 3:00
  - the best care possible in our region,
• 3:03
  - and we've seen it time after time when
• 3:06
  - that independence is lost.
• 3:08
  - Those often... It means services are cut from
• 3:11
  - the community. And so for us, from a
• 3:13
  - pure strategic perspective,
• 3:14
  - we wanna keep those decisions local. For us,
• 3:17
  - being a rural organization,
• 3:19
  - we provide a lot of services that communities
• 3:22
  - our size typically don't. And if we weren't
• 3:24
  - independent,
• 3:25
  - there's a lot of things we wouldn't provide
• 3:27
  - here. And I think about, you know, all
• 3:28
  - of the cancer services that we provide. I
• 3:30
  - think about our orthopedic care,
• 3:33
  - ENT.
• 3:34
  - We have a neurosurgeon.
• 3:36
  - We have a number of other specialties like
• 3:38
  - endocrinology.
• 3:39
  - We really have a number of specialties
• 3:41
  - that had we not been independent,
• 3:43
  - it would have been very challenging to recruit
• 3:46
  - those kind of folks into our community. And
• 3:48
  - for us, that's huge to to be able
• 3:49
  - to provide that locally instead of driving an
• 3:51
  - hour, hour and a half to get that
• 3:53
  - care. And so going back to our goal
• 3:55
  - to preserve our local independence while making the
• 3:57
  - technology boundaries
• 3:59
  - largely invisible to the clinician, whether that patient
• 4:02
  - was seen at Schneck, another organization.
• 4:04
  - Our providers ultimately just need the information necessary
• 4:07
  - to safely care for that patient. What does
• 4:10
  - connectivity mean from both the clinical and the
• 4:12
  - operational perspective?
• 4:14
  - We've participated in the Indiana Health Information Exchange
• 4:17
  - for a long time. One of the most
• 4:18
  - mature,
• 4:19
  - oldest information exchanges,
• 4:21
  - very successful.
• 4:23
  - It's absolutely provided value, but it's not perfect,
• 4:26
  - and there are challenges.
• 4:27
  - And you think about the situations where we
• 4:30
  - technically had access to information, but finding that
• 4:33
  - information
• 4:34
  - in an easy way or a quick way,
• 4:36
  - it was really challenging. And in other cases,
• 4:39
  - we had some organizations who didn't even contribute
• 4:42
  - all of the data that we need to
• 4:44
  - the information exchange. And then you layer on
• 4:46
  - to that from a workflow perspective,
• 4:48
  - an alternative that was often provided was, hey.
• 4:51
  - Go to another portal. And once you start
• 4:53
  - telling physicians,
• 4:54
  - for this organization,
• 4:56
  - you gotta log in to this portal. And
• 4:57
  - for this hospital in in this city, you
• 4:59
  - gotta go to this portal. I mean, that
• 5:01
  - is just friction that works against any kind
• 5:04
  - of adoption and does not fit into that
• 5:07
  - workflow. So for me, that's an important part
• 5:10
  - of the evolution of interoperability.
• 5:12
  - The goal can't simply be, did we successfully
• 5:14
  - exchange a document, or did we get in
• 5:16
  - the portal and find what we need? It's
• 5:18
  - really about bringing that information together for the
• 5:21
  - clinician in their workflow in the moment that
• 5:24
  - they need it. Before newer frameworks like TEFCO,
• 5:26
  - what challenges did Schneck experience when trying to
• 5:29
  - access information from neighboring health systems, and how
• 5:32
  - has that experience evolved?
• 5:34
  - Yeah. So prior to frameworks like TEFCO,
• 5:38
  - we had seen a real challenge getting information
• 5:41
  - from EPIC hospitals.
• 5:43
  - You know, being rural, single hospital system, you
• 5:46
  - know, our folks and our patients are getting
• 5:48
  - care from from other organizations,
• 5:50
  - but we had a real challenge getting data
• 5:52
  - from Epic, even Cerner and Allscripts and other
• 5:56
  - EHRs.
• 5:57
  - And so for us, having gone live with
• 5:59
  - Traverse Exchange
• 6:01
  - and through the TEFCA framework,
• 6:04
  - we've seen some significant improvements
• 6:07
  - from the data that we're able to receive.
• 6:09
  - Since going live with Traverse Exchange,
• 6:12
  - over 90% of the data that we are
• 6:14
  - seeing come through the exchange is from Epic
• 6:16
  - Hospitals,
• 6:17
  - and that was information that was not visible
• 6:20
  - to us
• 6:21
  - prior to going live with Traverse Exchange.
• 6:23
  - And, also, we have seen that over 75%
• 6:26
  - of the patients that are arriving at our
• 6:28
  - hospital
• 6:29
  - have information available
• 6:31
  - on Traverse Exchange. And, again, that's just data
• 6:33
  - we've never had before. So next selected Meditech
• 6:36
  - expands in part because of interoperability capabilities like
• 6:39
  - Traverse Exchange, as you mentioned. So So with
• 6:42
  - Traverse Exchange, obviously, you're accessing those national frameworks
• 6:45
  - like TEFCA as well as the ability to
• 6:48
  - connect to regional HIEs and other data sources.
• 6:51
  - But with Traverse Exchange,
• 6:52
  - we're also providing
• 6:54
  - or including a consolidated patient summary. So when
• 6:57
  - you compare the clinician experience before and after
• 7:00
  - adopting
• 7:01
  - that consolidated patient summary, what's the most meaningful
• 7:05
  - change you've seen in how providers access
• 7:08
  - and use patient information?
• 7:10
  - Prior to the consolidated patient summary and prior
• 7:12
  - to TEFCA,
• 7:14
  - the workflow for our providers,
• 7:16
  - you know, they might receive 20 or 30
• 7:18
  - different documents
• 7:20
  - that they have to go through to be
• 7:22
  - able to understand and to be able to
• 7:23
  - tell that patient's story. With a consolidated patient
• 7:26
  - summary, that's important because the collection no longer
• 7:28
  - has to do that. They have the collection
• 7:31
  - of all these external documents,
• 7:33
  - and it brings it together in one view
• 7:36
  - within their workflow
• 7:38
  - that they're already using day to day. We're
• 7:40
  - seeing adoption
• 7:41
  - follow that. Since January, our Traverse Exchange utilization
• 7:45
  - has increased
• 7:46
  - about a 187%.
• 7:48
  - We went from roughly 500 launches of Traverse
• 7:52
  - Exchange per month to more than 1,400
• 7:54
  - per month.
• 7:55
  - And what I find even more meaningful than
• 7:58
  - just, you know, that data and the number
• 8:00
  - of clicks up into the system that we're
• 8:02
  - getting, we're hearing good feedback from clinicians. They're
• 8:04
  - telling us that they're using it to quickly
• 8:06
  - find outside medical history, locate lab results that
• 8:09
  - patients may not even know the details of
• 8:12
  - those lab results,
• 8:13
  - and have... I've even had some feedback
• 8:15
  - that providers have been able to avoid repeating
• 8:18
  - testing that's already been done elsewhere. And so
• 8:20
  - that sort of breadth
• 8:22
  - of the network,
• 8:24
  - it's really important to us. A significant percentage
• 8:26
  - of the information we're receiving, it's coming from
• 8:29
  - not only Epic, but Cerner. I mentioned Allscripts
• 8:32
  - earlier. And in a market where Epic is
• 8:36
  - dominating
• 8:36
  - in our region,
• 8:38
  - that demonstrates what I said before about we
• 8:40
  - don't all have to be on the same
• 8:41
  - EHR. Yeah. It demonstrates it can work across
• 8:44
  - those boundaries. I think that's a key distinction
• 8:46
  - there too is we have these national frameworks
• 8:48
  - like TEFCA. So we've always been able to
• 8:50
  - get access to information, sometimes limited, sometimes not.
• 8:53
  - National frameworks
• 8:55
  - providing more data, but more data doesn't necessarily
• 8:58
  - mean better data. So I think as you
• 9:00
  - highlighted,
• 9:01
  - being able to use the consolidated
• 9:03
  - patient summary and get a synopsis of what
• 9:06
  - that patient's longitudinal care record looks like without
• 9:08
  - having to hunt and pack for data, I
• 9:10
  - think is a game changer because it's actually
• 9:12
  - providing data utility
• 9:14
  - to vast amount of information that's out there.
• 9:17
  - Have you seen any early examples where having
• 9:19
  - a more complete consolidated view of patient information
• 9:22
  - directly improved care delivery?
• 9:25
  - One provider talked about how valuable Traverse Exchange
• 9:27
  - has been in caring for patients with diabetic
• 9:29
  - foot issues.
• 9:31
  - Those patients will sometimes arrive without knowledge of
• 9:33
  - their recent lab results or having all their
• 9:35
  - medical history readily available,
• 9:38
  - and that provider being able to quickly pull
• 9:39
  - that external information
• 9:41
  - gave them a much more complete picture without
• 9:43
  - spending time trying to track it down somewhere
• 9:45
  - else. We had another provider describe having access
• 9:48
  - to the patient's past medical history as invaluable.
• 9:51
  - Instead of trying to reconstruct that history through
• 9:53
  - the patient, phone calls, faxes, or logging into
• 9:57
  - another portal, they can access it through Traverse
• 9:59
  - Exchange and make more informed decisions and make
• 10:02
  - them much more quickly.
• 10:04
  - And there's also a a very tangible patient
• 10:06
  - benefit as well. Our providers have specifically told
• 10:09
  - us that when they can see testing that
• 10:11
  - has already been completed at another facility,
• 10:13
  - they don't necessarily have to repeat it. That
• 10:15
  - saves time, reduces unnecessary testing,
• 10:18
  - and reduces the overall cost of care.
• 10:21
  - Another one that we had that I think
• 10:23
  - was pretty interesting, the emergency department is another
• 10:25
  - clear example because that's where time and incomplete
• 10:28
  - information can matter the most. And we're now
• 10:31
  - able to access external data for more than
• 10:33
  - seventy five percent of our patients arriving in
• 10:35
  - the ED, giving clinicians more context when patients
• 10:38
  - have been hospitalized elsewhere, had imaging or lab
• 10:41
  - work performed elsewhere, or had changes in their
• 10:43
  - medications.
• 10:45
  - What do you believe has driven the increase
• 10:47
  - in traverse exchange adoption?
• 10:50
  - We have a very strong clinical steering committee.
• 10:52
  - So that clinical steering committee is made up
• 10:54
  - of 14 providers
• 10:56
  - and is led by doctor Stone, our chief
• 10:58
  - medical officer. And, you know, that group was
• 11:01
  - not only our early adopter of Traverse Exchange,
• 11:04
  - but they were also the people that have
• 11:06
  - helped promote it. So for us, that program
• 11:08
  - and then sort of rolling it out and
• 11:10
  - then rolling it out also to our nurses,
• 11:13
  - That came later on in in the rollout,
• 11:14
  - but I think all of those things together
• 11:16
  - have led to an increase in utilization. But
• 11:19
  - I also think it's people aren't gonna utilize
• 11:21
  - something if it isn't helpful. And so I
• 11:24
  - think seeing that increase over time is telling
• 11:27
  - me that usability is there. It's improving. They're
• 11:30
  - seeing value in getting the information.
• 11:32
  - We often talk about interoperability as a way
• 11:34
  - to exchange information between organizations, but it's also
• 11:37
  - becoming the foundation for innovation.
• 11:39
  - So as Schneck looks at future technologies, including
• 11:43
  - AI,
• 11:43
  - how important is it to have an interoperable
• 11:46
  - EHR platform at the center of that overall
• 11:49
  - strategy? Yeah. That was part of our decision
• 11:51
  - making process when we selected our partnership with
• 11:54
  - Meditech and the Expanse platform.
• 11:56
  - The interoperability
• 11:57
  - becomes even more important,
• 11:59
  - as we move into that next generation of
• 12:01
  - health care technology. And I know AI is
• 12:04
  - certainly everywhere today, but it... It's a great
• 12:06
  - example of where we're going. An AI tool
• 12:09
  - can only be as useful as the context
• 12:12
  - and the data available to it. And having
• 12:14
  - access to a complete picture of the patient
• 12:17
  - becomes really important in that scenario. Otherwise, we're
• 12:20
  - applying AI and very sophisticated technology to an
• 12:23
  - incomplete dataset.
• 12:24
  - And so we selected
• 12:26
  - Expanse
• 12:27
  - as our EHR platform. We weren't just thinking
• 12:30
  - about what it needed to do day one.
• 12:32
  - We really wanted something in place for us
• 12:34
  - to be able to scale and grow with
• 12:36
  - us, whether that's interoperability,
• 12:38
  - patient access, APIs, automation,
• 12:41
  - things we haven't even thought of yet. We
• 12:43
  - wanted to be on a platform that could
• 12:44
  - help support that, and it was very clear
• 12:47
  - with Traverse Exchange and some of the other
• 12:49
  - things that are coming down the pipeline that
• 12:51
  - Expanse was really that platform for us. I
• 12:53
  - think the other piece that I just wanted
• 12:55
  - to kind of double click on a little
• 12:56
  - bit that you mentioned was patient access. So
• 12:58
  - I know that the focus right now had
• 13:00
  - been on adoption,
• 13:03
  - of the, of of Traverse Exchange for the
• 13:06
  - purposes of of of treatment. But,
• 13:09
  - I think it'd be interesting, and we should
• 13:11
  - definitely, you know,
• 13:13
  - follow-up on,
• 13:15
  - how we see the impact on the patient
• 13:17
  - themselves and how they're kind of orchestrating their
• 13:19
  - care and and and
• 13:21
  - and having the ability to gain access to
• 13:23
  - their health records. Patients themselves are part of
• 13:25
  - that ecosystem, and it it can't be... Interoperability
• 13:29
  - can't be viewed as just a hospital to
• 13:31
  - hospital
• 13:32
  - exchange of information.
• 13:33
  - Patients really are part of that ecosystem, and
• 13:36
  - patients should be able to access and direct
• 13:38
  - their own information as easily
• 13:40
  - as well. Craig, as we wrap up, is
• 13:43
  - there one message you like health care leaders
• 13:45
  - to take away about interoperability,
• 13:47
  - TAFCA, the importance of broad data exchange? What
• 13:50
  - would it be? My biggest takeaway would be
• 13:52
  - that interoperability
• 13:54
  - should ultimately make the boundaries between health care
• 13:56
  - organizations invisible. Patients don't receive all their care
• 13:59
  - in one building, one health system, one EHR,
• 14:02
  - and our technology has to reflect that. And
• 14:05
  - for independent organizations like us here at Schneck,
• 14:07
  - that's especially important. We shouldn't have to give
• 14:10
  - up independence in order to achieve connectivity.
• 14:13
  - TEFCA gives health care an opportunity to create
• 14:15
  - a truly national framework for exchange, and I
• 14:17
  - think we need to keep pushing beyond simply
• 14:19
  - moving documents from one organization to another.
• 14:22
  - The destination
• 14:23
  - for this is truly
• 14:25
  - getting the right info to the right caregiver
• 14:28
  - at the right time
• 14:29
  - within the workflow where they can actually make
• 14:31
  - a difference for the patient.
• 14:33
  - Craig, thank you for sharing your perspective, and
• 14:35
  - the work Schneck Medical Center is doing to
• 14:37
  - improve connectivity
• 14:38
  - and patient care. It's been great hearing how
• 14:41
  - interoperability is delivering value today while also laying
• 14:44
  - the groundwork
• 14:45
  - for future innovations.
• 14:47
  - And thanks to our listeners for joining us
• 14:49
  - for this Becker's Healthcare podcast.
• 14:52
  - Thanks, Mike. I appreciate the leadership of Meditech
• 14:55
  - and all the work that you're doing to
• 14:57
  - push interoperability
• 14:58
  - forward. Thank you.