Irvine-based St. Joseph Health, one of the largest healthcare operators in Orange County, set out four years ago to establish a single electronic record for each patient who visits any of its 16 hospitals spread across California, Texas and New Mexico.
The data-driven initiative required syncing about 100 disparate electronic medical records systems in Southern California so that patients wouldn’t have to fill out the same documents over and over again.
Doctors and other caregivers at St. Joseph Hospital-Orange; St. Jude Medical Center in Fullerton; Mission Hospital, which has campuses in Mission Viejo and Laguna Beach; and some others facilities outside the network now have access to patient records within seconds through a web portal.
The streamlined system is one of several big developments on the data front at St. Joseph’s, which has had its share of accomplishments and failures during the most technologically transformative period in its 34-year history.
“St. Joseph Health has invested in a strategy we call ‘IT Sophistication,’ which has helped us prepare for trends, such as better management of healthcare data and digital technologies that enhance the physician and consumer experience,” said Senior Vice President and Chief Medical Information Officer Dr. Michael Marino by email. “Getting more information in the hands of the patient is revolutionizing care. In the old days, we simply told patients what they should do. Now we use technology and data to involve patients in managing their care.”
Marino, who took the additional role of interim chief information officer at St. Joseph in June after the departure of Bill Russell, was the first doctor at St. Jude to enter orders electronically in the late 1990s.
Health on the Go
Establishing a single records system allowed St. Joseph’s internal IT department and its 75 contract developers to build applications on top of the platform. It introduced a remote patient monitoring app about a year ago that allows users to gauge blood pressure, weight and glucose levels, among other features, with the touch of a button.
More than 110,000 St. Joseph patients now use the Android- and iOS-based Follow My Health app, which provides personal healthcare information through a smart device, and the healthcare system is making strides in increasing adoption of its telemedicine services.
The nonprofit enterprise offers Telestroke, a service that’s particularly beneficial in rural areas and the High Desert through which neurologists remotely access CT scans, vitals and medication to deliver optimal care to small hospitals; Telepediatrics, which allows patients to interact with a specialist at Children’s Hospital of Orange County via a robotic display; and Telepsyche, which links psychologists and psychiatrists with patients.
St. Joseph also made an undisclosed strategic investment in 2014 in Airstrip Technologies, a San Antonio-based company that developed a mobile app that allows cardiologists to scan EKGs and radiologists to look at CT scans in real time, among other uses.
“Patients love it,” Dr. Jack Cox, senior vice president and chief medical officer at St. Joseph Health, said of the technological offerings. “It’s really about convenience and price,” he added, highlighting the cheaper cost of the distance services.
St. Joseph’s team of engineers try to mimic the user interfaces and displays of popular apps used by consumers to boost adoption and ease operability for both customers and care providers.
“Google, Amazon and Microsoft have already done all the work,” Cox said.
Data Deluge Challenges
The proliferation of data and storing, utilizing and securely managing it have presented new challenges for St. Joseph’s IT department and doctors.
The healthcare system in March settled a class-action lawsuit to pay $7.5 million to 31,000 patients whose personal healthcare information was breached in 2012 and published on the internet. An additional $3 million was set aside for potential identity-theft losses.
The disclosures included lab results and other personal data, but didn’t include Social Security numbers, financial data or addresses, according to St. Joseph.
“Since the situation was discovered, we have invested in a number of initiatives to ensure the continued security of patient data, including enhanced data security infrastructure,” spokesperson Nisha Morris said in a statement to the Business Journal.
St. Joseph has spent more than $17 million since the breach to upgrade security and $4.5 million on credit monitoring services for affected patients. It’s still a small percentage, considering the operator generates about $6 billion in annual revenue.
Investments in Evolution
The hospital operator has spent millions more to improve software.
It moved the technology development arm of Datu Health from its Boulder headquarters to Irvine in October following a $10 million investment in the company, which makes software that connects clinical records, personalized healthcare data, and consumers’ health-related preferences.
A month earlier Hart Inc., a Newport Beach-based company St. Joseph invested in last year, partnered with St. Joseph Hoag Health—an alliance between St. Joseph Health and Newport Beach-based Hoag Memorial Hospital Presbyterian—to introduce a mobile app designed to safely and securely manage patients’ health and wellness via a PC or mobile device. The app enables users to manage their health by accessing medical records, lab results, post-visit instructions, pill reminders and more.
The partnership and the resulting HartOS API technology, which was co-developed with Chicago-based electronic health records vendor Allscripts Healthcare Solutions Inc. and Massachusetts software maker Information Technology Inc., was lauded by the White House in February for using “health data to drive shared decision making, individualized treatment plans and better outcomes.”
Healthcare has been one of the industries that’s been slow to adopt significant technological advancements in services, largely due to regulatory hurdles and competing interests among the throng of constituents involved in providing and receiving care. A generational gap among key stakeholders also has presented challenges in deciphering the major findings of data-driven initiatives and in administering care.
“It’s still an evolution. Right now, we’re faced with so much data. Before, we griped we didn’t have enough,” Cox said. “How do you use that in a meaningful way to improve your outcomes to improve safety and experience with the patient?”
The data overload, gathered from medical records, service listings, labs, outpatient charts, out-of-network healthcare providers, and third-party sources, such as insurance companies, has taxed U.S. doctors, 54% of whom show signs of burnout due to information and regulatory burdens, according to a 2015 study in the Mayo Clinic Proceedings journal that queried nearly 36,000 physicians.
“We need to help make their work easier by building simpler, more connected systems. Also, we have to agree on the data most important to collect,” Marino said. “We can’t forget that each advancement in health care IT should be made to help a human life.”
