Spring _____ 2015
Access to care
HCAâ€™s urgent care, surgery centers and freestanding ERs create more patient-centered care
EXECUTIVE PERSPECTIVE The purpose of HCA is simple: to give our patients the care they deserve, which is patient care that is safe, high quality, compassionate, efficient and convenient. At HCA, we not only want to make our patients well, we want them to be extremely pleased with their overall experience at our facilities. In many cases, to meet the expectations of our patients, we must provide greater convenience by offering multiple facilities in the communities we serve. Simply put, we must take our services to our patients, who often want, and need, care closer to home. HCA operates in many different communities. Our goal within these communities is to be the provider of choice for patients by offering services that are closer to home and by offering a full array of services across our local networks. These offerings provide our patients with easy access and convenience while also providing an opportunity for them to stay inside an HCA network if more complex care or additional services are needed. Over the past four years, HCA has invested heavily in expanding our local networks to provide easier-to-access, more convenient care settings. For example, we have grown our network of outpatient centers, including emergency rooms, urgent-care centers, ambulatory surgery centers and physician clinics. These outpatient centers are typically located away from our hospital campuses and closer to our patients. They are designed to be standalone and easy to enter and exit, but they also are connected back to our hospitals for clinical support, as needed, and for administrative support. These centers have high levels of patient satisfaction because of the convenience, efficiency and patient care provided. Another part of our efforts to make our facilities more convenient and accessible is improving our facilitiesâ€™ websites by standardizing our platforms. This effort will make it easier for our patients to access information about our facilities, and our physicians, from mobile devices and tablets, and it will make it easier for them to navigate our websites and handle administrative issues. This year, we are implementing MyHealthOne, a new online patient portal that allows patients to access lab reports, schedule doctor appointments and even enroll for classes and seminars. Online access to records and services is perhaps the most requested service by our patients and their families, and over the coming months this aspect of HCAâ€™s service offerings will continue to grow. And finally, the company continues to invest in our nurse call centers as a way to connect with our patients and provide them with readily available resources to support their needs. Today, we respond to more than 1 million calls annually. I hope you can see from this letter that HCA has made, and will continue to make, significant investments that are designed to improve convenience and access for our patients. As we seek more innovative ways to provide our services, your role in actually delivering the service and patient care is what makes the difference. Working together, and leveraging the size and capabilities of HCA, we can make a real difference in peopleâ€™s lives, and that is truly why we exist as a company. I want to thank you for what you do, and more importantly, I want to thank you for providing our patients the care they deserve.
Spring 2015 HCA Mission Statement Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high-quality, cost-effective healthcare in the communities we serve.
HCA Values In pursuit of our mission, we believe the following value statements are essential and timeless. We recognize and affirm the unique and intrinsic worth of each individual. We treat all those we serve with compassion and kindness. We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives. We trust our colleagues as valuable members of our healthcare team and pledge to treat one another with loyalty, respect and dignity. We foster a culture of inclusion and diversity across all areas of our company that embraces and enriches our workforce, physicians, patients, partners and communities.
HCA Chairman & CEO R. Milton Johnson Retired Chairman & CEO Richard Bracken Senior Vice President, Corporate Affairs Jana J. Davis Vice President, Communications Operations Jeff Prescott Director of Communications Thad Taylor Send comments to YOU.Magazine@hcahealthcare.com
Designed and Published by Parthenon Publishing www.parthenonpub.com President Bobby Stark Chief Operating Officer Carlton Davis Managing Editor Joe Morris Creative Director Laurabeth Thurmond & Lauren Kessinger
Sincerely, Sam Hazen Chief Operating Officer
2 you spring | 2015
INSIDE F E AT U R E S
4 Access to care
With freestanding emergency rooms, ambulatory surgery centers and more, HCA offers care to communities in more ways than ever before.
7 Revamped Atlas site launches
More interactive features, news portals and other upgrades are highlights of the new Atlas.
8 The learning healthcare system
Evaluating data from multiple sources, then integrating that knowledge into operations, is how HCA is leveraging technology to provide the best care.
11 The doc and the documentary
A Denver orthopedic surgeon got to relive his high-school football glory days on NBC’s “Today” show as part of an NFL series.
12 Hold the phone
The rollout of iMobile has been an unqualified success as nurses and technicians leverage technology to ease bottlenecks and boost efficiency.
14 Ebola preparedness
Systems already in place combined with new measures as HCA hospitals led the nation after an Ebola case appeared in Texas.
16 Tomorrow’s treatments today
Sarah Cannon Research Institute ramps up community-based treatments and research efforts.
18 Doorway to better care
New online portals will give patients faster, easier access to their records, as well as offer appointment setting and other functions.
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HCA names Sam Hazen Chief Operating Officer HCA has promoted Sam Hazen to the position of Chief Operating Officer. A 32-year veteran of HCA, Hazen has served as president of operations for HCA since 2011. Prior to that, Hazen served in a number of leadership roles at the company, most notably as president of HCA’s Western Group, a position to which he was appointed in 2001. In that role, he had responsibility for seven divisions and 63 hospitals in nine states. Hazen began his career in Humana’s Financial Management Training Program in 1983. He has served as CFO for hospitals in Georgia and Nevada and as a regional CFO in Kentucky. In 1994, he became HCA’s North Texas Division CFO. He was named HCA’s Western Group CFO in 1995 and served in that role until he was promoted to Western Group President.
HCA appoints Lyn Ketelsen Chief Patient Experience Officer Lyn Ketelsen, RN, MBA, has been named HCA’s first Chief Patient Experience Officer. She is responsible for leveraging the best practices developed at HCA’s affiliated hospitals and other healthcare providers throughout the company to help ensure patients have the best experience possible. Ketelsen joins HCA after more than 12 years with Studer Group, an organization that helps healthcare providers improve outcomes, particularly with respect to patient experience. There, Ketelsen helped organizations build a culture of operational excellence and improve patient, employee and physician satisfaction levels. A registered nurse for more than 29 years, Ketelsen has worked in a variety of healthcare settings and has clinical experience in pediatrics as well as neonatal intensive care. For the first 17 years of her career she worked with Genesis Health System holding a variety of positions from staff nurse to nurse manager. Most recently at Genesis she served as an internal consultant, developing a customer service strategy that led to significant improvements in patient satisfaction.
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2015 | you spring 3
OUR STRATEGY Recently acquired CareNow expands patient access in the Dallas-Fort Worth area
Access to care Surgery centers and freestanding ERs create more patient-centered care IN THE NOT-TOO-DISTANT PAST, most patients entered an HCA facility either through physician’s referral or the emergency room. Today, patients have a much greater variety of HCA access points to get the care that they need. That’s all part of the company’s strategy to improve the patient experience. HCA’s employees are dedicated to delivering quality, compassionate care in a changing healthcare environment. Now that means actively expanding the places and ways that care is delivered. Through multiple access points, HCA now gives healthcare consumers more choices and increased convenience, which enhances their overall experience. In many markets where HCA provides care, patients can access an urgent-care facility in their neighborhood for flu shots or minor health issues. If their need is more serious, they 4 you spring | 2015
may go to a freestanding emergency room — also in their part of town. They may also schedule surgery at an HCA-affiliated outpatient surgery center. An increasing number may choose to access HCA online to schedule care, view test results or pay their bill. Sam Hazen, HCA Chief Operating Officer, says, “We are significantly increasing the ways patients can access our network. This provides them with more convenience, and enables us to care for more of the population in the communities where we have hospitals.” What’s more, Hazen adds, “We have wonderful caregivers and physicians throughout HCA. As an organization, we are continually striving to enhance the care we deliver. We continue to learn from each other to improve patient outcomes, and also are leveraging our scale to provide more access to our network. All of this improves the patient experience.”
Freestanding ERs allow HCA to provide faster, more convenient community care
The Emergency Center at Plant City provides high-quality, convenient care to area residents who don’t need the services of nearby Brandon Regional Hospital.
HCA’S HOSPITAL EMERGENCY ROOMS do an amazing job taking care of everything from accident victims to nagging sore throats. But if an area’s residents don’t live near the hospital, access to high-quality care can be a challenge. That’s why HCA continues to build freestanding emergency rooms, or FSERs, all around the country. The company now has 44 of these standalone facilities in operation, and projects about 60 sites to be up and running by the end of 2015. The goal of HCA’s network of FSERs is simple: extend 24 hours a day/7 days a week emergency services into areas without timely access to life-saving treatment. This allows HCA to become a valued healthcare provider in these communities without having to build a full-scale medical facility. “Our first FSER opened in the mid-1980s,” says Joseph Cazayoux, AVP of HCA’s Strategic Resource Group. “While several FSERs were developed over the next 20 years, between 2006 and 2008 HCA’s FSER strategy gained significant momentum, particularly in Texas, as healthcare providers began to really look at the value of offering convenient and timely services beyond the main hospital campus.”
A solution for many situations A FSER may be the right answer for many reasons. HCA’s first one resulted from a hospital relocation, for example, and was created so that the affected area wouldn’t be left completely without a healthcare presence. The community appreciated the gesture, and that FSER continues to be a success, Cazayoux says. “There’s no ‘one size fits all’ approach to FSER placement,” he says. “A number of strategic factors are considered: proximity to HCA and other hospitals, population and predicted population growth. At the same time, there are several other important considerations, including the need for a FSER to be able to offer all the services available in a hospital emergency room, so that a consumer in need can go to either setting and receive the same level of care.” In addition, most states require that a FSER be no more than 35 miles from the “sponsor” hospital, which is the facility mostly likely to receive transfer patients requiring additional treatment, surgery, or inpatient care. That means that a fairly tight geographic circle is drawn, and then the areas within it are closely analyzed to ensure that the need exists and to determine the precise location. “We usually look at areas within a 10-15 minute drive time of our facilities that offer convenient access, and have a significant and growing population, when considering sites,” Cazayoux explains.
existing space, such as an existing retail setting. Others are built in conjunction with HCA-affiliated medical office space or imaging centers. “Several have been constructed with the vision of an acutecare hospital eventually being built at that location,” Cazayoux says. “Others have been built where there was no longer a need for a full-service hospital, but there was a desire to maintain an emergency care presence in the area. And in many cases we have gone into an area in order to establish an HCA FSER presence, knowing that the population will not sustain a fullservice hospital.” Whatever the case, FSERs are likely to continue as a way for HCA to provide quality emergency care closer to home for residents who might otherwise have to travel long distances to a hospital, or delay seeking care until their physician’s office opens. Each FSER can extend HCA’s high-quality health care options beyond the nearby hospital, and so help those one-time
Different locations, different layouts The size and shape of HCA’s FSERs differ as well. Some are completely freestanding, while others are retrofitted into an 2015 | you spring 5
visiting patients achieve access to more comprehensive health solutions. “FSERs are a way for HCA to quickly and effectively create a presence, and introduce us to those underserved communities,” Cazayoux says.
Ambulatory surgery centers a longtime patient care component
The Genesis Women’s Center is a part of Citrus Memorial Hospital in Inverness, Fla.
FOR DECADES, A MAJOR CHALLENGE for hospitals was how best to treat patients who didn’t need extended hospitalization, but would require anesthesia and other hospital-related treatments for minor surgery. More than 20 years ago, HCA sought to solve that problem when it purchased Medical Care America, a provider of outpatient surgery services in many cities where HCA had hospitals and related physician practices. HCA took on Medical Care America’s 96 surgery centers in 1994, and over time has grown the total number to 124. In the process, it has lent its strengths to a care model that continues to rate highly in terms of quality care and positive patient experience, says Greg Beasley, President of HCA’s Surgery Center Division. “On its own, Medical Care America provided good services and was very physician friendly, but lacked the strength of a hospital system. With HCA, the Ambulatory Surgery Centers were able to provide the systems, processes and savings that made the centers operate more efficiently and provide even better service to patients.”
Growing in different ways Every community has differing levels of need for an ambulatory surgery center, so HCA has grown its locations through a mix of renovation, new construction and acquisitions. Some centers are fully standalone, while others are on hospital campuses or in medical office buildings connected to hospitals. Unlike freestanding emergency rooms, an ambulatory surgery center does not have to be situated within a certain geographic distance to a hospital. On the staffing side, HCA also aggressively seeks out physicians and physician groups for partnerships around a center’s operation, Beasley says. “A lot of these are owned and operated by physicians, and they’re looking for a major system like HCA as a partner,” he explains. “We typically purchase a 51 percent interest in the center, and it operates as an HCA/Physician Partnership. We are so strong in our markets that we really do bring the best of both worlds: HCA understands how the centers operate in terms of providing care, but we also understand the entrepreneurial style that drove the doctors to build a center in the 6 you spring | 2015
first place. When we come in, the physician partners are able to maintain the operating efficiencies they have always enjoyed but also access programs and services available through the HCA system such as our quality programs, managed care contracting and equipment purchasing.” In fact, he adds, “Having an investment opportunity in a surgery center has become an expectation of surgeons who do outpatient work. If HCA weren’t able to offer it, they would likely go to a competing surgery center. So we build and add these not only to provide good patient care, but also to help us affiliate and add new, high-quality physicians that improve our services as well.”
Role of centers keeps evolving As surgical techniques and other technologies advance, ambulatory surgery centers will continue to play a growing role in patient care. At the same time, those same developments will also move more care into physicians’ offices, so there will be some movement away from the centers and back to the doctors themselves, Beasley predicts. “The first big move was from hospital inpatient treatment to hospital-based outpatient sites,” he says. “Those could admit a patient into the hospital if necessary. The ambulatory surgery centers licenses don’t allow admission into a hospital setting but they have not really found that to be an obstacle. We will continue to see surgical volume move from hospital settings to surgery centers and from surgery centers into physician offices… so it’s a never-ending process.” For HCA, the centers continue to serve as a popular option for people needing same-day procedures, and that’s unlikely to change. “The surgeons like the convenience, and so do the patients,” Beasley says. “You can’t do all elective surgeries there, but more and more types are scheduled in the centers all the time. Even though they are busy, the turnover times are very good, which works well for the physicians and the patients alike. The convenience afforded by the smaller size and throughput continues to be a positive for both our patients and our physicians. Our physician satisfaction is typically very high.”
Change is good Atlas 2 system gets new home page, adding new and improved features AT HCA, COLLABORATION IS KEY TO SUCCESS. That means people need to connect, whether they are separated by a couple of floors or a couple of states. For more than a decade, the Atlas 2 intranet has helped make that happen. And now, Atlas Connect is making these connections even easier. Atlas Connect, an overhaul to the Atlas system, launched on Feb. 24, and is available to all employees. Like its predecessor, the system will offer access to HR information and forms, as well as various modules where all types of data can be stored for sharing within departments and across all of HCA. But it does all that, and much more, in a more streamlined, powerful format that takes advantage of the latest webdesign technology. For example, one of Atlas 2’s most popular features was the ability to connect with other employees on shared projects
or ideas. By visiting Atlas Connect (www. connect.medcity.net), HCA employees can still do that, but with more tools at their disposal to make the process even easier. Project teams, business units and departments will have common online workspaces, so that teams from one end of the country to the other will be able to discuss, share and exchange information.
A needed overhaul “Atlas 2 has been up for years and years; the system’s manufacturers didn’t even support the version we were using any more,” explains Gina Mosley, Development Technology Director. “We wanted to produce a collaboration site that provided current enterprise news/information/documentation that was relevant to the users while providing a friendly user interface with a new look and feel, something different than what we had, and also to take advantage of the many changes on website design and functionality that have taken place over the years.” Now, Mosley adds, “We have a place where people can collaborate and find current information to help them with their day-today responsibilities and activities, but also post messages and receive feedback from others who may be tackling the same challenges, or have already found solutions that they can share.” A team was pulled together from many different departments to envision and create the new
Update your Atlas Connect Profile All HCA employees are encouraged to visit Atlas Connect and update the Personal Profile section — please include a photo! To get started: • Click on the Configuration Wrench on the top right side of the page. • A sub-window will appear. Select manage my account. • Your “My Account” page will open. • Click “Change” photo and upload your profile picture. • Click “Additional Email Addresses” under Identification section (on the right of the page). Add an email address. interface. Many different versions were created and tested over the past few months, all leading to the goal of building the most robust interface possible. Without the team’s collaboration, support and contributions, Atlas Connect would not have been possible, Mosley says.
A comprehensive look at HCA Atlas Connect’s differences from its predecessor are evident the moment the home page opens on a browser. A scrolling carousel with news and updates from across HCA is front and center, as are links to message boards, blogs and other content. A steady stream of stories will report on news within the company, as well as the broader world of healthcare. There also is a new feature, the “Heart of HCA,” where profiles of newsmakers and innovators within the company will be shared. All employees are encouraged to share ideas for this section, and may do so from the Atlas Connect page. “We wanted something state of the art, but we also wanted something people can, and will, use,” Mosley says. “Atlas Connect offers as much as possible, but in a very user-friendly, accessible way.” 2015 | you spring 7
Bringing wisdom into the workflow
Data evaluation and implementation create HCA’s learning healthcare system how to predict events and A PATIENT IN DENVER create better outcomes for our LOGS IN to an online portal to patients and better operation of see her lab results. A nurse in our system.” Florida gets a smartphone alert Dr. Perlin refers to this that a patient is in the very process as creating a “learning early stages of deterioration healthcare system,” one that is and needs attention. A doctor is continually using the informainformed via computer that there tion it discovers and generates has been a recent outbreak of to its best advantage, becoming Legionella pneumonia and that Left to right: Dr. Jonathan B. Perlin, President, Clinical Services Group more efficient and also creating she should consider expanding and Chief Medical Officer; Dr. Edmund Jackson, Chief Data Scientist, better outcomes. The Clinical the usual antibiotic coverage to Clinical Informatics; and Dr. Jim Jirjis, Chief Health Information Officer, Informatics team’s partnership include that more rare cause. An the Clinical Informatics team. with HCA Information Techelectronic report informs a Chief nologies and Services (IT&S), led by Marty a tremendous opportunity that is being Medical Officer in Dallas there’s been a Paslick, is designed to put the right talent led by Dr. Jim Jirjis, Chief Health Informarise in readmissions, and it appears that together at the right time to take the next tion Officer, the Clinical Informatics team, improper medication use is a big step forward in clinical informatics. and thousands of experienced and capable contributing factor. HCA-affiliated associates across departThese diverse situations all have one ments, facilities and service lines, says thing in common: data. More specifically, Electronic reporting a new tool Dr. Jonathan B. Perlin, President, Clinical data provided by, and through, HCA to its in improving analysis Services Group and Chief Medical Officer. caregivers. Growth and innovation in HCA To better understand where HCA is “It’s easy to think of it as just getting Clinical Informatics is helping provide now in this process, a bit of history is in data and warehousing it, but that’s just one better, more efficient care and improve the order. When the federal government set part of the overall process,” Dr. Perlin says. patient experience. The strategic effort unMeaningful Use standards a few years “What we are doing is creating a healthcare derway to ensure those data are collected, ago, hospital systems initiated the hard system that takes data from multiple sorted, reviewed and optimally shared work of building systemwide electronic sources, integrates it, prepares it to learn across HCA is a massive process, but also record-keeping systems. That includes 8 you spring | 2015
HCA’s learning healthcare system
Enterprise data services
Knowledge base Results
Learning and analytics
Quality Growth Efficiency Patient experience Provider engagement
Data application Care systems
Apply knowledge to our patient care and business HIE Services App Dev Services CareSystem Services CRM Services Tracking Services Mobile vServices
doing is somewhat akin to that. We are all our processes.” documentation of all care and provider enhancing a system that offers insight What’s happening in healthcare mirorders being done electronically. HCA into the ‘health of our care’ and what’s rors the rapid deployment of data-trackwas already well along this path, and in going on inside our facilities.” ing devices in the general population, addition to meeting the ongoing MeanFrom that point forward, we can run says Dr. Edmund Jackson, Chief Data ingful Use criteria, our system is now usanalytics through our system to obtain Scientist, Clinical Informatics. ing that data stream to analyze patients’ much better information about vital signs and much more. That “We are creating a healthcare system what’s actually going on.” information is also used to create that takes data from multiple sources, One example is taking raw data analytics and a knowledge base obtained from a patient — such as that will better integrates it, prepares it to learn how vital signs and medication dosages support caregivers. to predict events and create better — and organizing it into a frame“We are making better decioutcomes for our patients and better work that is studied and then put to sions earlier to avoid expensive swift use to predict outcomes and or otherwise undesirable outoperation of our system.” next steps based on those analytics. comes,” Dr. Jirjis says. “We also — Dr. Jonathan Perlin “By examining the specifics of use the information we obtain to what is going on with a patient, or deliver better, more personalized within a specific area of the hospital or “There are already wristbands with care. An important aspect of what we real-time pedometers, heart-rate trackers, with a particular drug, and what is hapare doing is getting data, but it’s equally pening, we learn things we didn’t know and now the Apple watch. All these prodimportant that we are adept in becoming before,” Dr. Jackson says. “Then, we apply ucts give wearers voluminous informaexpert at how we are able to manipulate an effector arm, such as iMobile (a secure, tion,” Dr. Jackson added. it, learn from it, and use the wisdom we electronic communication platform “Metaphorically speaking, what we are gain to improve the workflow involved in 2015 | you spring 9
which HCA physicians and nurses use to communicate (see story, page 12); to change how the healthcare is being delivered, based on the wisdom we’ve gained from analytics.”
Building a world-class system The advent of electronic record keeping vs. paper notations, and the ability for multiple different systems to talk to each other and share information, often referred to interoperability, has created an entire new realm of capabilities. HCA is investing heavily in the data, resources and people to create the most comprehensive learning healthcare system possible — and also important, focusing on the endpoint of the process. With the advent of Meaningful Use, care has now shifted from paper to computers — and the process of care will become fully digitalized. By investing in advanced analytics, HCA is innovatively using data as never before to improve quality, growth and efficiency in new ways. “There are new roles, new professions and new tools emerging as a result of our work, and we are making sure that we capitalize on all of it,” Dr. Jirjis says. “But in the end, a primary matter of importance is that we apply that wisdom into workflow. Presently, we are doing that in two new ways. We acquired PatientKeeper (a provider of intuitive software and mobile applications doctors use to access and work with patient information) and HCA continues to acquire and invest in other user interfaces, because we want to ensure that what our clinicians see is the best possible information.” “Capitalizing on that advantage, we can share all our data, and the wisdom gained from it, to benefit our patients anywhere across the continuum of care in all types of facilities and physician offices. To make that happen in real time, we will eventually control all our systems with a user-friendly, front-end application that is as intuitive and simple to use as Amazon. com,” says Dr. Jirjis. Dr. Jackson says rapid deployment of information to nurses or physicians via iMobile, by way of PatientKeeper, is a game-changer. “The connection the device — or the system — creates between the data, the nurses and the physicians at the point of care is what is really powerful about these advances,” Jackson says. “It affects 10 you spring | 2015
what that nurse or physician sees. And when that caregiver subsequently talks to someone else, or sends messages regarding patient care, that data is captured and brought back into the system, which can then provide warnings or other next, important steps to continue guiding care.” “We amass and create data and turn it into information,” Dr. Jirjis adds. “We then use analytics to create knowledge, and by applying that knowledge to improve our goals, we gain wisdom. People want useful data to improve patient outcomes, and we are doing that through the platforms we are acquiring and building.”
HCA is doing now is creating a system to ensure our investments in Big Data will be successful in the future.” This will require targeted testing, or as Dr. Jackson puts it, “sending one real-time algorithm out into the wild,” to test all that goes on around one particular issue, such as bacteria detection, and process it through the developing information system. “We’re going to start seeing changes happen in targeted areas or specific projects, at various facilities, on this journey to implement an enterprise-scale project,” Dr. Jirjis says. “We want to gain benefits from the many lessons we experience prior to full usage. As each particular aspect debuts and is Flexible interface, tested, and people like it and use it, we trial runs coming will gain wisdom. These actions will result In the coming months, work will in our improving quality of operations continue on a front-end portal that will while also reducing costs and increasing incorporate Meditech, iMobile, Patientefficiency.” Keeper and many other applications and “At the same time,” he points out, “our systems. Dr. Jirjis and his team, bolstered efforts are improving physician and by a strong collaborative partnership with caregiver satisfaction, patient care and the IT&S, are working on an open-architecture patient experience. The Clinical Informatsystem that will facilitate this, as well as other new technology that will be added as ics approach is for each pilot and point solution to provide near-term value, while it becomes available. being built in a “Flexibility way that makes is going to be a “Connecting data to individuals sense for the primary requilonger term.” site for sucmaking decisions offers the ability Dr. Perlin adds, cess,” Dr. Jirjis to understand and improve all “Of course, it explains. “All of would be imposthese Electronic dimensions of patient care.” Medical Record — Dr. Edmund Jackson sible to make this transfor(EMR) systems mative project have to be happen without the Clinical Services de-coupled from each other. Currently, Group’s collaborative partnership with they are integrated in such a way that if IT&S. Chris Pair leads the technologies you change one thing, you have to change behind the analytics and data quality, everything across multiple systems. What and Chris Wobensmith leads the technologies behind the Electronic Health Records tools (including PatientKeeper) and Decision Support. Both these leaders possess years of HCA experience, as well as intimate knowledge of what it takes to make these technologies work. Marty Paslick, HCA’s Chief Information Officer, has assembled an experienced team who are our partners in bringing these advanced technologies together in a forward-looking, integrated way. “ “These are exciting times,” Paslick says. “The depth and breadth of the data we are collecting, combined with emerging analytic tools, positions HCA to be a leader in Clinical Informatics.”
The doc and the documentary Orthopedic surgeon recalls his football days as part of NFL series
EVER HEAR OF A HIGH SCHOOL FOOTBALL STAR eventually making it big in the NFL? Sure, but how about the players, fans and families who took their gridiron experiences into remarkable lives far from the playing field? These people are the focus of “Together We Make Football,” a series of segments produced for the “Today” show by NFL Films and NBC. And as producers cast about for professionals to profile, they found an ideal candidate in Dr. Ron Hugate, an orthopedic surgeon in the Denver Clinic at Presbyterian/St. Luke’s Medical Center in Denver. For Dr. Hugate, the lesson that carries over from football to medicine is all about teamwork. Whether looking at his medical teams at Presbyterian/St. Luke’s, or his surgical trauma teams in a war zone, or even his flag football teams on the weekends, success is about assembling the right team. Working as a team also drives his innovative side, as he and a team of engineers and patients focus on the development of a transcutaneous device that would give amputees a more efficient, functional new limb.
Developing a ‘can do’ attitude The doctor himself says that the discipline and teamwork he learned in football, as well as the desire to never give up, have served him well in many of life’s challenges. These challenges have included tours of Iraq and Afghanistan as an Army reservist, as well as his daily work to save the limbs — and lives — of cancer patients. Dr. Hugate and his team at Presbyterian/Saint Luke’s Medical Center have the highest survival rate for osteosarcoma in the entire world. They take a team approach to cancer treatment, with
Dr. Ron Hugate, right, found himself talking to a national audience about the importance of teamwork when he appeared on the “Today” show.
radiologists, oncologists, plastic surgeons and other team members working together to care for patients. The team uses intra-arterial chemotherapy to treat bone cancer. This method sends the chemo directly to the tumor in a high concentration to shrink it. Once the tumor reacts to the chemo, Dr. Hugate uses surgery to remove it and reconstruct the limb. Two of his osteosarcoma patients surprised Dr. Hugate during his live appearance on the “Today” show in October of 2014. After the documentary aired, Jason Lansdown and Hunter Baker joined Dr. Hugate and the “Today” show anchors on set for an emotional and happy reunion. Both Jason and Hunter were diagnosed with bone cancer as teenagers. Thanks to Dr. Hugate and his team, they are both living healthy lives.
Game-changing prosthetic tech Another top priority for Dr. Hugate is his work with amputees. He’s been inspired by his military experiences to improve their lives by creating a permanent prosthetic. He and his development team are working on a transcutaneous device that would implant into the bone just above the amputation site, and would allow the patient more normal mobility and function than is currently possible. “This will be a game-changer for amputees. Right now a prosthetic fits over the limb. It can be challenging for many because of skin issues, perspiration, and weight gain or loss,” Dr. Hugate says. “I am working on a prosthetic that attaches directly to the bone and avoids the fit problems many amputees have right now.” The device acts much as a dental post for a crown does in the mouth. It is placed into the bone, and the prosthetic limb is snapped onto it. There’s no skin interface, so if the wearer sweats, or fluctuates in weight, they won’t have as many problems with irritation as there are with today’s options. This prosthetic anchor would also make gait much more efficient, taking less energy. Though his patients and research keep him busy, Dr. Hugate and his team still make time to leave the OR and hit the football field. “A lot of my patients saw the “Today” show, and it was fun for the team as well,” he says. “When we go out and play some flag football, it’s a great way to blow off some steam, and it’s a great team-building activity too.”
See Dr. Hugate on “Today “ at: bit.ly/1bJZCjf 2015 | you spring 11
Sarah Lynne Gates, Clinical Staff Pharmacist, uses the smartphone to communicate results and track other lab functions.
Hold the phone Mobile platform increases efficiency for caregivers throughout hospital AFTER MONTHS OF RESEARCH and testing, HCA is now conducting a pilot of a smartphone program that allows nurses, doctors and other clinicians to connect and share patient information without running afoul of HIPAA rules and other privacy concerns. “We had been asking the clinical community what they wanted from a secure messaging platform on a smartphone,” says Kelly Aldrich, Chief Nursing Informatics Officer for HCA. “They told us they needed a device to communicate about many different aspects of patient care — not just messaging. So we got to work on a solution that would include requests for nurse call-bell integration, lab values, an ability to broadcast to multiple devices, and more.” All these functions are packaged into an iPhone, and the first devices were rolled out at TriStar Southern Hills Medical Center in Nashville last summer. After receiving overwhelmingly positive feedback from clinicians and physicians, the devices are also live now at several other facilities. “The communication is phenomenal when it comes to patient throughput,” Aldrich says. “If the PACU nurses send a message to a floor nurse that a patient’s on his or her way, they are better prepared to receive the patient. And because the system is being used by physicians, pharmacy techs, and almost everyone in 12 you spring | 2015
the hospital, it’s improving efficiency between departments and also increasing patient satisfaction because people are getting better, quicker care.”
Adoption fast and easy There had been some concern about how quickly staff could get used to the system, but everyone was up to speed in short order, says Chris Staigl, Chief Nursing Officer at TriStar Southern Hills. “The transition time was nil,” Staigl says. “Texting and using a smartphone is technology that people have already embraced, so we saw usage skyrocket. It’s providing staff with a way to not only call each other, but also securely text doctors, which was something they really wanted.” There are around 1,000 messages being sent daily within the facility, and a hefty portion of those also include updates on lab results, another feature that was in high demand. Within that function, the user can see if results are in and, if so, also look at the patient’s history to see if the new results trigger specific actions. “We have a directory of everyone in the hospital on there, so you can find the person you need right away and send them pertinent information,” Staigl says. “Now everybody’s getting a lot more done, and this is just the tip of the iceberg in terms of
what these phones can offer us.” A camera feature is in development, which will allow caregivers and offsite providers to consult and deliver care not only more efficiently, but also safely. The transferred image files will be encrypted so they can’t be saved to the device, ensuring that the patient’s medical records will remain protected.
Samira Kamal, Clinical Staff Pharmacist, is able to reach out to caregivers much more efficiently.
Doctors eager to get on board Being able to see patients in her office and also handle requests from the hospital has indeed been a major selling point for Dr. Tracy Osborne, who agrees that the technology has huge ongoing potential as other features are added and integrated into it. “The immediacy is good, and it saves a lot of time if I need to tell a nurse something,” Dr. Osborne says. “Before, I would call and get the unit secretary, who’d have to find the nurse, or take a message. This is much more fluid, because I am in immediate contact with that person. Anything that can save all of us time is
going to be welcomed, and being able to see labs, and eventually imaging, is wonderful. I’m able to move quicker in terms of patient care, which is our shared goal.”
“This is much more fluid, because I am in immediate contact with that person. Being able to see labs is wonderful. I’m able to move quicker in terms of patient care.”
Pharmacy issues solved in seconds
Avoiding multiple calls and leaving messages is also a boon for the hospital’s lab professionals, according to the staff members who are most closely involved. “iMobile has been a wonderful addition to our technology and workflow,” says Sarah Lynne Gates, Clinical Staff Pharmacist. “It has improved medication safety through more timely information about medication orders, and also has facilitated communication between pharmacists, physicians, nurses and other clinicians. It has helped immensely increase efficiency because the sender knows that the information has been sent directly and securely to the intended recipient.”
— Dr. Tracy Osborne
The program helps speed the lab process, as nurses can be easily contacted about the status of the specimens they collected, or need to collect. “Even if they just tell us that they’ll have it soon, that’s fine,” Gates says. “We just need to know that it’s on their list of things to do and that it’s coming to us eventually.” Patients are pleased to hear about the new technology, although there has been some education in that regard as well. “We give an information card that looks just like the phone case to patients,” Aldrich says. “Our care team lets our
“Because the system is being used by physicians, pharmacy techs, and almost everyone in the hospital, it’s improving efficiency between departments and also increasing patient satisfaction because people are getting better, quicker care.”
The smartphones are centrally stored and charged, and so are accessible to staff when they begin and end a shift, or need to swap devices.
— Kelly Aldrich patients and family members know that we are coordinating care in both synchronous and asynchronous ways to best serve them.” 2015 | you spring 13
DOFFING TIER 2 PERSONAL PROTECTIVE EQUIPMENT (PPE) Doffing PPE, PAPR Option – PPE doffing should be performed in the designated PPE removal area. Place all PPE waste in a leak-proof infectious waste container, http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html. http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html *Exact steps may differ depending on style of PAPR used. 1
Trained Observer: Doffing process is supervised by a trained observer who must:
a. Read each step of the procedure aloud and confirm visually that the PPE is removed properly. b. Remind healthcare worker to avoid reflexive actions that may put them at risk, such as touching their face. Post this instruction and repeat it verbally. c. Assist healthcare worker with removal of specific components of PPE, as outlined below. *Observer PPE may be the same as the caregiver, depending upon facility policy for staffing and PPE readiness. Doffing steps may differ with a buddy dual doffing process.
Inspect: Inspect PPE for cuts, tears, or contamination before removal. If any PPE is potentially contaminated, disinfect using 10% bleach wipes. If conditions permit and appropriate regulations are followed, an *EPAregistered disinfectant spray can be used, particularly on contaminated areas.
Outbreak treatment guidelines, facility upgrades benefit patients and employees
b.To remove coverall, tilt head back to reach zipper or fasteners. Use mirror to help avoid touching skin. Untape & unzip, or unfasten coverall completely before rolling down and turning inside-out. Avoid contact with outer surface of coverall, touching only the inside.
d. Disinfect their outer-gloved hands immediately.
Remove Gown or Coverall: Remove and discard. a. Depending on gown design/location of fasteners, healthcare worker can either untie fasteners, receive assistance from trained observer to unfasten them, or break the fasteners. Avoid contact with outer surface of gown. Pull gown away from body, rolling inside-out, touching only the inside.
Disinfect Inner Gloves: Disinfect inner gloves with either %10 bleach wipes or ABHR
Disinfect Washable Shoes: Sitting on a new clean surface (e.g., second clean chair, clean side of a bench) use 10% bleach wipes to wipe down every external surface of the washable shoes.
Disinfect Inner Gloves: Disinfect inner gloves with either 10% bleach wipes or ABHR.
Remove Respirator (if not already removed): If a PAPR with integrated self-contained filter and blower unit inside the helmet is used, then remove all components. a. Remove and discard disposable hood b. Disinfect inner gloves with 10% bleach wipes or ABHR c. Remove & discard inner gloves - do not contaminate hands d. Perform hand hygiene with ABHR e. Don a new pair of inner gloves f. Remove helmet and the belt & battery unit. This step might require assistance from the trained observer.
Disinfect and Remove Inner Gloves: Disinfect inner-gloved hands with 10% bleach wipes or ABHR. Remove and discard gloves - do not contaminate hands.
Disinfect Outer Gloves: Disinfect outer-gloved hands with 10% bleach wipe or ABHR. Allow gloves to dry. *Establish separate ABHR units for patient care use vs doffing to minimize cross contamination of hands.
Remove Apron (if used): Remove and discard apron taking care to avoid contaminating gloves by rolling the apron from inside to outside.
Inspect: Following apron removal, inspect PPE to assess for visible contamination or cuts/tears. If contaminated, then disinfect affected PPE using a 10% bleach wipe.
Disinfect Outer Gloves: Disinfect outer-gloved hands with 10% bleach wipes or ABHR. *Establish separate ABHR units for patient care use vs doffing to minimize cross contamination of hands.
Remove Boot or Shoe Covers
Disinfect and Remove Outer Gloves: Disinfect outer-gloved hands with either a %10 bleach wipe or ABHR. Remove & discard outer gloves, taking care not to contaminate inner glove during removal process.
Perform Hand Hygiene: Perform hand hygiene with ABHR.
Inspect and Disinfect Inner Gloves: Inspect inner gloves for contamination, cuts, or tears. If inner glove is soiled, cut or torn, disinfect with 10% bleach wipes or ABHR. Remove inner gloves, perform hand hygiene with ABHR, don clean pair of gloves. If no visible contamination, cuts, or tears are identified on the inner gloves, disinfect the inner-gloves with either 10% bleach wipes or ABHR.
Inspect: Trained Observer - perform a final inspection of healthcare worker for any indication of contamination of the surgical scrubs or disposable garments. If contamination is identified, immediately inform infection preventionist or occupational safety and health coordinator or their designee before exiting PPE removal area.
Scrubs: Healthcare worker can leave PPE removal area wearing dedicated washable footwear and surgical scrubs or disposable garments.
Remove Respirator (PAPR)***: a. If a PAPR with a self-contained filter and blower unit integrated inside the helmet is used, wait until Step 15 for removal and go to Step 11. b. If a PAPR with an external belt-mounted blower unit is used, all components must be removed at this step. i. Remove and discard disposable hood. ii. Disinfect inner gloves with either 10% bleach wipes or ABHR iii. Remove headpiece, blower, tubing, and the belt and battery unit. This step might require assistance from trained observer. iv. Disinfect inner gloves with either 10% bleach wipes or ABHR v. Place all reusable PAPR components in ii. & iv. an area or container designated for the collection of PAPR components for disinfection.
20 Shower: Showers are recommended at each shift’s end for healthcare workers performing high-risk patient care (e.g., exposed to large quantities of blood, body fluids, or excreta). Showers are also suggested for healthcare workers spending extended periods of time in the Ebola patient room.
Protocol Evaluation/Medical Assessment: Either the infection preventionist or occupational safety and health coordinator (or their designee on the unit at the time) should meet with the healthcare worker to review the patient care activities performed, to identify any concerns about care protocols, and to record healthcare worker’s level of fatigue.
THE EBOLA VIRUS went from being a “what if” discussion to a “now what” one when a patient was hospitalized at a nonHCA facility last fall in Texas. Local, national and even international reports analyzed everything from patient care, to infection prevention, to quarantine for care teams. Across town and around the country, teams throughout HCA already had researched these concerns exhaustively as they put plans into place to ensure patient safety and quality 14 you spring | 2015
Ebola scare showcases HCA’s preparedness
of care should a patient with Ebola, or any other highly infectious disease, seek care at an HCA facility. That’s no surprise. A vigorous response to a major health crisis, such as a potential viral outbreak or natural disaster like Hurricane Katrina or the earthquake in Haiti, is a hallmark of HCA’s ongoing and robust preparedness efforts. Throughout the Ebola crisis, that response was very much on display.
Facilities spoke to each other continually about facility readiness issues, as well as to response teams in division offices and at HCA’s corporate offices in Nashville. At the same time, the changing CDC guidelines were being assessed, and that information was shared across HCA as well as with other healthcare organizations, says Scott Cormier, Director of Emergency Preparedness & Management for HCA’s Clinical Services Group. “We began monitoring Ebola in Jan-
uary 2014, and by the end of July, we were having conversations with our Capital Division because they are near Dulles Airport, which is a top spot for inbound travel from West Africa,” Cormier says. “By August, we had issued guidance across HCA on how to deal with suspected or confirmed Ebola patients. This was before the CDC released their guidance, and in our guidelines the personal protective equipment (PPE) we specified for our caregivers was actually above what the CDC standard was for Ebola because we wanted to take extra precautions in order to protect our staff.” The CDC has since upgraded its guidelines around respiratory equipment and standards, he adds.
protective equipment (PPE), staff training on patient screening and donning and doffing PPE, lab preparations for specimen handling, and detailed patient flow planning in emergency departments. These processes and protocols have since been shared with all HCA facilities, and showcase the rapid, professional response to major medical challenges that is a cornerstone of HCA’s culture. “A team of eight people went to North Texas to conduct an intense training session centered on the practices and policies related to the updated CDC recommendations, so that our people were ready,” explains Dian Adams, Associate Vice President of Nursing Leadership. Another site of tremendous activity during this time was Oklahoma University Medical Center, which is now the state’s official go-to Ebola treatment center, says Dan Raiden, Vice President of Support Services and Strategic Operations Improvement. “We have our amended license to add two additional beds, and have created dedicated space for those beds in a sepa-
”We also shared our resources with other healthcare organizations around the country, and worked to make sure significant issues were addressed.”
Guidelines, training in place When the first patient presented at a Dallas hospital and healthcare workers subsequently became infected, HCA facilities in the area and nationwide were prepared, thanks to these guidelines. Now every facility is ready to move should an Ebola patient present in any HCA care facility. “We did webcasts on very basic things, such as explaining what Ebola is,” Cormier says. “We also shared our resources with other healthcare organizations around the country, and worked to make sure significant issues were addressed, like making sure there was, and will be, enough personal protective equipment in the supply chain to protect healthcare workers.” “We were really on top of this when Ebola was not a concern for a lot of people,” Cormier adds. “Our guidance was placed on the Federal government’s Homeland Security Information Network site, and in August and September, it was that site’s most downloaded document.”
— Scott Cormier
rate building on campus,” he says of the multifaceted project, which included both new construction and renovation. All the moving pieces show how the HCA system comes together to provide rapid training, deployment of resources and excellent patient care, Adams points out. “We can deploy resources where and when they are needed,” she says. “Now we will work to ensure that every facility continues to train and maintain their skills.”
Preparing for an Ebola outbreak meant a lot of new equipment, including special protective suits.
Facilities lead the way With all this in place, when the news broke that “patient zero” was in Dallas, HCA hospitals in the North Texas Division were prepared to swing into action. That included updating inventory of personal 2015 | you spring 15
Tomorrow’s treatments today New Sarah Cannon research facility in Denver means latest treatment options are closer to home for patients SARAH CANNON RESEARCH INSTITUTE (SCRI), the research arm of Sarah Cannon, HCA’s global cancer enterprise, is one of the world’s leading clinical research organizations, conducting community-based clinical trials in oncology, cardiology and orthopedics through affiliations with a network of more than 1,000 physicians across the United States and United Kingdom. With a mission to advance therapies for patients in a community setting, SCRI has enabled thousands of patients each year to benefit from accessing clinical trials and promising new therapies closer to home. To continue reaching more patients, Sarah Cannon Research Institute is expanding its footprint to complement the cancer services offered throughout the Sarah Cannon Cancer Network of Excellence. Sarah Cannon helps an ever-growing number of cancer patients — more than 100,000 newly diagnosed per year in our system — navigate their cancer journey through cancer-trained nurse navigators and integrated cancer care across HCA’s family of hospitals. The newest SCRI Drug Development Unit recently opened in Denver, Colorado, and supports patients throughout the HealthONE system and the Rocky Mountain region. SCRI at HealthONE performs Phase 1 clinical trials for many types of cancer, similar to select other research programs in the network, including first-in-human trials of new drugs and new treatment combinations. The opening of SCRI at HealthONE enables patients in the Rocky Mountain region to participate in research without traveling long distances, a barrier that often prevents patients from participating in clinical trials, according to Howard A. “Skip” Burris III, MD President of Clinical Operations for Sarah Cannon, and Chief Medical Officer and Executive Director of Drug Development for Sarah Cannon Research Institute. “Sarah Cannon has one of the largest drug development programs in the world,” Dr. Burris says. “We’ve surpassed most academic institutions in our investigation of new therapies for patients, with the enrollment of more than 1,000 patients in
2014 and now having initiated more than 150 first-in-human trials. SCRI has led the way in providing these novel therapies closer to those fighting cancer. It is why we continue to expand our research facilities so that patients have better access to clinical trials.”
”Sarah Cannon has one of the largest drug development programs in the world. We enrolled more than 1,000 patients in 2014.”
Now, cancer specialists have the ability to look at a tumor’s genetic makeup and treat many patients specifically for their unique mutation, rather than treat all patients the same way. “The tumors are as different as the people who have them. More people enrolled in clinical trials will improve the speed and quality of the research,” Dr. Burris explains. “If we can identify the key characteristics of the tumor, we can get the right therapy to the right patient at the right time,” he says. “Facilities such as SCRI at HealthONE are specially equipped and able to do this early investigational work. We are expanding our prominence in the area of blood cancers, so we’re able to offer patients access to new therapies in that arena as well.” The Sarah Cannon Blood Cancer Network performs more than 900 blood and marrow transplants each year throughout the enterprise, making it one of the world’s largest treatment providers for those patients too, Dr. Burris adds.
— Dr. Howard “Skip” Burris
16 you spring | 2015
Tumor genetics play increasing role
Mile high and busy already In Denver, the newest research facility is led by Gerald S. Falchook, MD, MS, Director of Drug Development at SCRI at HealthONE. Dr. Falchook came to HCA in 2014 from MD Anderson Cancer Center, and has been the lead or co-lead investigator on more than 160 clinical studies, including many first-inhuman studies that have received FDA approval. He and the facility’s other providers began seeing patients in October 2014, and saw tremendous patient interest and enrollment right away. Clinical oncology is a fast-moving field, but by committing to expanding the number of facilities, staffing, and trials, Sarah Cannon is well-positioned as a leader in the field, Dr. Falchook says, noting that he’s doing his part to help with the deluge of Sarah Cannon information now available about Research Institute new cancer treatments. “Keeping up with what’s coming Facilities down the pipeline is difficult, so • Nashville, Tenn. a former colleague and I have developed a handbook that provides • London, UK concise summaries of the results of • Sarasota, Fla. recently published clinical trials. • Denver, Colo. It has more than 50 contributing • Oklahoma City, Okla. authors, all of whom are leaders in the field of cancer research.”
At the same time, he says the early success of the new Sarah Cannon Research Institute at HealthONE is encouraging from the treatment standpoint as well as the research perspective. “People don’t like leaving their physician and their home to be treated,” Dr. Falchook says. “They want to drive across the city, rather than fly across the country. Plus, when patients enroll in a clinical trial closer to home, their physicians are able to stay involved in their treatment. I think that’s why we’re getting more referrals than expected, which is a very good problem to have.”
Expanding pool of sites, treatment options That’s why future growth for Sarah Cannon Research Institute will include some smaller cities, so that, like HCA itself, it will have treatment centers in communities of all sizes. “Because we are able to provide the oversight and expertise, we’ve been a trusted partner of pharmaceutical and biotech companies for many years,” Dr. Burris says. “Our collaborative effort results in successful partnerships and as we continue to work together we’ll be able to expand our services.” That’s important, because having a broader pool of patients will help researchers identify the many different paths a developing cancer can take, which will make the treatments they develop all the more robust. And that, in turn, will hopefully produce better, more effective treatments that save lives.
Left to right: Gerald S. Falchook, MD, MS, Director of Drug Development at SCRI at HealthONE, and Howard A. “Skip” Burris III, MD President of Clinical Operations for Sarah Cannon, and Chief Medical Officer and Executive Director of Drug Development for Sarah Cannon Research Institute. Top right, the new Sarah Cannon Corporate Headquarters building under development in Nashville; Above left, below center, right; SCRI at HealthONE in Denver is focused on providing a high-quality patient experience
2015 | you spring 17
Doorway to better care Enhanced online patient information system debuts in Nashville and Denver WHEN ASKED FOR their healthcare “wish list,” patients routinely request online access to resources and tools like lab results, bill-pay ability and appointment scheduling. MyHealthOne, a new patient portal combining many existing online features, is about to turn those wishes into reality. The patient portal has been in development within HCA’s Information Technologies and Services department for the last couple of years. In the coming months, a growing number of HCA facilities will see the portal functionality added to their websites. The rollout will be slow, because the system will not only be testing patient access and usage, but also folding in new capabilities as it grows and expands. 18 you spring | 2015
“We are piloting our expanded patient portals in Denver and Nashville, because those are areas where the Meditech system is in place,” explains Kari Longoria, Assistant Vice President of Customer Relationship Management Field Deployment. “We want to make sure that everything is working properly on a small scale before we ramp up the release.” In addition to meeting an important patient satisfaction goal, the portal also helps HCA meet a major requirement of the federal government’s ongoing Meaningful Use criteria around electronic record keeping and access, adds Deb Reiner, Vice President of Customer Relationship Management. “We are required to have some patient information available
online, but we also want to have services on there so that it’s more meaningful for them,” Reiner says. “We spent some time finding out what they wanted, besides clinical data, and found that they want to preregister for procedures, to schedule followup appointments, to get education around diseases and to pay their bill. We are putting all those functionalities into this system, as well as the ability to register for classes and events.”
she explains. “What we’re doing is creating a seamless site experience as the front door from the web, and then the portal as another door in the house once the patient is in there.” Information entered in the portal by the patient also feeds to HCA’s contact centers, so that if the user calls with a question about a scheduled appointment or other issue, the center staff can quickly access records to help facilitate the call. “Before, they weren’t connected, so they couldn’t follow what was going on,” Hobbs says of the call centers. “So much of what we’re doing is making connections we haven’t had before on the back end, and making the user interface more seamless for the patients and other site visitors.”
New functions will come quickly
While the MyHealthOne test launches will focus on these core functions, they also will be laying the groundwork for additional services within the portal framework, adds Longoria. In some parts of the country, MyHealthOne will gather toThat’s also according to plan, because the system will continue gether functions that are now available on a hospital’s website, to evolve based on both internal and external feedback. but that must be accessed through different click-through “We’ve been going out and talking to hospitals about this, and prompts. For instance, a patient might want to schedule an they are very excited,” she says. “They have a very clear vision appointment and also see his or her bill, which currently would and a sense of urgency, and we get feedback from them every require two different interactions. The new system will remove single day. The idea is not to build a portal, go live and then that duplication while also providing a much easier navigathat’s what we have for several years. This is going to be a contion experience, says Jill Hobbs, Assistant Vice President for tinual, interactive process, just like the updates people get for Customer Relationship Management, Web, and Digital Media apps on their phones. We will be getting enhancement requests Systems in IT&S Enterprise Product Development. from hospital teams and consumers, and we’ll be prioritizing “When we began the portal project two years ago, we didn’t and completing those in an ongoing conversation.” realize all the connections we would be making,” Hobbs says. The result will be an intuitive and evolving system that meets “A lot of things have just naturally aligned during the process, the needs of facilities, clinicians and patients alike, Reiner notes. which in the end is giving us a much better project.” “All the data we receive will be going A prime example of that is HCA’s overall into our clinical data management sysweb strategy, which focuses heavily on unitems, which is a very good and realistic fied technology so that all facility websites MyHealthOne Patient Portal: use of the data warehouse that we are have common basic functionality. The end Initial Features creating,” she says. goal is to create scalable platforms so that “For example, if someone is in the updates roll out throughout the system • Schedule a class (register and pay) emergency department, and told to folinstead of each site requiring individual up• Find a doctor/make an appointment low up with an orthopedic surgeon, we’ll dates. The portal works within that strategy, • Pay a bill be able to present them with a list of Hobbs says. • Preregister for admission doctors who can treat that specific need “If someone comes to one of our websites • Manage your personal profile when they log in to see their lab results. as a consumer or patient, they can get a • Manage the health of a loved one The portal is a big part of the personallot of information, and also go through the ized care path that HCA is creating.” portal to access their specific information,”
Single portal system replaces duplicated versions
2015 | you spring 19
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THE HCA WAY
Girls code, too Mentoring efforts prepare next generation of women in IT paired freshmen girls with a group of around 40 women several times over the course of the school year. “We had about 180 girls, and we think by exposing them to guest speakers, activities and some serious conversations that built relationships, they learned a lot about the field of IT, and how a woman can excel there,” Pickett says. “About 13 percent more girls chose the IT academy compared to the prior school year, and so we’re back this year and have increased the program so that we are partnering with and mentoring sophomores, and looking at web design, networking and programming tracks so we can better match up girls to the proper IT pathway for them.”
Mentoring opportunity appeals
Around 180 girls took part in the first IT mentoring sessions led by women from HCA’s IT&S department, and now it has added web design, networking and programming tracks to foster specific interests.
THE IT GENDER GAP isn’t just a Silicon Valley issue, and that’s why a growing group of women in HCA’s Nashville offices are stepping up to work with young women who may be considering a career in technology. “I was at a conference, and one session focused on the perceived ambition gap when it comes to women in technology,” says Sasha Pickett, Manager of Web Operations for the Web and Social Media Services Department within HCA’s Information Technologies and Services. “One quote that stayed with me was, ‘you can’t be what you can’t see.’ Then I read about a nonprofit in New York that was encouraging girls to enter the field, and we began to look into something like that at HCA. We formed a group of people who met for several months and decided on our focus.” Along the way, they partnered with the Pencil Foundation, which connects community resources with the Metro Nashville Public Schools. Officials there suggested Overton High School, which already had an IT academy in place. In fall 2013, IT Girls
For participants, the chance to connect a talented girl with a career where she can thrive was too good to pass up. “I wanted to share my insights and experience, what I have learned,” says Heidi Henline, Web Production Manager with HCA’s Web Services Team. “It’s been a great experience. I can exercise my creative side, by working on session activities and lessons, and it’s rewarding to see the benefit that the program has been to the school and the girls. It’s a joy to invest my time in a program that has significance beyond the 9-to-5 of my job. We do so much more than just sit down and type, and it’s wonderful to be able to share what I do, and to help break down the barriers to entering this field, for young women.” For Overton, it’s a chance to not only bring in guest lecturers who are in the field, but also make its technical programs more appealing for girls. “We really work on recruiting female students into that academy, but it’s been a struggle,” says Mary York, Academy Coach, who liaisons with community business partners. “This got more of our students engaged right away. And the more girls see other girls going into IT, it absolutely will grow itself. They are seeing successful women doing many different IT-related jobs at HCA, and they are learning that these skills are transferrable to fields outside health and science. It’s been very eye opening for them. We are extremely pleased with HCA’s commitment to this partnership.”