Frustrations of a Healthcare CIO

By Mark Crandall, CIO, Consulate Health Care

Mark Crandall, CIO, Consulate Health Care

As a national leading provider of senior healthcare services to 150 care centers in 15 states, Consulate Health Care has grown with a strong focus on patient needs. When I took the post as CIO back in 2014, my team was driven by company goals where I knew a world-class Information Technology (IT) team could make a difference: improved care coordination through data interoperability, better clinical outcomes through data-driven decision making, and the protection of our patients’ health information.

In 2014, most computer users at Consulate were back-office employees. We needed to extend our IT services to more than fifteen thousand practitioners employed by Consulate as well as third-party physician groups that care for our patients every day with their hearts and hands. It was our responsibility to put tools in their hands (cell phones, tablets, etc.) that delivers the data they need to care for our patients at the bedside. To be successful, we required a solution that would allow simple and secure access to permitted devices (those carried by our employees and trusted physicians) while locking out devices that weren’t pre-authorized. Adding a user-friendly, internet-accessible network for our patients’ families that provided convenient internet access, without access to our secure network, was another requirement when designing our wireless network.

After three years of time and investment, we have that solution. We have blanketed each care center with a wireless infrastructure and upgraded circuits to be sure that the bandwidth-hungry applications are satiated without impact to enterprise systems. We have strong security policies coupled with user-friendly on-boarding procedures to be sure that whether you are an employee, a third-party practitioner, or a state surveyor, you can get the data that you need. Yet I am frustrated as I write of these successes. Why? Because this wireless infrastructure is largely untapped!

"Consulate is positioned to use the expansion of data available today to increase the effectiveness of the care that we deliver to our patients and residents"

A goal in our industry is to reduce the unnecessary trips from a skilled nursing facility (SNF) to a hospital, for very good reason; these trips are costly, potentially harmful to our patient, and often the care needed can be delivered to that patient right in the SNF. It is widely reported (especially by solution providers) that telemedicine and telehealth increases the quality of care that can be provided right at the bedside, without the need for transitioning our residents from the comfort of their own surroundings. This is particularly impactful in rural areas where a doctor on call may be miles away.

This is not a new concept, yet it is far from easy to implement. And I am not referring to the technology – it is the logistics of providing credentialed care to our patients and then getting properly reimbursed for those services. We have no issue providing synchronous audio and video connectivity for “real-time” communication, but the regulations surrounding the practice and reimbursement are dizzying and vary from state to state. Telehealth solution providers have no issue when it comes to providing a solution that does not eat up our bandwidth, but when it comes to practitioners that are credentialed to provide services and Medicare, Medicaid, and managed care rules for reimbursement of these valuable services, it couldn’t get any muddier.

We have come a long way since 2014 – we have made extensive use of a stable wireless environment to roll out an electronic health record (EHR) platform that gives the practitioners in our buildings the data they need, right at their fingertips. As the healthcare industry in general moves towards a model of value in episodic care, Consulate is positioned to use the expansion of data available today to increase the effectiveness of the care that we deliver to our patients and residents. Walking through one of our care centers in Central Florida that had just gone through a monumental shift from a completely paper-based workflow to an EHR platform, our team was thrilled to hear that the practitioners are able to spend more time with the patient and less time with the process of medication pass. Delivering a consistent, efficient user experience with the right data at the right time, whether the device is a laptop, a kiosk, or a mobile device, is much more possible today than it was just five years ago.

In the end, my job as CIO is to work with our Operations teams and our vendor-partners to employ stable and secure technology to allow our practitioners to do their jobs more effectively, thereby delivering a higher level of care and improved patient experience. Telemedicine and telehealth are technically possible; we just need to get our partners in legislation and payer sources on the same page for the benefit of America’s Seniors!