As the safety net health system supporting Harris County, Texas, Harris Health System has provided essential medical services to the underserved of its community for more than 50 years. Harris County is the third most populous county in the U.S. and has the highest uninsured rate in the nation with more than 1 million uninsured. Harris Health was one of the first safety net systems in the country to expand beyond hospital-based care and establish a large outpatient care platform in an attempt to prevent many from becoming so ill that they required hospitalization. Harris Health System is an academic medical center affiliated with Baylor College of Medicine and The McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), which provide medical staff for our network of 48 healthcare locations.
Back in the early 2000s, Harris Health’s sprawling network of hospitals and outpatient facilities made it challenging to ensure physicians had patients’ medical records at the time and place of the their appointments. Physicians would recreate patients’ medical history and search for test results for most of the visit, which extended the length of the visit and resulted in inefficient delivery of care. Operating on paper and antiquated information systems essentially drove the organization to operate in silos. These issues made it difficult to bill and collect for services in a health system where more than 65 percent of the patients were self-pay. Something needed to change.
In search of a “New World”
Working with the health system’s leadership and the board of trustees, an Information Technology Strategic Plan was developed and aptly named “New World,” a symbol of the desire for organizational transformation. The plan modernized the IT platform, enabling the organization to truly become an integrated health system and medical home to the patients we serve.
Executing the Plan
The cornerstone of this plan was to invest in advanced enterprise information systems, including an Electronic Health Record (EHR) system. We began rolling our new EHR to our clinics in 2005 and finished in 2006, almost a decade ahead of the vast majority of the industry. By 2010, we had completed the implementation of Epic’s enterprise system, including revenue cycle, enterprise scheduling and the inpatient EHR.
Once we implemented the EHR system, patient medical records were available to physicians at any facility, any care setting and anywhere in the world through our secure network. We now had the ability to truly coordinate care across our system. After connecting to three health information exchanges, our physicians not only had access to health records across our system, but across our community. In 2016, we exchanged 1.3 million medical records with outside institutions.
"Telehealth will be one of the biggest drivers of our digital transformation and will change the traditional healthcare delivery model"
Arriving in the New World
As it turns out, our destination was a new beginning with new and endless possibilities. Achieving “meaningful use,” utilizing the EHR to support quality improvement, supporting the standardization of medical practice and implementing chronic disease management capabilities enabled our clinical organization to tackle our health and wellness goals for the patient population we serve.
Telehealth: One of Harris Health’s Latest Transformational Goals for the Future
Other industries have transformed their entire way of doing business; they have “gone digital.” The retail industry moved large portions of retail sales to online sales. Entire new sales channels have emerged, such as Amazon and eBay. High-technology software companies now deliver solutions in the “Cloud,” eliminating customers’ need to buy equipment and expand their data centers.
Telehealth will be one of the biggest drivers of our digital transformation and will change the traditional healthcare delivery model, making healthcare more accessible, more convenient and more cost-effective. This move will allow for a quantum leap in truly patient-centered care.
Words of Advice
As the U.S. healthcare industry continues its rapid transformation, we in IT need to work with our stakeholders to constantly redefine our destination— our “New World.” Build a plan to take you to the “New World” and develop the organizational support needed to fund and implement it.
Simplify your technology infrastructure and information systems architecture to ensure security, agility and supportability. Done correctly, your investments can shift from infrastructure to advanced functionality, enabling greater value from your existing investments rather than chasing the next shiny object in the world of information technology.
Select your partners wisely. Our success is often limited by their abilities, so ensure your technology partners listen, respond and are nimble. Collaborate with your technology partners to deliver the solutions your organization needs and drive them to make sure those solutions are available when needed.
Work with stakeholders to measure outcomes versus expectations and report the result/value derived from your initiatives. This provides positive reinforcement to leadership and the board, who ultimately shoulder the responsibility for the significant investments in technology.
Use the nationally-recognized IT benchmarking studies as a measure of your maturity in the market and identify your strengths and weaknesses.
Hire, train, support and develop the best IT team you can. In the end, it is that team that will build your bridge to the New World.