Penn Medicine is a Philadelphia-based $3.5 billion enterprise consisting of the University of Pennsylvania School of Medicine and the University of Pennsylvania Health System, (UPHS) which includes three hospitals — the Hospital of the University of Pennsylvania, Pennsylvania Hospital and Penn Presbyterian Medical Center. HCI Editor Daphne Lawrence recently spoke with VP and CIO Michael Restuccia about his IT projects and new patient portal.
Part I DL: Can you describe the structure of your department?MR: We don’t have a CMIO yet, but are we’ll be recruiting for one.
DL: Any physician champions at the hospital that might fit the bill?
MR: Well with 1600 docs, we have many physician champions. But to get somebody to dedicate a large portion of their time we’ll see what the recruitment brings. But in addition to that, we have CIOs at each of our hospitals. Each of our facilities does have its own unique needs in addition to utilizing our own standardized corporate solutions. We have a CTO who oversees our data warehouse, our data integration and our Web applications team. That’s a corporate position. We have associate CIOs of applications responsible for all clinical, financial and administrative systems. And then we have an associate CIO of ops and that’s the person who’s responsible for our project management office. We tend to run in general 200 is projects at any given time. We don’t have an automated system, we just use Excel.
DL: Why aren’t you using any of the project management stuff that’s out there?
MR: We’re looking at some of it now, because we do think trying to manage 200 projects with Excel is a little tough. The role of operations is also responsible for our linkage with CSC (Computer Science Corporation). We outsource our infrastructure support to CSC and they are responsible for our help desk, our data center, our desktop support and our WAN support. Previously it was outsourced to First Consulting, and interestingly, CSC bought First Consulting.
DL: Can you tell us about the patient portal you’re developing?
MR: Our patient portal is a product from Epic called MyChart and we’ve re-branded that here for Penn to be called My PennHealth. So there’s a few key things: patient consumerism, it takes all different shapes sizes and forms, and one of them is better linking with your patient population. But in order to link with your patient population, you have to have data. Right? You can’t have a patient portal if you don’t have an EMR. In particular this patient portal focuses on the ambulatory and so this is their view into the Epic system.
DL: Is it integrated with billing? Can your patients pay bills on it too?
MR: We have not implemented that yet. So the capabilities we have are the ability to request an appointment, the ability to request a referral, the ability to request a medication refill, ability to view past appointment dates. Those four things are primary right now. In February we’ll roll out the ability to view your lab results. That will be a big step from the clinical perspective. And tied to those lab results will be informational icons, like if you have a CBC count of 112, what does that mean?
DL: How did your doctors feel about their patients being able to look at their lab results online?
A: Here’s what we decided. Number one, we’re only releasing common lab results, so anything that has to do with one-off tests or non-standard testing, all of that would still have to be called in and reviewed with the physician. If anything is outside the normal range we don’t release it. The health system believes that anything that’s outside the norm requires a discussion.
DL: Is that a best practice?
MR: Patient consumerism is still kind of new and evolving. You and I would think it makes a best practice, but on the other hand if the patient isn’t going to call or you can’t get in touch with the patient, is it better to get the result out there quicker and let them react? It has pros and cons on either side.
DL: Are you using the patient portal to establish a competitive edge and position yourself in the community?
MR: We’re looking at this from a patient satisfaction perspective and also, remember we’re an academic medical center, so we’re looking at this once we get the communications in line, to better facilitate communications with our patients regarding clinical trial opportunities, gathering feedback information on their treatments, what’s taken place since they’ve been on the therapy. So we’re looking at it as an enhanced communication vehicle to support and streamline not only the front desk activities, but more importantly from a clinical research perspective.
DL: So what do you do with that information?
MR: Well initially it goes to our researchers. But you have to think of it as the patient portal has the opportunity to be an eight-lane highway of information flowing back between you and your patients. We’re going to start off with a one-lane highway which is ‘let’s start off with some front desk stuff to make sure we’ve got all the technology on place, the communications in place, the help desk in place.’ But over time as we add results, we add survey information and clinical trials information and throw some marketing information on there. And it does, as a byproduct, establish you as a higher-end IT shop, which gives the perception that we’re more technically advanced than other facilities. We’re about to embark on some kind of marketing campaign around the patient portal because we’re truly unique for the Philadelphia space.
