Lee Memorial Health Systems is one of many healthcare providers around the country implementing electronic medical health records. As the largest healthcare provider in southwest Florida, Lee Memorial Health Systems owns all the hospitals in that area, and also handles long term care, home health, and physician offices. Mike Smith, CIO of Lee Memorial, stopped by theCUBE at IBM Edge to talk about how the Informatics and IT Department helps the company provide a smooth “continuum of care coverage” for medical patients in southern Florida.

Changes in the Healthcare IT Structure

To provide IT for four hospitals, Lee Memorial runs all their infra-patient technology out of one central location, also their backup center. This centralization, Smith says, is a structure that’s useful to “deliver integrated care to every community.” Delivering more coordinated care is one of Lee Memorial’s many goals, and one that they intend to use information technology to handle. ‘

• Alterations in personnel roles

Implementing electronic medical records involves a lot of input from medical professionals, which is  Lee Memorial has “something in the neighborhood of 35 nurses on the informatics staff,” in addition to physicians and pharmacists.

Other business staffing structures have also adapted to the changes at Lee Memorial — the chief data officer role, for example, is fulfilled by “a combination of individuals. We had clinical disciplines around the data, financial disciplines around the data, so we really have several domains that are handled by different individuals and the data officer role is really shared.”

What’s spurred many of these changes, Smith said in conversation with Dave Vellante, is the Affordable Care Act. Aspects of the new law, like the funding attached to “meaningful use effort,” mean that Lee Memorial has been able to accelerate its goals.

• Moving in the direction of “meaningful use” 

Many aspects of “meaningful use,” Smith added, encourage “what Medicare is trying to do, which is move us towards evidence-based care, best-practice care, move us toward coordinated care.” One of the changes the Centers for Medicare and Medicaid Services (CMS) are trying to implement is to reimburse healthcare providers for “delivering an outcome for physician visits,” something that’s tough to do, Smith says, “if you don’t have everything wired together.”

• Adapting to a changing priorities

Changes in Lee Memorial’s business needs have lead Smith to highlight three priorities for his Informatics and IT department:

“1. Keep the lights on.” It would be better to leave everybody on paper, Smith says, then to have the automation be flakey. And, he cautions, “if we do not deliver good care, good services with our information systems then everything else we put in place is going to fail.”

“2. Those projects, those activities, those new systems that we planned during the capital budgeting process and the health system that we elect as an organization that we’re going to fund.”

3. The “other” category, which Smith describes as “everything else the organization dreams up during the year — which is a lot.” It’s a challenge because the company adds to the “other” column every day, “And every day we put more in which creates more demand, which is more we can’t necessarily get done. And the whole industry is dealing with that problem.”

The Role of Data, Business Intelligence, and Analytics

Responding to Miniman’s question about how his own job has been affected by new technologies and IT possibilities, Smith laid out just how integral data is to healthcare, since it’s how doctors diagnose and decide what to prescribe to their patients: “to give care, [a physician] would ask for information about you. Maybe your family history. Maybe he orders a test.” Healthcare providers support physicians by “providing information to them as well as information to run a business.” In his own job, Smith says, “I spend a lot of my time working with physicians, working with clinicians, working with the business leaders to set strategies to meet those needs.”

• Using data and analytics to create alerts and rules

One of those strategies takes advantage of data and analytics, leveraging “alerts and rules, so that if a provider, a physician, or an extender places a medication, our system has rules that are smart enough to day, ‘[…] did you know that patient is on a similar medication?'” Technologies like these, Smith describes as the product of the input of “clinicians and business people to the information technology discipline,” and made possible by new technologies. “Whether it’s the data storage, whether it’s power and processing, the redundancy, the tape backups,” Smith said, “those kinds of things matter deeply because that’s the integrity behind what we do.”