CIO: How data saves money, changes habits in the OR

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Mike MistrettaSurgery might be one of the biggest drivers of volume and profit, but it's also an expensive service line--and one where there's lots of room to cut costs and improve efficiency without jeopardizing quality of care.

"As we're being challenged to reduce costs, we've got to look at ways to do so in the OR," notes Kermit Randa, chief operating officer of software firm Surgical Information Systems (SIS). "Leaders are trying to figure out: If surgery is the driver, how can we automate, get more information down there, be innovative?"

Mansfield, Ohio-based MedCentral Health System leaders are asking those very questions--and finding the answer in data. FierceHealthIT sat down with Mike Mistretta (pictured), vice president and CIO, to talk about how the system uses data to help control costs, improve efficiency and facilitate better communication along the continuum of care.  

FierceHealthIT: Tell us a bit about your organization, the systems you use and your goals for your surgical program.

Mike Mistretta: We bought an outpatient surgical center recently. So now we have two hospitals and a surgery center. The surgical center wasn't automated--we're a Siemens shop. We wanted to make sure that we had a product that was going to be able to integrate back to our record. We already had SIS in our hospitals. So we're going to expand what we're doing there and go to the surgery center with anesthesia and the full suites. Because we want to make sure we have the full continuum of care for patients.

FHIT: What are your biggest health IT challenges in the OR? What challenges do you see yourself facing down the road?

Mistretta: We're pushing right now for integration along the continuum. It's not just surgery. It's pre-surgery and post-surgery. For pre-surgery we want to get the pretesting and those things streamlined. From an economic perspective, we're also collecting co-pays for elective surgeries. Post-surgery, we've got the data running through the continuum of care for that patient. So in your post-op suite they know what happened in the suite. They don't care about the whole thing--they only care about certain aspects of what happened. So as long as I can get those data to the different points, I can improve my financials and I can improve my turnaround.

In the suite, how am I going to be able to incorporate things like digital imaging into scheduling? A neurosurgeon who wants specific slices on a CT scan, how do I pre-stage them as a piece of the scheduling system? Afterward, how are we going to run the productivity and utilization reports to start controlling some of the costs?

Those are challenges we're going to have.

The real focus is integrating the products with everything else. It's no longer a compartmental piece and a nice little system to have running over there. Meaningful Use certainly changed the game on us, for sure. And it's only going to get more integrated down the road.

FHIT: One problem healthcare organizations face is that surgeons don't like to change their habits, behaviors and preferences. How do you present them with the data that gets them to make changes to control costs? How do you convince them the data is reliable?

Mistretta: In some cases they're very stuck on what they do--they say they get great outcomes with this implant, for example. A lot of times you can come back and say "You're using this one and he's using this one and his outcomes data is the same or better than yours. So why does that make a difference?" You have to get to that level to be able to have the conversation.

That's the key, being able to drill down to details behind the summary level.

The way you get to reliability is to drill down to their questions, almost in real-time. The first thing you hear when you present to physicians is that their patients were sicker. Well, fine. Tell me which one was sicker? We'll take him out. Now what does the data look like? Ninety percent of the time it doesn't change.

So those arguments go away very quickly.

Editor's note: This interview was edited for length and for clarity. 

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