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April 2, 2008
by jlee
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Welcome to the Mark Harvey Ambulatory Healthcare IT, Leadership, and Medical Management Blog.

OK, so I know that I need to come up with a catchier name, but that can come later.

Let me give you a little bit of background about me, the environment I work in, and some of what I’m interested in. That should help set the stage for some of the things that I’d like to write about as this blog develops…

I work for a multispecialty group practice that’s headquartered in southeastern Ohio. When folks ask me what big Ohio city we’re close to I tell them “None of them.”

We’re tucked away on the Ohio River, on the border of West Virginia, about 45 highway miles up the river from Huntington, WV. People don’t generally associate Ohio with Appalachia, but our corner of the state is part of the area of the country so designated by the ARC.

As such, we deal everyday with many of the issues that probably came to your mind when you read “Appalachia”- poor economic development, high rates of smoking and obesity, less than ideal transportation and other infrastructure.

What you may not have thought of are the similar limitations we see with our data transportation infrastructure. The kind of connectivity taken for granted by many who live and work in more urban areas is generally just not available to us. What we do have tends to be slow, expensive, unreliable, or all of the above.

So, one might expect a medical facility in that environment to be pretty basic, pretty backward, kind of scraping by. One might be surprised.

Our organization is thriving. We’re more than 100 doctors, 50 or so mid-level providers. Almost all of our growth through the years has been organic, so we haven’t had to deal so much with lots of little practices scattered around with their own systems, separate chart rooms, their own policies and procedures, and so on.

We do have facilities in each of the counties that surround our original location, as well as one in South Charleston, WV, about 50 miles away. Each of those came about, however, because we decided that there was a need and a market in that community that we could meet, so we built or bought a facility, installed our systems, and staffed it with our physicians.

We’ve learned through the years that providing our own ancillary services allows us to provide better, more cost effective care to our patients, as well as providing a revenue stream to offset some of our other economic disadvantages. As a result, we run a complex lab from one of our support buildings, basic labs and basic imaging at each remote campus, lots of mammography, ultrasound, and some CTs and MRIs scattered around the service area. Needless to say, those undertakings don’t endear us to some of the acute care facilities with whom we overlap territory.

Since we run all those departments, we need to run a lot of systems to manage them. We use GE Centricity Business (formerly IDX Flowcast) for practice management, Centricity RIS (old Imagecast) for radiology, SCC for lab and path.

We are pretty much fully implemented (whatever that means) with the Allscripts Touchworks EMR product- all pieces of it, including note creation, online orders and charge entry. We haven’t pulled a paper chart routinely for nearly three years.