Making Healthcare Work


“There may be multiple ways to treat a breast cancer patient today,” says Schonherz. “What the iKnowMed application does is truly narrow that down and present treatment options based on the most current, most compelling scientific evidence available. However,” Schonherz stresses, “the application only facilitates the clinician’s decision process. It should never be thought of as substituting for the medical decision-making of a physician.”

The iKnowMed application also contains intelligent alerts that support the clinician’s decision-making and safeguard the patient against adverse reactions. Doctors that encounter particularly challenging cases can reach out for consults to hundreds of US Oncology-affiliated physicians. Right now, this interaction takes place through an e-mail integration system. By late summer, it will become a true Web 2.0 portal, powered by Oracle technology, with enterprise-level capabilities such as secure online discussion groups, wikis, blogs, and enterprise search.

Ultimately, Schonherz’ goal is to extend this portal to create a robust online community of patients and give them access to data on treatments and outcomes. Access to information about their condition—what, for example, is a normal side effect of a particular medication—will help them avoid traumatizing and expensive (and sometimes unnecessary) hospital and emergency room visits and give them a measure of control over their lives.

Reforming and transforming quality cancer care in a cost-effective way is US Oncology’s ultimate goal, and says Schonherz, the barriers to achieving that “on an individual provider-by-provider or hospital-by-hospital basis are insurmountable. However,” he continues, “US Oncology’s network, added to the investments we’re making in people, in technology, and in creating collaboration, makes that transformation more than feasible.”

Lahey Clinic Medical Center: It’s About the People
As if changing the ways in which healthcare is delivered and paid for weren’t challenging enough, today that change must be accomplished in the face of a looming practitioner shortage. The U.S. Bureau of Labor Statistics predicts that there will be 212,000 physician openings in the U.S. by 2014 due to population growth and net replacement of retiring doctors. At the same time, the Bureau’s Occupational Outlook Handbook, 2008-09 Edition points out that an aging population “will drive overall growth in the demand for physician services” even as the American Medical Association reports that the number of medical school graduates remains flat.

In an environment where demand threatens to overwhelm supply, it’s critical for health centers to focus on their people—on recruitment, management, and retention, says Lahey Clinic Medical Center Executive Vice President and CFO Timothy O’Connor. To that end, in May of this year, Lahey rolled out an upgrade to its Oracle human capital management application because, O’Connor explains, of its “robust recruiting toolset” and its improved functionality for managing contractors and consultants as well as full-time employees.

Part of the reason for the expected physician shortage, according to O’Connor, is the vast and growing quantity of paperwork demanded by insurers and the time doctors must spend filling it out. O’Connor believes that automation can lift such non-value-added activities from the physician’s shoulders.

Lahey’s experience with digitization parallels its history with Oracle, going back to the clinic’s 1998 ERP implementation. Lahey has upgraded its PeopleSoft ERP system several times since, most recently moving from client/server to Web-based software. Integrating all its business processes on Oracle’s PeopleSoft software, Lahey is able to save between US$2 million and US$2.5 million annually by rationalizing its purchasing and, like TOH, leveraging its scale to negotiate lower prices for materials and equipment. Recently, by implementing Oracle Hyperion budgeting and planning software, Lahey completed the migration from the last of its homegrown administration applications to a completely Oracle-supported back office that will, says O’Connor, “stand the test of time” and create a shorter budgeting cycle for Lahey’s management team. The completion of the Oracle-based ERP system will allow the approximately 100 people involved in the process to lift their heads from their ledger sheets and “spend more time on analytics.”

That was the original goal of Lahey’s 1998 ERP implementation: “To integrate on a single vendor, with common applications; to deploy systems and reporting tools that could deliver more-timely and -efficient data to management; and to make the hospital’s IT staff true business partners,” says O’Connor. Along with those benefits, Lahey has been able to reduce costs and find new efficiencies in payroll purchasing and accounts payable, even as the number of transactions in the latter has doubled.

Last fall, the Oracle infrastructure also enabled Oracle partner Orion Health to roll out its Orion Concerto Clinical Portal, which provides an integrated view of Lahey’s EHR and has been deployed to approximately 2,000 providers in the Lahey clinical community, as well as to emergency rooms in northeastern Massachusetts. As Paul Viskovich, president of Orion Health North America and EMEA, says, “If a Lahey patient gets injured and has to present in an emergency room, the doctors can access that patient’s records whether or not the doctor is a Lahey physician.” The portal is being rapidly adopted, Viskovich says, as word of its ease of use spreads.

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