Pensacola Independent News

COVER STORY | Vol. 12, No. 3, January 21, 2010
(Healthcare Transformed)
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Healthcare Transformed

by Sean Boone

The Local Healthcare Plan That Will Change The Nation

Imagine a "Silicon Valley" focused entirely around the healthcare industry. A place where the U.S. government and the private sector are able to channel into one computer network to streamline health records, provide diagnosis to patients in their homes and ultimately save money and lives with common sense innovation.

Welcome to Northwest Florida...no, really.

For the past four years, Pensacola-based technology company Cogon Systems has been developing a virtual network that allows private health facilities and the military the ability to access health records from each other.

Last year the network went online for testing and has so far been successful in leveraging civilian files for the military--even prompting President Obama's health advisor Dr. Ezekiel Emanuel to take interest in the project.

Although medical information technology (MIS) is nothing new to the world of healthcare, the concept of creating a system that streamlines records across the country is.

"We didn't land a man on the moon," says Cogon Chief Executive Officer Dr. Huy Nguyen. "If you walked into any other sector they would have said, 'What rock have you been hiding under?' We weren't so much innovators as we were disruptors of technology."

Today, partnered with the Pensacola Bay Area Chamber of Commerce, Cogon Systems is the catalyst for what is now known as Strategic Health Intelligence (SHI).

BREAKING GROUND

Nguyen created Cogon Systems in 2004 after leaving his position as Senior M.D. at NAS Pensacola.

He says he saw how MIS was coming of age, particularly for the military and was keenly interested in leveraging the technology to contain costs.

"Cost inefficiencyit's the number one thing to go after in healthcare," he says. "I was very interested in cost containment. I saw the power of mobile technology."

Around the time Nguyen became a technology entrepreneur, he found out the military was interested in streamlining health information between the military hospitals and the Department of Veterans Affairs.

"The CIO of the Military Health Center, Carl Hendricks, was interestingly enough rolling out the same technical approach," he says. "Through him, we were able to get modest funding and a partnership. But we were told off the bat that we were welcome to do this, but if we wanted to sustain this we were going to have to find our own funding."

Nguyen soon approached the Chamber, which was also looking for a new way to spark innovation--only in the business community.

"You now have a thought leader and a community poised to do something innovative," says Craig S. Dalton, Vice President of Armed Services for the Chamber. "For us at the Armed Services, it was a natural fit. We could now bring the healthcare community together and give some semblance to government structure that would allow innovation to happen."

Dalton says SHI was formed primarily as a way to diversify the local economy and become a more agile market.

"We asked, 'How do we make our businesses here more competitive? How do we foster innovation and entrepreneurship?' So we created this military innovation project and brought high-tech military command with high-tech companies to identify a global problem."

IN THE BUSINESS WORLD

In 2007, the Chamber began hosting the SHI Summit as a way to promote innovative solutions to both the private and government sectors related and unrelated to the health field.

The Chamber's idea is to create a baseline for health innovation, which companies can use to lower their employee health costs.

For instance, a business could use the technology to allow its employees access to medical files on their computer and find out potential health risks they have without leaving their home.

"It can be various companies with various applications that want to participate," says Dalton. "This is how you can innovate, and this is very attractive."

According to Dr. Michael A. Brown, Vice President for Medical Affairs at Sacred Heart Hospital and SHI board member, the idea has also been widely supported by the local community.

"We've gotten input from West Florida Healthcare, the Escambia County Medical Society, the local social security office.basically everyone we have turned to has said shared information can work here," he says.

Dalton says SHI is different than projects the Chamber has initiated in the past that promote economic development in the region because this is something that is at the forefront.

"This is decidedly different," he says. "We're not going to be 'me toos'. This is one where we can tout that we have really tried to lead the rest of the nation. The ground is very fertile and we have demonstrated success.

"We have remained agile," he adds. "It's still guerilla warfare, but we're winning in ways that other communities can't because we've remained agile. At the end of the day we just out-hustled everyone. If we're going to be leaders, we have to work harder than everyone else."

One advantage Pensacola has for promoting SHI is the wide range of professionals for a town of its size that can push forward the project off the ground.

"We are a great test bed," says Nguyen. "There are lots of things in this community for our size--a large university, as well as innovators and developers who want to become better healthcare managers to their employees and consumers. It's just like Internet banking, where people are in control of their money like never before. Now they will be able to leverage the system with their health records."

HEALTHCARE BAIT

In February 2009, the Obama administration passed the American Recovery and Reconstruction Act, which allocated $19 billion for healthcare practitioners and physicians.

Hospitals can get $2 million per year for three years with a market basket multiplier if they meet certain standards.

Brown says the federal money will likely be the ticket for health providers to jump on board with an idea like SHI in the coming year.

"It's sort of like 'Show me the money and show the product to me when you get it made, but don't bother me right now.' Our challenge for the first few years (with HSI) was saying, 'How do you create a utility that will change lives so that they will incorporate it into the workflow before they see a patient?' Now if we can qualify for a grant I think we can change the way we practice."

Like any federal payout, the grant must be applied for--something Sacred Heart is still in the process of doing for this upcoming year.

"If we don't make this cycle we'll try again for next year," says Brown. "But we'll learn from the application."

LOWERING THE COSTS

Last year the Research and Development (RAND) Corporation completed a study on the cost savings of converting 90 percent of physician offices and hospitals in the U.S. to electronic record systems and found that "the higher the adoption rate over time, the greater the savings, thanks to the growing ability of healthcare providers to connect to an expanding network of interoperable information systems that could support a patient's care wherever and whenever it is needed."

In 2007, healthcare costs rose to $2.2 trillion in the U.S., up from $253 billion spent in 1990, according to the Centers for Medicare and Medicaid Services.

The RAND study showed that over 15 years, hospitals would save $46 billion and physician offices would save roughly $18 billion.

Nguyen says that SHI is in a position to save money across the board because it is aligned with how the healthcare industry is progressing.

"What we are doing is right where our country is going," says Nguyen. "If healthcare reform takes hold, there will be a lot more insured people. The country's bet is that the cost of paying for them will be negated by all the savings. That's a big, big, big, if but I can tell you that you aren't going to remotely meet that if you don't know how to leverage information systems properly. We are now ready to put a lot more people on the cost side and I think this community has the potential to shed the light."

Because the SHI is still in its groundwork phase, there has been no study yet on the cost savings potential for the program, according to Dalton. The Chamber is planning to use the University of West Florida Haas Center For Business Research and Economic Development to conduct a study once the project is completely operational.

THE NITTY GRITTY

The original virtual system created by Cogon was built on a Microsoft SQL server but was later scrapped to use a Java-based platform, which is easier for local health providers to manage data with.

"We originally deployed a service-oriented architecture," says Nguyen. "We now have an overall architecture broken into a distinct layer. We were early advocates of telling hospitals, 'You're going to be much better off cost sharing how you house and manage this data flow with your competitor inside of a data framework.'

"Why build a dinky data center in your basement when you've got fantastic data centers that are going Java," he adds.

Using that layer has been successful in allowing doctors to quickly see what problems a patient has had in the past when they are in an emergency situation.

"A guy went into a health center last year on base with chest pains, and they were able to pull up health records in five minutes that he had a catheterization note done in May," says Nguyen. "In this particular case, the patient had severe blockage in his main left coronary artery and the right was fully blocked. Here is a guy who could have had a heart attack in the industry standard of obtaining the information."

Currently, Baptist Healthcare and Sacred Heart Health Systems--the two largest local healthcare providers involved with SHI--are not online with a virtual network.

"Right now it is pretty much information shared with the Navy Hospital," says Brown. "They have been able to ping military dependents or military retirees and be able to pull data back. The next iteration is Sacred Heart and Baptist sharing info, then they'll pull from the VA."

Cogon is in the process of consolidating data within workstations at Baptist and making sure the system is secure and follows new federal laws. Once that work is complete, work will begin at Sacred Heart.

"Other physician offices, the VA and others will be joining the activities soon," says Robert Johnson, Baptist Health Care's Chief Information Officer, who has been involved with the SHI project. "The concept is to collect clinical data from where care is provided and present that information in a chronological and understandable manner according to new federal guidelines in an electronic portal across a secured Internet connection."

sean@inweekly.net

InWeekly

Healthcare Transformed