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The ‘IT’ Factor

Growing IT industry is leading innovation in health care

By James Amend

Pages 38-40

When one of the nation’s worst public health disasters involving contaminated medication broke out last year, St. Joseph Mercy Hospital Ann Arbor found itself on the front lines and, like a growing number of metro Detroit care centers, armed with the latest information technology to battle the epidemic.

Infectious disease specialists at St. Joseph Mercy made an early connection in September 2012 between six patients it was treating for meningitis-like symptoms and a multi-state investigation by the Centers for Disease Control (CDC) into a surge of fungal meningitis cases nationally.

The culprit behind the meningitis, the CDC discovered, was contaminated epidural steroid injections from an East Coast pharmacy.

Here in Southeast Michigan, a Brighton pain clinic had already distributed the medication to more than 600 people dating back

to August, making the region ground zero for the outbreak and St. Joseph Mercy the epicenter for treatment at its emergency units in Ann Arbor, Brighton and Livingston.

Information technology proved to be a key weapon against the outbreak.

Together with the CDC, St. Joseph Mercy physicians developed a treatment strategy and uploaded the information to the hospital’s electronic health records. Emergency room physicians had the information at their fingertips, allowing them to treat in the final months of 2012 an astonishing 170 fungal infection cases, or 25 percent of the cases in the nation.

“We were able to develop overnight a specific plan that gave physicians directions on exact doses to use for medication, and we were really able to standardize and streamline the care of those patients,” said Errol Soskolne, M.D., and chief medical information officer for Saint Joseph Mercy Health System.

Just as the assembly line transformed the automobile industry 100 years ago, information technology is revolutionizing health care. After years of paper-based record keeping, hospitals and doctors’ offices, billing centers and insurers across the country are going electronic. It’s making for safer, more efficient and less costly care.

For example, inside the emergency room, the medical record is available immediately and saves doctors precious time to focus on the patient. At the radiology unit, there is no need for duplicating X-rays that may not have been documented previously on a paper record, and laboratory technicians run fewer redundant tests.

At the drug store, pharmacists no longer must decipher a doctor’s handwriting and automated drug checks reduce the risk of prescribing a drug that may adversely interact with a patient’s current medication or allergy.

“It just makes everything so much safer and more efficient,” Soskolne said.

IT also keeps caregivers up to speed professionally. Historically, physicians would learn of changing care guidelines or standards through journal articles or conferences and implementation could take months. Technology erases the lag time and makes for faster clinical decision making.

Business is Booming

Never has the regulatory environment of health care been more fluid than today, either. The Affordable Care Act marks the biggest regulatory overhaul of health care in the U.S. in more than 50 years and much of its rules still must be written. IT will play a major role in disseminating and implementing the new federal and state standards.

IT also heightens scrutiny of physicians, ensuring they actually follow the latest guidelines and can quickly receive updates on their performance.

“The ability to analyze that data is much better now than it was in the past,” said Eric Hartz, M.D., and chief medical information officer at Trinity Health, one of the nation’s 10 largest health systems and parent to St. Joseph Mercy.

The productivity of nurses also improves with the use of IT. An electronic record allows nurses to input information on a patient at the bedside without the need to update other files with the same information later in the day.

“We spend more time with the patient and less time charting,” said Miriam Halimi, R.N., system director for nursing informatics at Trinity Health.

Not surprisingly, the health care IT business is booming.

According to the consultant KPMG, health care currently ranks as the fastest growing industry in the U.S. and by 2020 will account for more than 20 percent of the nation’s gross domestic product.

The automobile industry, by comparison, contributes about 3.5 percent annually to the GDP.

KPMG also expects health care expenditures to rise to $4.6 trillion in 2020 from $2.58 trillion today. To meet the growth, the health care industry will need to add 50,000 IT jobs by 2017.

Here at home, the health care industry is witnessing the same meteoric growth.

The industry employs about 547,000 people, according to the Michigan Economic Development Corporation (MEDC), and by

2020 health care jobs in the state will increase by 42 percent. The industry currently employs about 3,500 computer occupations and that number will grow to 4,300 by 2020, not counting the myriad of companies supplying technical services and IT-related products to the health care sector.

An Expanding IT Connection

Expansion of the health care IT industry is also driving growth in IT, generally in Michigan. The state currently employs some 85,000 IT professionals across 2,000 organizations, according to the MEDC. Those figures, while relatively modest today, are expected to grow as more companies bring work formerly performed overseas back to the U.S.

GalaxE.Solutions is one of those firms. It set up shop in downtown Detroit in 2010 and now employs about 150 people. More than half of the global IT firm’s workforce resides in the U.S., compared to less than 20 percent among the industry’s bigger players. More than 80 percent of its business focuses on health care IT.

The firm sets itself apart from others in the space and regularly wins business away from those larger players, said Chairman and CEO Tim Bryan, because of the rigor it applies when transforming an organization’s legacy processes and technologies to today’s standards. The firm also specializes in commonizing systems brought together by mergers, as well as keeping organizations up-to-date on the regulatory front.

“We’ve taken military grade applications development and testing techniques and applied them to the commercial sector,” Bryan said.

“You’ve got no tolerance for failure in an F-16 fighter jet when you must launch a missile,” he said. “By the same token, if you’re moving patient information, there is no tolerance for failure.”

Bryan said the importance of accuracy in health care IT systems development compelled the New Jersey-based firm to come to Detroit.

“As an international firm, we recognize that a great percentage of our workforce needed to be on-shore in order to ensure the systems we deliver function as they are supposed to,” Bryan said. “We chose Detroit because the city had all the elements we were looking for in terms of workforce and affordable real estate.”

Bryan also cites the number of educational institutions in the region with track records for turning out highly technical graduates, and the willingness of those colleges and universities to partner with the industry on new technology.

Adding thousands of skilled graduates to its workforce and collaborating more closely with academia are seen as two of the most critical elements necessary for the health care IT sector to keep pace with the broader growth of the industry.

Bryan said health care IT must also reach levels of flexibility and ease of change to accommodate demands of the Patient Protection and Affordable Health Care Act passed in 2010.

“We need a workforce focused on facilitating that dexterity and that’s accomplished with a much greater domestic footprint, and it brings us back to Detroit,” he said.