At Milford Regional Medical Center, phrases such as “not enough resources” or “not enough people” don’t serve as excuses for not getting the job done. Instead, they are used as fuel to push even harder to achieve success.
The nonprofit, acute care hospital based in Milford, Massachusetts, houses 145 beds and serves a region of more than twenty towns. It resides under the Milford Regional Health System umbrella, along with Tri-County Medical Associates and the Milford Regional Healthcare Foundation.
The IT division, led by chief information officer and vice president Nicole Heim, comprises just fifty people, but provides support to all physicians, nurses, and other employees of the medical center. Heim’s responsibilities include overseeing all applications, interoperability, informatics, networking, system administration, technical specialists, help desk, switchboard operation, telecommunications, and clinical engineering.
Since Milford Regional is a small community hospital, many senior leaders have to wear multiple hats. One of Heim’s hats is Health Insurance Portability and Accountability Act security officer, a key position, as protecting patients’ medical files is at the top of the security team’s priority list.
Heim admits the role is a tough tightrope to walk between satisfying users’ requests to make information systems more usable and keeping their information secure. “Sometimes those requests introduce additional security risks,” Heim explains. “I’m weighing security and usability, and it goes either way depending on different scenarios. Often, the security requirements we need to put into place add a layer of frustration to users, so I think it’s really important to have communication so staff are aware why we have to put these measures in place.”
Two security options Milford Regional may add to its portfolio are secure texting and data loss protection (DLP). Secure texting was identified as a need last year, especially for physician-nurse communications. Currently, Milford Regional is in the middle of its investigation for a secure texting solution and hopes to have one during fiscal year 2017. DLP is a different story. Heim admits her team has been looking at it for some time, but the high costs are an issue. For the time being, the IT division is looking at a proof of concept to see how big the risk is.
“We in IT don’t obviously provide direct patient care, but we definitely have a huge part in assisting the clinicians that do.”
“We have policies and procedures in place of course to protect our data, but DLP just makes it easier for us so we can set in policies and enforce it automatically versus just educating the staff on what they shouldn’t be doing,” she says.
Along with keeping its patients’ information secure, Milford Regional has also accomplished a lot over the past few years, despite being a lean operation, personnel-wise. In 2011, the first year of the program, it achieved Meaningful Use Stage 1 and reached Stage 2 just three years later. This past year, Milford Regional was recognized by the Healthcare Information and Management Systems Society as a Stage 6 hospital and is currently looking at the requirements to hit Stage 7, which will include going completely paperless.
“It was a rush to implement a fair number of projects to achieve those meaningful use milestones, and we received more than $2 million in incentive payments from the government,” Heim says. “We could use that money to invest back in technology and the hospital in general.”
As a whole, Milford Regional also has its sights set on reducing patient readmissions. It received a grant in 2013 from MeHi and used the funds to pilot sending post-discharge continuity of care documents to a visiting nurse association and a skilled nurses facility, a program which proved successful.
Milford also received two more grants through the Health Policy Commission to focus on reducing readmissions, which it used to reach out to other organizations to encourage them to connect to the Massachusetts Health Information Highway (also known as the HIway). Unfortunately, a lack of personnel or resources prevented other organizations from moving forward with the connection. Milford Regional was able to offer some of the grant funding to help these other organizations pay the initial cost to connect to the HIway, but even with the added support, it turned out that they weren’t able to connect to the project long-term.
“It was rather frustrating for our staff because it wasn’t through any lack of effort on our part,” she says. “Those facilities are just not in a position yet to connect electronically. They must still rely on paper.”
Milford Regional also looked at technology to assist case managers as a way to help reduce readmissions. However, it was determined the most impactful intervention in the chart grant initiative was its people. Milford Regional has a staff who works with patients while they’re at the hospital and then postcharge to make sure they have their medications and appointments, and sometimes help with transportation to and from those appointments.
“We definitely look for technology to help us, but in the end, I think the most impactful intervention again is the people resources we dedicated to this project,” Heim says.
When she’s not running the IT division and helping to keep patients’ information safe, Heim gives national talks to fellow industry professionals. One of the messages she hopes to get across is the need to leverage technology to assist hospital business operations and help the clinical staff improve their workflow so they can focus on providing high-quality care.
“We in IT don’t obviously provide direct patient care, but we definitely have a huge part in assisting the clinicians that do,” she says. “We’re an important part of the team and add value to the whole process. We can impact the patient care without providing it directly.”
With limited funds and personnel, Milford Regional’s IT division has managed to secure multiple grants, help its clinicians provide great patient care, and play a key role in the organization to reach Stage 6 recognition. That would be quite an accomplishment for a fully funded and staffed organization, but Milford has proven limited resources don’t have to mean limited success.
“I think you have to look at what you have available to you and just try to achieve what you set out to do,” she says. “We have a talented, dedicated team, and we leveraged our investments that we already had in place to make our systems workable for our clinical staff and secure for our patients, and to show that we can really use technology in a meaningful way.”
