In 2006, a group of physicians set out to create an HIE that would allow them to follow patients in real time, make fast, safe decisions, eliminate redundancy, and improve care quality. The result is Sandlot, LLC, a wholly owned subsidiary of North Texas Specialty Physicians (NTSP).
Thomas Deas Jr., MD, board-certified gastroenterologist and internal medicine physician, is the chief medical officer of Sandlot and an active board member and past president of NTSP. In the following interview, Dr. Deas shares his perspective on the origins and potential of physician-driven HIE systems.
Q: How have clinical experiences helped inform and shape Sandlot's mission and solutions?
A: Five years ago-anticipating the rapid adoption of ambulatory electronic medical records (EMRs)-NTSP physicians realized we will make better clinical decisions with more information at the point of care through true HIE within our medical community. Since then we have accomplished a great deal. Today we integrate three leading ambulatory EMRs and an acute EMR with independent lab, radiology, and other sources of community patient data.
Q: Do you find adoption rates of physician-centric solutions more favorable than those generated through other approaches?
A: Given my experience with Sandlot, physician-centric designs are the best methods to drive innovation and adoption of technology for patient care. The volume of data a physician is required to sort, retain, and apply grows exponentially each year. With care quality and cost efficiency also driving the accountable care model, physicians need just-in-time patient data and clinical decision support at the point of care. Just as we all rely on calendar reminders and other alerts to highlight important daily events, Sandlot presents longitudinal information and reminds physicians of quality measures to be addressed during patient care.
"American architect Louis Sullivan instructed us that 'form ever follows function.' That philosophy also drove the design of our HIE solution."
-Thomas Deas Jr., MD, chief medical officer of Sandlot, LLC
Q: How important is physician collaboration to the development of software and an implementation strategy?
A: When done right, developing and adopting new software is a joy-of-use event and not an exercise in survival. HIE originated from physicians recognizing the need for quick and comprehensive sharing of patient clinical data. The software tools physicians struggle with tend to be those that over-rely on technology and lack physician input in their development. When the physician user is involved throughout a patient care project, the end result-in our case, software tools that help physicians make better decisions at the point of care-is attained. The technology forms the cornerstone for quality improvement, connecting physicians, hospitals, and insurers for a complete HIE and successful accountable care organization.
