Wayne Fellmeth, MD, is the chief medical information officer at Hunterdon Healthcare Systems in Flemington, New Jersey, though he continues to see patients in his office.
Dr. Fellmeth joined Hunterdon Pediatric Associates in June 1989. He recently took the position of Chief Medical Informatics Officer at Hunterdon Medical Center but will continue to see patients in the office. Previously, he was chairman of the Pediatrics Department as well as president of the Medical Staff at Hunterdon Medical Center.
He received his undergraduate degree at the U.S. Air Force Academy in Colorado Springs and his medical degree at Georgetown University School of Medicine in Washington, DC. To fulfill his commitment to the Air Force, Dr. Fellmeth completed his pediatric training at David Grant USAF Medical Center in California.
Q: Like many American healthcare providers, Hunterdon Healthcare is transitioning from fee-for-service to risk-based revenue. You are working with bundled payments and are part of several Accountable Care Organizations (ACOs). How has the organization prepared itself for this kind of fundamental business transformation?
A: We are a community-based integrated delivery system, which includes most of the local physician practices and has alliances with tertiary referral centers. Several years ago we adopted a system approach to healthcare that relies on a medical home to coordinate and manage care across all settings – acute, ambulatory, post-acute and community. We have a strong focus on community outreach, wellness and delivering high quality care in the most appropriate setting. As a health system, we have the lowest rate of ambulatory sensitive admissions in the region. So, culturally and organizationally, we think we are well positioned for value-based reimbursement. We also believe we are making the right information technology (IT) investments to support population health management.
Q: How does your IT strategy align with your strategic plan?
A: Just as the center point of the healthcare system is the medical home, the center point of our information infrastructure is a private health information exchange (HIE), which I refer to as our “health cloud.” This is composed of a master patient index, a comprehensive composite health record, and information flow across the entire health system. As it matures, the health cloud will become the single source of truth and information gateway into and out of Hunterdon Healthcare. We will use it to connect to our regional HIE, Jersey Health Connect, to tertiary referral hospitals, and to public health agencies.
Ambulatory and inpatient electronic health records (EHRs) are required to support the exchange of information in standard formats. But post-acute and community care settings don’t necessarily have EHRs and will contribute using HL7 and/or direct messaging. Some may simply view our records. All providers will have access to consolidated patient records using our Clinical Viewer.
Q: You have patient portals available in your EHRs and as part of Jersey Health Connect. Why are you investing in a “third-generation” portal like HealthShare Personal Community?
A: If you have to log into one portal for your primary care provider, another for your health insurer, another for your mother’s geriatrician, another for your local hospital, and yet another for the specialist who manages your heart condition, and then try to figure out which pieces of that puzzle are relevant to the Google search you want to do, we don’t think you are going to bother with any of it more than once. But in a managed care environment, it is essential that patients take their health into their own hands.
To further enhance wellness, we want to encourage healthy behaviors. A relatively healthy patient interacts with his or her physician for only about one hour per year. So we have a vision to extend that interaction through a consumer-centric online patient wellness environment. We want to provide one place where you can not only find all your own health records, but where you can research options, manage the health of your family and communicate with your care team. Our portal leverages the comprehensive record in our health cloud, and over time, we hope to make it the starting point for all community interaction with our healthcare system.
Q: What is next on your agenda?
A: With each data source we connect to the HIE, we have a richer analytics environment to help us understand how we are delivering care, what is working well, and where the opportunities for improvement lie. We are thinking about how, in fact, we can measure patient engagement, how we can support remote care models, and how we can encourage healthy behaviors within the entire Hunterdon community.
