HCA Continental’s CIO on adopting cloud-based image sharing

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 - Andy Draper, CIO
Andy Draper, CIO

Despite its immense institutional know-how and its pure heft—11 hospitals, 5,000 medical staffers, $4 billion in net revenues—the Hospital Corporation of America’s multi-state, Denver-based Continental Division still found itself sending CDs and printouts via, among other low-tech image-sharing options, the chests of patients in ambulances and helicopters.

That was as recent as 2013. CIO Andy Draper knew that the time had come for things to change. He set out to combine his team’s down-with-CDs initiative with a move to leverage the image-sharing power of the cloud. The endgame would not be simply modernization but, rather, in keeping with the parent company’s mission and vision, helping to dramatically increase the division’s referral base.

Measurable success followed sooner than Draper expected. In January 2015, HCA Continental became a Nuance PowerShare Network user. Three months later, the division had connected 30 referring hospitals, clinics, and other provider sites, and at the six-month mark, the count topped the 100-site mark. HCA Continental is growing its PowerShare network referral base at an average monthly rate of 28%, including some sites that had never previously referred to HCA.

Draper took questions from Clinical Innovation + Technology about what it took to gain buy-in so quickly—and how the HCA Continental will build on its momentum moving into 2016 and beyond. 

Q: The drive to get away from CDs set you on the path to looking for a new solution. Can you talk a bit more about how you arrived at PowerShare?

Draper: I’ve known some of the Nuance leadership team, including [Nuance Healthcare president] Trace Devanny, since we worked together at Cerner years earlier. I think very highly of him, so I had very high expectations. Plus, folks on the provider side—radiologists, technologists, PACS users—are aware of PowerShare and its predecessor technology. Our people were excited that Nuance owned it now.

The imaging community is tight-knit. These people know things. They knew this was an ancestor product of a proven technology. And they saw that the technology is secure and very easy to use. We sent it through the HCA information security team, which is very rigorous.

Q: What was your priority in settling on a solution?

Draper: What’s most important is getting information from a referral source, whether it’s a physician in a small clinic or a hospital, to the clinician as quickly as possible. PowerShare is as easy to use as Facebook. Creating an account takes less than a minute. Then you upload the image and, immediately, there is a site on the web to which that image can be pushed so that others who need it can access it. And practices subscribe to it, so it’s a pull technology.

Q: Can you give a real-world example?

Draper: I went on a couple of sales calls with our team because I love that part of our work. There was a referring OB/GYN practice in Kansas. They saw how easy PowerShare is to use when the [pregnant] patient comes in for an ultrasound. She is excited to see her sonogram. But the doctor sees something that looks a little funny. The doctor can leave the exam room, immediately upload that ultrasound to a maternal-fetal imaging specialist in Wichita and say, “I’ve got the patient here and I see something funny.” The specialist can log in, look at the image and say, “Yes, have her come here in the morning.”

Then that OB/GYN physician goes back into the exam room and says, “I found something that, just to stay on the safe side, should be looked at by a specialist. I’ve already reserved an appointment for you with your doctor in Wichita and he will be able to see you tomorrow at 9 a.m.” That is amazing.

Q: Let’s talk about implementation. How would you compare getting up and running system-wide with PowerShare to implementation of, says, a new PACS?

Draper: Well, the ultrasound scenario I just described would not have been possible without a solution like PowerShare. It would have required a B2B configuration with a dedicated VPN. Those configurations are nifty, but they require a lot of maintenance. Some high-dollar network people have to make sure that they are up and running. They are often not up and running when you need them or during off hours, and they’re really not very reliable.

With the CD-ROM, what we found is you need a kind of modality-neutral, reader-neutral image viewer. And there are not very many of them. PowerShare is probably the most elegant.

So to get back to your question,