Use of Smart Card Technology Puts Texas System on the Cutting Edge

Project's flexible approach fits needs of rural facilities


Use of smart card technology puts Texas system on the cutting edge

Project's flexible approach fits needs of rural facilities

"Interoperability, how to get one system to talk to another is one of the hottest topics in health care today, and a challenge that every hospital and health system must face in some fashion," says Shannon Calhoun, executive director for the Southeast Texas Hospital System (STHS), a Goliad-based organization.

An organization's needs and priorities, she adds, will determine exactly how it approaches that challenge. In the case of STHS, which is made up of eight independent hospitals, five of which are rural, the goal is "to create economy of scale and scope, while allowing our hospitals to maintain autonomy," Calhoun says. "This is not a system that owns a bunch of hospitals, but a group of hospitals that owns a system."

In rural communities, there typically is not enough patient volume to support the infrastructure required for cutting-edge technology projects, she points out, which is one of the reasons for such collaborations.

"If we can do it better together, then why not," Calhoun adds. "It doesn't change how each of [the hospitals] operates."

STHS received a Healthy Communities Access Program (HCAP) grant from the federal Health Resources and Services Administration (HRSA) in late September 2005, she says, which provided an infusion of funding for endeavors that "create through efficiency, quality or access, services for the uninsured and under-insured."

"It's generally a three-year grant, but we were at the end of the program, so we only got two years," Calhoun explains. "Then the federal funding didn't pass, so we only got the first-year funding.

"We consolidated and refocused our efforts, and started in January 2006, with an Aug. 31 deadline," she adds. "So we had eight months to spend [the grant money]."

Among several other HCAP projects, an STHS technology team had looked at creating an electronic medical record (EMR), a smart card, and a data repository, Calhoun says, but time constraints led to the elimination of the EMR project.

"We focused on establishing the foundation of the data repository and initiating and moving forward as much as possible with the smart card project," she says.

By the end of the funding period, STHS was set to have five hospitals connected through software to a central data repository, to "allow patients to carry a card with a microprocessor chip that will have their personal health summary," Calhoun says.

"It is a wonderful approach to a win-win for patients, providers, and stakeholders," she says. "It's a different win for each, but in all it means better quality and better access."

The STHS initiative is "the first live RHIO [regional health information organization] completely relying on smart card technology as the RHIO backbone," notes Vicky Judd, director of marketing for HealthMeans Inc., the vendor that worked with the health care system. "It will be the second-largest live health care smart card project in the country to date."

The STHS smart card

While there are "a host of things" a smart card can provide, from creating customer loyalty to achieving efficiencies in the registration process, STHS's approach is probably different than that of most organizations, Calhoun says. "Our focus has been that we wanted regional, portable access to patient information.

"We want to have it across multiple hospitals, with a regional community logo that is like a watermark," she explains. "Our hospitals have a choice of how to interface, how they want it to flow in their process. It's not rigid. It's about automating what you're doing well, and there is also the opportunity to improve through automation what is not working well."

Each of the STHS hospitals has addressed the question of interoperability differently, Calhoun points out. "There are commercial health information systems and there are proprietary health information systems. One hospital has a programmer in-house who is writing an HL7 interface."

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