The views of Utah’s Wasatch Mountains are spectacular from the east side of Intermountain Medical Center, but as 40-year-old Lee Pierce walked down a hallway on the fifth floor of the hospital’s administrative building, he hardly noticed them. Pierce, Intermountain’s chief data officer (CDO), was more focused on the giant countdown clock the implementation team had put up in the corridor. The clock was approaching zero, which marked the moment in February 2015 when Intermountain Healthcare would switch on its new electronic health records (EHR) system in two of its 22 hospitals and 24 of its 185 clinics.
Pierce was hardly the only health care executive concerned about a major EHR installation. Indeed, a year earlier, a key provision of the American Recovery and Reinvestment Act of 20091 went into effect, mandating that all health care providers adopt and demonstrate “meaningful use” of EHR systems to maintain their Medicaid and Medicare reimbursement levels.2 But while others scrambled to meet the deadline, Intermountain executives were thinking past it — because Intermountain was replacing an EHR system, not installing its first one.
In fact, Intermountain had created its own EHR system in the 1970s, helping the not-for-profit hospital develop a reputation as an innovator in evidence-based medicine. But that system had aged: It had become incompatible with new forms of input, like speech and data from wearable devices, and it was cumbersome and challenging for the nurses and physicians using it to navigate the antiquated interface to document and retrieve patient information.
Over the years, clinicians had learned to work with the system. It was part of a concerted effort to bring data-based insights to clinicians and managers across the Intermountain Healthcare organization. All clinical programs had embedded analytics support teams; procurement decisions were heavily influenced by data and analytics; and patient interactions were continuously enhanced by data, from the application of population health analytics to analyses of patient self-reports. A culture of data use was widespread among Intermountain’s clinicians and managers.