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Clair Detraz, partner in corporate planning for Encore Health Resources. PHOTO BY EMILY MOSELEY
Clair Detraz might be the perfect poster-child for the idea that in today’s world you really can live in and enjoy the lifestyle of a place you love while pursuing a career that certainly would have once required relocating within commuting distance of a brick-and-mortar office.
“With wireless access just everywhere, I can work anywhere I need to be. I travel some. I work a lot out of my home, and it’s just marvelous. I would have never have had an opportunity to have a career in the consulting world if all that technology hadn’t been in place,” said the new partner in corporate planning for Houston-based Encore Health Resources, a provider of advanced health-care information- technology consulting services, a market sector that has rapidly emerged in response to recent health-care legislation.
The longtime Lexington resident and UK graduate began a career in medical information technology at the University of Kentucky Medical Center in the days before anyone had even conceived of the desktop computer, not to mention the smartphone or iPad.
“There was one small data-processing department of about seven or eight people that supported the medical center,” she recalled of her early years in the ’70s at UK. “In those days, we had punch cards. We were in the medical center, and the main computer was over on campus in the basement of McVey Hall. And we had a courier service. So you’d write your programs on paper and then sit down and type them into a keypunch machine and create these cards. The courier would come twice each day, and you had to have it right, because you only had two shots at it all day long in order to correct things. Heaven help you if you dropped the cards.”
For a mind suited to comprehending the implications of emerging information technologies in a health-care industry that only very recently began to ease its clenched grasp of the paper record, Detraz was in the right place at the right time.
In 1976, the university purchased IBM’s online health-information system, designed to organize and manage information related to hospital admissions, discharges and transfers.
“Everything was online. It was real time, and I was very fortunate to be asked to lead that project,” she said.
And it was a profound experience.
“The whole world changed for us. Things were up and going 24/7. And then the hospital embarked on this huge technology initiative, and we were computerizing departments all over the place. We were one of the first in the country to have an automated appointment system for all of the clinics.”
Detraz would go on to join CTG Health Solutions, which meant frequent commutes to and from the company’s Cincinnati office, where she was most recently vice president. In that position, she was responsible for strategic planning, marketing, and the quality management office for CTG’s health-care division.
She was with CTG when, in 2009, Congress passed the Health Information Technology and Economic and Clinical Health (HITECH) Act, a bi-partisan provision of the American Recovery and Reinvestment Act (ARRA.) It carried dramatic implications for the medical information technology industry.
Suddenly, as much as $27 billion in federal incentives spread over 10 years became available to physicians and health care provider organizations that could demonstrate “meaningful use” of electronic health records (EHRs). The first payments were distributed in May.
Eligible professionals receive as much as $44,000 over a five-year period through Medicare, according to the Centers For Medicare and Medicaid Services.
For Medicaid, the payment is as much as $63,750 over six years. Medicaid providers can receive their first year’s incentive payment for adopting, implementing and upgrading certified EHR technology but must demonstrate meaningful use in subsequent years in order to qualify for additional payments.
That’s the carrot. The stick? Starting in 2015, hospitals and doctors will be subject to financial penalties under Medicare if they are not using electronic health records.
The imperative to comply — and soon — with the “meaningful use” requirement has given rise to a burgeoning consulting industry staffed by professionals with the contextual knowledge and experience to ensure that doctors and hospitals can comply and qualify for those federal funds.
“At a time when innovation is the cornerstone of survival, we will benefit from Clair’s deep industry insights as we leverage health-IT-driven clinical and business analytics to help clients surmount today’s health-care reform demands while preparing for a future of value-based care delivery,” Tom Niehaus, president and chief operating officer for Encore Health Resources, stated in a release announcing the hiring of Detraz.
The heat is on. While industry professionals anticipate that many hospitals and physician offices will manage to comply with the first of three stages of “meaningful use” requirements, Detraz expects rough going for quite a few.
“The problem is with the smaller hospitals and physicians practices or hospital organizations that are financially challenged. They’re really struggling because they don’t have the resources or the financial means that are required in order to do it,” she said.
And with stages two and three as yet undefined, a significant sector of the industry is in something of a defensive crouch.
“I think we’ll see a new wave of mergers and acquisitions in order for them to survive. In smaller communities, if there is a small hospital on each side of town, you might see them combining resources to get all of this done,” she said.
Detraz cites as key to surviving and thriving what she describes as an industry shift from volume to value, “capturing, analyzing, and effectively managing the right data to provide the needed information.” To become more nimble, responsive and capable of making effective, timely clinical and business decisions, health systems and emerging care-delivery organizations, she noted, are going to need powerful analytics and business intelligence capabilities.
“Right now, health care is delivered in silos,” she explained. “The hospitals are over here, the physicians are out in the community, your cardiologist is in this group and your primary care is in another group. Most patients, as they get older, have multiple conditions, so each one of those entities is focusing on that one particular problem for that patient. There has not been an alignment of incentives to entice physicians and hospitals to work together to see how they could improve the health care of patients and reduce the cost collaboratively.”
It’s a lot to absorb and comprehend. Detraz worries that the explosion of medical information technology in such a relatively short period of time could become overwhelming.
“We’ve got to be very careful about technology fatigue with all of the physicians and caregivers,” she said. “You can’t just roll out something new to them every three or four months. You have to be careful about how you stage those. You don’t want to interrupt their workflow. Yet, you want to leverage this technology and figure out the best way to use it.”
Arriving at Encore, Detraz joins an organization founded in 2009 that expanded its employee base nearly 200 percent in 2010 and another 95 percent in 2011. According to a company statement, Encore increased its revenues by more than 400 percent between 2009 and 2010 and another 115 percent in 2011.
Detraz will continue to work from her Lexington home.
“I’ve had a love affair with Lexington forever and a day. I grew up right outside of Louisville. I love Louisville, but Lexington is just a wonderful place to live,” she said. “You can be anywhere. Our consulting firm is full of people who are all over the country. It’s a very special set of expertise that’s needed, and you just can’t accumulate it in all of the places where we have health care, which is in every nook and cranny across the United States.”