What began as a small health information technology company, founded to provide affordable financial systems to community hospitals, is today one of the region’s largest HIT providers. Health Management Systems, Inc. launched in 1984, is the provider of financial and now clinical solutions to about 600 hospitals nationwide.

 

While the company’s reach and breadth has expanded exponentially, President and CEO Tom Stephenson said the company’s mission remains much the same: “To build a system that community hospitals could afford and use as a foundation to run the hospital. Although it looks a lot different today, that’s still what we’re trying to do.”

 

Stephenson joined the company just a year after its inception and worked his way up through the ranks from a programmer/analyst to vice president of customer services to chief operating officer to the head of the table in 2005. HMS clients include behavioral and specialty hospitals, as well as long-term acute care facilities, yet its base is the community hospitals, many in rural areas. 

 

“One thing that we’re very proud of, especially given our location in Nashville, is our success with our corporate customers,” Stephenson said. “In total, we have somewhere in the neighborhood of 25 to 30 different for-profit, corporate groups that we work with.” In the Nashville area, those include Community Health Systems, LifePoint and Psychiatric Solutions. “We were there when Community Health bought its first four hospitals, and we implemented in those four hospitals,” he said.

 

HMS’ bread and butter has been financial and administrative systems, with products that handle accounts payable, general ledger, payroll, time and attendance, fixed assets, patient eligibility, materials management, patient scheduling and much more. In the last couple of years, a new emphasis has evolved – advanced clinical solutions, from patient care charting at the bedside to electronic recording of physician orders. “Those are the ones that are driving the market. Those are the ones that ‘meaningful use’ in this stimulus plan are really targeting, ones that help drive patient safety,” Stephenson explained.

 

Offering higher Medicare and Medicaid reimbursement rates, the Obama Administration’s stimulus initiatives incentivize hospitals to implement and upgrade health information systems. Thus, existing HMS customers are “rounding out their suite,” Stephenson said, and new customers are looking to upgrade HIT opportunities and expand into clinical solutions.

 

HMS’s clinical offerings include patient care documentation, surgery management, laboratory, pharmacy, radiology, microbiology, blood administration, image archiving, mammography reporting, transcription and eMAR (the electronic medication administration record).

 

About 75 of HMS’ more than 400 employees work as software developers – programmers, systems analysts and product managers. Their constant feedback from customers and market demand drive their jobs, Stephenson said. Government regulations do, too. “On the financial side, we’ve dealt with that for years around billings and DRGs (the roughly 500 diagnosis-related groups that hospitals are required to use by Medicare to categorize patients), and you have to update every year. Now, that’s obviously flipped over into the clinical side,” Stephenson added.

 

In 2007, HMS was CCHIT certified, a designation bestowed by the Certification Commission for Health Information Technology. The commission emphasizes HIT improvements resulting in better quality, safety, efficiency and access. Stephenson said HMS now is embracing meaningful use in a big way, pushing physician utilization of the tools and interoperability, as in sharing data outside the walls of the hospital. Stephenson said a big 2010 emphasis will be certification of products to meet meaningful use criteria. “We’ve spent a significant amount of time in development, and we’re at the point now of going into Beta,” he said. “In late spring or early summer, we’ll be going through the certification process.”

 

Since its inception, HMS has partnered with IBM. The company currently uses the IBM System i, a mid-range platform with the power to run HMS’ suite of products. “The aspect of that, that’s very advantageous to us and to our customers, is that it’s very scalable. You can run a very small hospital on it, or we have customers that run 100 hospitals on one server,” Stephenson said. “It’s also just reliable. It never stops. The reliability is almost unmatched in the market.” And that’s what you want in a healthcare environment, he noted.

 

Most HMS customers buy a server and physically house it at their hospital, yet HMS also offers systems through an ASP model. The company runs more than 60 hospitals out of the HMS data center with servers physically located at its West End Avenue facility in Nashville. In addition, corporate customers may choose to run their network of hospitals through a headquarters or data center. “Whatever fits best with either your economic model or your infrastructure, we can accommodate that,” Stephenson said.

 

When it comes to arming hospital employees with individual technologies, one of the most prevalent strategies for the bedside is a laptop on a mobile cart that nurses move from room to room. “Some hospitals have actually implemented devices in each room, and some applications exist for handheld devices and probably more of those to come,” Stephenson said. Also, handheld devices make easy work of barcode scanning on patient bracelets and medication containers. He said the new Apple iPad may have potential in healthcare environments. “It really gets down to preference at times. How heavy are they? How hot do they get, and what’s the battery life?” Stephenson explained, predicting that the iPad may better adapt to the ambulatory setting, the clinic and the physician practice.

 

Stephenson also predicted that 2010 will be a busy year for HMS. Since economic stimulus regulations were released in December, hospitals know just the kind of upgrades that are eligible. “Before, there was a lot of hurry up and wait,” he said.