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.