Issues with HCA Hospitals

Hi Andrew,

We are currently working with HCA hospitals in Virginia. They have been a challenge, in part because of their issues and limitations, and partly because of our own resources. HCA has assigned groupings to their hospitals in VA based on geographical area, and we are handling each "market" separately after a frustrating trial trying to onboard the entire system at once. All hospitals are sending ELR in one feed, but each facility has different protocols, testing and coding. We have successfully onboarded the "market" covering southwestern Virginia, but that means only that they have been able to make satisfactory changes to the ELR coming from those hospitals. They are not able to send a single market's ELR to our production systems. The issue that makes the process slow is that they are unable to retrigger a message for us to confirm a fix. We must wait until another result of the same test type is sent. For less common tests (which are often the ones that need refinement) this wait can be months. Another challenge is that they use their own hospitals as reference labs, causing us to receive multiples of the same test. For screens that reflex to confirmatory testing, this creates a confusing array of duplicates-perhaps as many as nine separate ELRs for, say, HCV antibody, RNA Qualitative and viral load. The HCA ELR team we work with are earnest, responsive and pleasant to work with, but the combination of so many hospitals, Meditech software, and multiple codings for the same tests at different hospital labs has made it a challenge. We are hopeful that we can get the system into our production this year.

Hi Andrew!

Here in Utah we have a network of HCA hospitals that we work very closely with on their ELR feeds. They have challenges, but we have had a great contact at HCA that we have been working with to improve their feed. The biggest struggle they have is with antimicrobial testing and reporting. They have a hard time properly formatting those HL7 messages (per the implementation guide) to report to us.

Another challenge they have is matching the data type to the result type. So, OBX.2 will be a 'CE' or 'CWE' and the result in OBX.5 will be a quantitative (viral load). We process the result based on the data type so when they don't match it causes issues within our system. They have been working on correcting this for some time, and some progress has been made.

We put HCA feeds into our production surveillance system, but QA their feeds heavily. Hope this helps!

--Emily Roberts at Utah Department of Health

We have been trying to engage HCA in onboarding for ELR here in TN but the contacts we've tried to engage are not being responsive. Would you all be able to share your contacts? Not sure if they would be able to help us here in TN but it's worth a shot. It's helpful to hear the issues you are facing while working with them. 

Randi Rosack, TN Department of Health

Thank you for the feedback, everyone.

It sounds like everyone is having slightly different issues.

We also have them in production, but QA them regularly and carefully. Their micros are so delayed that most of them end up being hand-entered by IP staff rather than imported through ELR (which kind of defeats the purpose of ELR). They also have completeness issues, with some tests coming through very inconsistently. Issues raised with them are rarely addressed, and even when they claim to have fixed an issue, it usually persists. This has been going on for several years.

Randi, my primary contact is Angie Bates: angie.bates@healthonecares.com. Good luck!

Thanks Andrew! We finally heard back from HCA last week. We plan to move forward with them despite all the issues everyone has reported. Wish us luck!