MLK Jr. Community Hospital Sets Blueprint for Hospital Reboots

Since reopening last year, MLK Community Hospital has been a showcase of how a safety net hospital can employ new technology and new thinking to serve a community.

In technology, too many problems often end up being solved by completely restarting a system.

In the hospital world, that's considered the last resort, but a hospital I visited last week suggests there is value in this approach when it's applied on a large scale, too—to an entire hospital.

And so it is that Martin Luther King Jr. Community Hospital, a 131-bed reboot and rethink of the old 400-bed Martin Luther King Jr./Drew Medical Center in south central Los Angeles, has become a blueprint for how to do such a restart.

Following in the wake of a series of terrible quality lapses more than a decade ago, the decision to completely close the old medical center, terminate all its staff, and start fresh was a costly one to the county of Los Angeles.

But since reopening last year, MLK Community Hospital has been a showcase of how a safety net hospital can employ new technology and new thinking to serve a community of 1.3 million people, an area with only one other hospital located within its service area.

I visited MLK Community last week and took away five tips on just how to leverage technology to maximize such a reboot in 2016. My guide was Sajid Ahmed, chief information and innovation officer.

Ahmed is not your average CIO. He was deliberately hired by president and CEO Elaine Batchlor as employee #2 because she valued IT-fueled innovation highly, Ahmed says. His background is in tech, as well as at L.A. Care, the nation's largest public health plan; this is his first gig as a hospital CIO.

1. Outsource IT staffing through a hybrid governance model.

Starting with a blank piece of paper, Ahmed invited competitive bids for a company to staff its IT department, while retaining key IT managers and directors in house.

The winning bidder, CareTech Solutions, provides the other IT workforce, everyone from application analysts to network engineers, at an affordable price to maximize the available skill set for a low-margin safety net hospital.

2. Maximize employee training at restart.

Relatively speaking, choosing and implementing technology is easy, compared to training employees to use that technology to have a smooth licensure and opening day.

Because the technology enables true collaboration between staff, getting the culture right, including freshly crafted policies and procedures to leverage that, is key, Ahmed says.

For instance, from day one, he banned all fax machines at the hospital, to force communications to all-digital. Aside from a few batch uploads involving claims, the fax ban has endured.

3. Start phishing drills early, and repeat monthly.

If technology has an Achilles' heel, it is the sometimes the unfounded trust that employees put in each others' emails.

While two-factor authentication can offer some trust, sophisticated phishing and spear-phishing are probably the root cause of many of today's successful ransomware attacks.

MLK Community recently staged its first internal phishing attack. "We're going to do it again next month in a different way, until employees pick up the habit" to educate themselves about phishing, Ahmed says.

Hospital leadership will also conduct a cybersecurity disaster drill next month, he says.

4. Remote host IT systems where it makes sense, and leverage available discounts.

MLK Community selected Cerner as its EHR, opting for the full Cerner instance instead of a community hospital edition, Ahmed says. Cerner hosts this EHR at its data center in Kansas City, reducing on-site data center needs at MLK, and further enhancing data security.

MLK gets a discount from Cerner because the public partner in the public/private partnership that runs MLK is Los Angeles County, whose health department also chose Cerner as its EHR.

MLK's financial systems, provided by Lawson, are also remotely hosted.

5. Think like a startup.

Because a separate nonprofit corporation runs MLK Community, the new private operators cannot simply turn to taxpayers for operational funds when times get tough.

With responsibility already in place for the top line and the bottom line, MLK Community has to think right now about the world that's coming–value-based reimbursement instead of volume.

So Ahmed has already pushed Cerner and other vendors to adapt their technologies to population health, even though Medi-Cal, California's version of Medicaid, is not yet set up to pay for value. Ahmed knows that day is not far off.

Thus, since last July, every patient at MLK Community has been assigned a care coordinator. The goal: Keep patients out of the ER as much as possible and prevent readmissions, and leverage "e-consults" for more efficient referrals.

As the "Rubik's cube of reimbursement" gets rearranged in the coming years, Ahmed knows he has to be flexible to adapt to changing reimbursement rules. And yet, in the short term, the new hospital has cut costs that the old hospital couldn't afford (too many beds) and increased revenue where it made sense (expanding its OB and maternity services).

It's still early at MLK Community, but Ahmed says internal patient satisfaction scores have been promising, and in February, the hospital achieved HIMSS Level 6 IT certification, a rare thing in a hospital's first year of operation. And Yelp reviewers give it 3-1/2 stars out of five.

As wrenching change continues, more hospitals are bound to close. As some of them are reborn, the lessons MLK Community has to teach shall reverberate.