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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

INHS: A QUIET GIANT


Tom Fritz, retired CEO of Inland Northwest Health Services, was found dead in Lake Coeur d'Alene on Monday, July 13, 2015. (CHRISTOPHER ANDERSON / The Spokesman-Review)

One of the largest employers in Spokane County also may be one of the least-known.

The company is Inland Northwest Health Services, the medical service provider jointly owned by Providence Services and Empire Health Services, the two major hospital systems in this area.

The for-profit organization recently topped the 1,000-worker mark, making it one of the largest regional employers in terms of total head count. Launched in 1994 to help streamline costs for the two Spokane hospital systems, INHS has become a provider of education, medical care, emergency services and training.

Its initial venture was operating Northwest MedStar, the air ambulance service that takes patients from remote locations to hospitals. It also operates St. Luke’s Rehabilitation Institute, a 102-bed center for patients recovering from injuries, strokes or surgeries.The company’s fastest-growing division is its technology management group, known as IRM (Information Resource Management).

In cities that have competing hospital systems, each group regards patient and diagnostic records as proprietary data. In the Spokane area, the hospitals have agreed to share the data, allowing quick and relatively simple access for doctors, clinics and other health care professionals.

Many advocates of health care reform say one solution to the nation’s health care problems involves the kind of network management used in Spokane, said Dr. Samuel Palpant, associate director of internal medicine residency training for the University of Washington here.

What Spokane has is interoperability — a system that lets various providers, hospitals and clinics all share data easily.

“The result is Spokane has done something that’s not just technically but communally very unique,” Palpant said.

The community’s shared data system is a significant key to efficiency and better health care, he added.

“Many patients have multiple doctors. When they go to a hospital, some of the data will be back at the doctor’s clinic. If it’s not available (at the hospital) it will need to be faxed over.” If patient records, including lab tests and prescription history, are quickly available, health care providers can figure out what to do — and what not to do, said Palpant.

Beyond Spokane, the INHS data network now stretches to more than 30 regional hospitals, including Kootenai Medical Center in Coeur d’Alene and facilities in Western Montana.

It’s been so successful that experts around the country point to INHS as a model for helping create more efficient regional medical systems.

The IRM group within INHS is facing 30 percent or greater yearly increases in workloads and budgets, the result of ever-increasing demand for digital management of the vast piles of medical records hospitals and clinics are creating.

“A large share of our recent employee growth comes in that technology group,” said Tom Fritz, CEO of INHS.

The INHS technology group has increased in size to about 250 workers; it just added 27 new people as a result of a deal signed with four Los Angeles hospitals that hired the Spokane organization to connect their data systems.

Some of those jobs are Web designers and Web managers. Others are in charge of operating a Spokane-based data center that will handle all the data traffic for the four hospitals.

This isn’t the first time INHS has signed deals with outside hospitals.

It already has similar contracts with hospitals in Bonners Ferry, Seattle, Enumclaw, Wash., and Palmer, Alaska. INHS is also talking with potential customers such as hospitals in San Diego and officials from Kaiser Permanente, the large HMO based in Oakland, Calif., said Fritz.

“We get (that interest) because we offer them operational efficiency,” said Fritz. “We’re able to take them to a fully integrated system that is both flexible and secure,” which Fritz said is a key concern due to federal rules regarding the privacy of patient information.

Despite landing among the 15 largest employers in Spokane County, INHS is barely known outside the medical groups, said Fritz.

“All along, we haven’t worked that hard at establishing our name recognition. Our main mission has been to support the medical community here.”

Fritz said a goal is to gradually build more name awareness for INHS. One small step has been moving recently into the downtown Wells Fargo building. A large INHS logo is now fastened to the north wall of the building, the former Metropolitan Mortgage tower and one of the tallest in the area.

Along with management of the shared data network, INHS now wants to work with other local groups to improve health care through advanced technology, said Fritz.

A proposed data-surveillance tool developed by two members of Spokane County Emergency Medical Services, called Pyramid, is being used in the four major Spokane hospitals. It relies on data collected in the INHS records a system to produce daily reports on the number and types of emergency room admissions and the types of admissions at the four hospitals.

It’s able to produce data snapshots, such as the daily average of 400 to 500 ER admissions among Spokane’s hospitals. Pyramid’s other advantage will be to highlight and draw attention to disease outbreaks or public health occurrences, said Dr. Jim Nania, the county’s EMS medical director and one of the developers of the technology.

Beyond Spokane, INHS plans to deploy an even more sophisticated technology tool, a visualization and analysis software application called Starlight that was developed by scientists at Pacific Northwest National Laboratory.

The software eventually could be deployed on a regional basis to track and analyze real-time reports of hospital admissions, ER incidents, unusual outbreaks of disease and even terrorist activity, said Fritz.

When the Starlight program will be deployed is uncertain, said Fritz, since INHS is still working with PNNL staff on learning the program’s features and options.

With all of these projects and plans in play, the challenge for INHS now is to manage growth without eroding the level of service needed by its Spokane customers, said Fritz.

Mike Smyly, INHS’s chief business development officer, said, “we must have about 5,000 different projects going on any one time,” ranging from hospital system upgrades, to new software tools, to improved network management consoles for delivering services to remote locations.

Mark Johnston, director of information technology for Spokane-based Pathology Associates Medical Laboratories, said the size of INHS and the extent of its commitments haven’t produced service problems.

“They are doing a lot and managing some innovative things in the marketplace. They don’t do a bad job in that area,” said Johnston, who works regularly with INHS staff and managers.

“But are they the gold standard for service? No, they’re not,” said Johnston, noting that a large operation like INHS needs to work harder than a smaller one might to achieve consistent excellent service.

Palpant, who is also a member of the Spokane County Medical Society’s informatics committee, disagrees somewhat with that assessment.

“They are gracious and thoroughly polite. They’re not just nerds sitting behind a computer. In their work, they need people who are technically proficient, but also people who know how to talk with others.

“That’s their saving grace. They have people who know how to relate to other people,” Palpant said.