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It’s easy to get caught up in all the issues associated with new health IT. From non-effective EMRs to mandated practices that cause stress and headaches, the past few years have been tough. But across the country, organizations have seen success by jumping on the bandwagon, and we have their stories to prove it.
From ICD-10 implementation to mobile apps and more, check out three health IT success stories.
1. ICD-10 assessment and implementation. With ICD-10 looming, Rex Healthcare in Raleigh, N.C., was just one of many organizations looking to get a head start on the transition. “We started mid-way through 2010 to structure a program,” said Peyman Zand, director of strategy and governance. “We created a team, and we brought in a firm to do a very high-level education of our staff members, doctors and nurses as well as our management team.” This training included determining what was ICD-10, and what impact it would have on the organization. As a result, Zand and his team looked to conduct a high-level assessment of their top 10 in-house systems. “We have about 400 plus systems in the hospital that we run on a regular basis,” he said. “We did an assessment to determine what it looked like from that view point.”
Rex Healthcare conducted the assessment in October 2010, and shortly after, they sent a request for proposal to several vendors to identify a vendor partner. After narrowing vendors down from 12 to six, and then interviewing three, Rex Healthcare decided on Experis, an organization dedicated to professional resourcing and project-based solutions. “It was a rigorous process,” said Zand. “Experis was engaged in the beginning of 2011.”
And once Experis was onboard, the organization broke its next move down into three steps. It contacted some of its 400 plus vendors and assessed all systems in the hospital. Next, it conducted detailed, one-on-one interviews with all departments in the hospital to discover their work processes and determine how ICD-10 would impact their flow. “This was beyond our health IT systems and medical records department,” said Zand. “It was into our oncology department, surgery department, every single discipline. And as a result of that, we put together a detailed road map, which included a training schedule and other projects we could tackle to remediate and complete our ICD-10 requirements.”
Looking back, Zand said there aren’t many things he or the organization would have done differently. “The only thing I would say is, we could have done some of the education ourselves, and I would have done a request for proposal earlier,” he said. Additionally, Zand said he would of looked to start the project earlier than the end of 2010. “Looking at the rest of the market, though, we still seem to be ahead of the pack.”
And the rest of the market can learn a thing or two from Rex Healthcare’s experience with beginning the ICD-10 implementation process. “We created a clear picture of what we need to undertake,” said Zand. “We have a clear road map, and we’re constructing the teams that need to tackle our projects.” For example, the organization has a clinical documentation team, a financial revenue cycle team, and a training team. “We have identified about 40 system remediation projects that we’ll be gearing up for as well as projects from our acute care side of the house to our EMR system to our financial billing system,” said Zand.
Zand’s final piece of advice If you haven’t gotten started on the transition already, now is the time. “That would be the number one thing,” he said. “We found this was a lot more involved, even though we started when we did. Don’t underestimate the work process reengineering that will have to go into effect -- the ICD9 to ICD10 dramatically changes the way providers work, and it will unearth a lot of inefficiencies you have. You need to work through those inefficiencies and reengineering the processes to be more efficient.”
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2. Going mobile. Back in 2005, Craig Horton, MD, joined the Meadows Regional Medical Center Team in Vidalia, Ga. as vice president of medical affairs. Shortly after assuming this role, the former pediatrician was charged with “stepping the hospital up to the next level.”
“Our CEO is very technologically inclined,” he said. “In April 2005, I began searching the Web for programs to make life easier.” When working as a pediatrician, Horton used a variety of programs that saved time and paper. “Not to mention, people in the office who were doing the billing didn’t have to contend with my handwriting,” he said. “So, I was looking for something that would be a hospital-wide system and could do something similar.”
Horton eventually came across a Web ad for PatientKeeper, a physician healthcare information system. Although the process of implementing new technology was delayed for a year or so, Horton pushed for a system and soon, the organization had pared down potential vendors to two. “There was a competing company that had a product that could meet our needs,” he said. “We had both them and PatientKeeper come in and do a demo, and the other company didn’t have it all together. So in August 2008, we finally decided to go live with PatientKeeper Mobile Clinical Results.”
Horton said the hospital was looking for technology that doctors and office personnel could carry around and use to access patient information. “The physician portal was a huge part of it as well, and after talking with people from PatientKeeper, we decided to do both at the same time.” Back in 2008, the organization decided to go with the two most popular smartphones: Palm and Windows Mobile. “That was fine back then because those were the top dogs as far as smartphones,” said Horton. “Unfortunately, that was the same time iPhones and others were becoming popular.”
Meadows Regional continued using the PatientKeeper Mobile Clinical Results on Palm and Windows Mobile from 2008 until about two months ago. “In August 2011, three years after we went live, we finally upgraded to the version of PatientKeeper that allows access with all the smartphones, and that was something I’ve been pushing for,” said Horton. “I’ve had doctors come up to me once or twice a week saying how the program saves them time because they don’t have to call nurses to get results; the results come up right on their phone.”
The hospital went from about six doctors with access to clinical results on their phone to about 30 -- a significant increase considering the size of the organization. “The reception has been outstanding,” said Horton. “The doctors are all happy with it. We had little issues, but they’re all fixed immediately.” Not to mention, Horton said the program is user friendly and required all of 15 minutes for training.
Looking back, Horton said one of the organization’s biggest drawbacks was not being able to access the program on all types of smartphones. “The usage would have been outstanding back in 2008 if we had done that,” he said. “For example, we audited the usage in January 2009, and there were 63 usages. In September 2011, we had more than 1,000.”
With the onslaught of mobile technology, Horton has a few words of advice for those considering apps similar to Mobile Clinical Results. “The main thing I would say is to do a face-to-face demo with whatever program you’re going to use,” he said. “That made a difference for us. The first program we were going to use had a good name, and we would have naturally leaned toward them, until they came in and did their demo. We compared them to PatientKeeper, and they knew their stuff.” Horton also suggests networking with other organizations to get a taste of what they’re using. “Get your references and do your due diligence,” he said. “Make sure people are happy with what they’re using.”
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3. Implementing an interface engine/connecting to an HIE. About six years ago, Riverview Hospital in Noblesville, Ind. decided to replace its EMR and patient financial system. During the process, CIO Michael Mover saw that the organization would be better off taking control of its own interfaces as well by implementing an interface engine.
After embarking on a search for the perfect vendor, Riverview Hospital and its 27 interfaces came across NeoTool, better known today as Corepoint Health. Mover and his team had surveyed vendors prior to finding Corepoint, and the general consensus for 27 interfaces was two months of work. Corepoint promised two weeks.
“What stunned me was the idea we could get this done in two weeks,” said Mover. “This is what I had dreamed of: interfaces becoming easy, because they had been a nightmare before. So I said, 'Name that tune,’ and in about seven days, we had about every interface finished.”
Riverview is also using the Corepoint Integration Engine to connect to the Indiana Health Information Exchange. Mover said since the organization partnered with Corepoint six years ago, it’s been self-sufficient. And in addition, the organization is one step ahead when it comes to the new medical device safety standards proposed by the FDA this past August.
“Even though we don’t have to do those types of things in our interface engine, I wanted to find out what our options were,” said Mover. “So I called the folks at Corepoint and talked to them about it. I had mentioned it to them two years ago, and they said told me they already put it in; I have change controls and all those things already built into my interface engine.”
All in all, Mover said he’s happy that the technology “just works.” And for those considering an interface engine, Mover said support is everything. “I would rather have a mediocre product with great support than a great product with mediocre support,” he said. “I would say to bring on the one with the best support. And lastly, if you don’t own an interface engine, there’s no more economically beneficial investment you can make. It’s also a fast return on your investment.”
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