Implementing Electronic Medical Records An Overview of Lessons Learned <ul><li>2011 Rural Hospital Conference </li></ul><u...
Who is CCMH? <ul><li>25-Bed Critical Access Hospital in Carrollton, MO </li></ul><ul><li>6 Clinics, 5 Physicians, 1 P.A. a...
CCMH EMR Timeline <ul><li>January 1, 2010 </li></ul><ul><ul><li>HIMSS ENRAM score of 1.7 </li></ul></ul><ul><ul><li>Runnin...
Our Decision-Making Process <ul><li>Why Purchase a new EMR? </li></ul><ul><ul><li>Completion of gaps in current system </l...
Cerner Partnership <ul><li>Partnered with Cerner in March 2010 </li></ul><ul><li>Cerner Solutions: </li></ul><ul><ul><li>R...
Benefits of the Cerner Model <ul><li>Years of Experience </li></ul><ul><ul><li>Project planning and implementation </li></...
Our Implementation Process <ul><li>Select internal implementation team </li></ul><ul><li>Prepare for Kick-Off </li></ul><u...
Key Lessons Learned <ul><li>Communication is Key </li></ul><ul><ul><li>Communicate plans with staff upfront </li></ul></ul...
Key Lessons Learned (cont) <ul><li>More upfront work = better outcomes </li></ul><ul><ul><li>Accurate and thorough data co...
Key Benefits  <ul><li>Imperative:  Improved Quality of Care </li></ul><ul><ul><li>Increased Documentation of Pain Assessme...
Meaningful Use – 2011 Planned Attestation <ul><li>Partnering with Cerner’s Regulatory Compliance team  </li></ul><ul><li>F...
Summary Observations <ul><li>Limit your Vendor analysis to 3-4 </li></ul><ul><li>Remember you are choosing a Partner for t...
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Implementing Electronic Medical Records

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Implementing Electronic Medical Records

  1. 1. Implementing Electronic Medical Records An Overview of Lessons Learned <ul><li>2011 Rural Hospital Conference </li></ul><ul><li>Inn at Grand Glaze, Osage Beach </li></ul><ul><li>June 2, 2011 </li></ul><ul><li>Presentation by; </li></ul><ul><li>Jeff A. Tindle, MHA </li></ul><ul><li>Associate Administrator and CFO </li></ul><ul><li>Carroll County Memorial Hospit al </li></ul>
  2. 2. Who is CCMH? <ul><li>25-Bed Critical Access Hospital in Carrollton, MO </li></ul><ul><li>6 Clinics, 5 Physicians, 1 P.A. and 2 N.P. </li></ul><ul><li>Current Services: </li></ul><ul><ul><li>Cardiac Rehab </li></ul></ul><ul><ul><li>Emergency Room </li></ul></ul><ul><ul><li>Standard Ancillary (Lab, Rad, Rx, PT, RT, Sleep, Nuc Med) </li></ul></ul><ul><ul><li>Extensive OP Clinic (Cardiology, Ortho, GI, Surgery, Podiatry, Urology, Pulmonology, etc.) </li></ul></ul><ul><ul><li>Home Health </li></ul></ul><ul><li>Planned Expansion/Renovation </li></ul><ul><ul><li>Summer 2011; adding new CT, MRI, complete renovation of E.R., renovate and relocate Lab and relocate Medical Records </li></ul></ul>
  3. 3. CCMH EMR Timeline <ul><li>January 1, 2010 </li></ul><ul><ul><li>HIMSS ENRAM score of 1.7 </li></ul></ul><ul><ul><li>Running on HMS, purchased in early 1990s </li></ul></ul><ul><ul><ul><li>Original Pat. Acct. software, no department integration </li></ul></ul></ul><ul><ul><ul><li>No CPOE </li></ul></ul></ul><ul><ul><li>Added Omnicell Med Dispensing in mid-2009 </li></ul></ul><ul><li>EMR RFP’s out in January 2010 </li></ul><ul><ul><li>Site visits in late January, early February </li></ul></ul><ul><ul><li>Presentation to Board in late February </li></ul></ul><ul><ul><li>Cerner selected </li></ul></ul><ul><li>Implementation Begins March 2010 </li></ul><ul><li>Go Live September 1, 2010 </li></ul><ul><li>HIMSS Stage 6 Designation, February 2011 </li></ul><ul><li>Certification of Meaningful Use Started February 2011 </li></ul><ul><li>Records </li></ul>
  4. 4. Our Decision-Making Process <ul><li>Why Purchase a new EMR? </li></ul><ul><ul><li>Completion of gaps in current system </li></ul></ul><ul><ul><li>Take advantage of stimulus incentives </li></ul></ul><ul><ul><li>Improve patient care, quality and workforce efficiency </li></ul></ul><ul><ul><li>Desire to be an “early adaptor” </li></ul></ul><ul><li>Why Cerner? </li></ul><ul><ul><li>Compliments our mission statement and strategic goals </li></ul></ul><ul><ul><li>Software as a Service (SaaS) model (Remote Hosted) </li></ul></ul><ul><ul><li>Implementation approach </li></ul></ul><ul><ul><li>Trusted they would be certified for Meaningful Use, confidence in their ability to keep up with changing criteria </li></ul></ul><ul><ul><li>Good partner </li></ul></ul>
  5. 5. Cerner Partnership <ul><li>Partnered with Cerner in March 2010 </li></ul><ul><li>Cerner Solutions: </li></ul><ul><ul><li>Registration/Scheduling </li></ul></ul><ul><ul><li>CPOE/ePrescribing </li></ul></ul><ul><ul><li>Nursing and Physician Documentation </li></ul></ul><ul><ul><li>Inpatient Pharmacy </li></ul></ul><ul><ul><li>General Laboratory </li></ul></ul><ul><ul><li>Device Connectivity </li></ul></ul><ul><ul><li>Ambulatory EMR and Practice Management </li></ul></ul><ul><ul><li>eMAR with Medication Bar-coding </li></ul></ul><ul><ul><li>Emergency Department </li></ul></ul><ul><ul><li>Radiology </li></ul></ul><ul><ul><li>Patient Accounting </li></ul></ul><ul><ul><li>EDI Transaction Services </li></ul></ul><ul><ul><li>Oracle EBS – General Financials </li></ul></ul>
  6. 6. Benefits of the Cerner Model <ul><li>Years of Experience </li></ul><ul><ul><li>Project planning and implementation </li></ul></ul><ul><ul><li>Always on latest code and content releases </li></ul></ul><ul><ul><li>Cerner handled a large portion of implementation and training, freeing up our staff to focus on patient care and operations </li></ul></ul><ul><li>SaaS Reduces our Dependency on In-House IT </li></ul><ul><ul><li>We contract out IT – network, PC’s, etc </li></ul></ul><ul><ul><li>Cerner handles hosting of Cerner Millennium and Oracle Financials </li></ul></ul><ul><ul><li>SLA for performance standards </li></ul></ul><ul><ul><li>Predictable TCO </li></ul></ul><ul><ul><ul><li>Upgrades are included </li></ul></ul></ul><ul><ul><ul><li>Hardware costs are included </li></ul></ul></ul><ul><ul><ul><li>Application management and help desk support is included </li></ul></ul></ul>
  7. 7. Our Implementation Process <ul><li>Select internal implementation team </li></ul><ul><li>Prepare for Kick-Off </li></ul><ul><li>Agree to communication plan </li></ul><ul><li>Take pulse of organization </li></ul><ul><ul><li>Culture </li></ul></ul><ul><ul><li>Assess comfort of staff with technology </li></ul></ul><ul><li>Decide what is negotiable </li></ul><ul><li>Find your “cheerleaders” </li></ul><ul><li>Essentially build your Strategy </li></ul><ul><li>However, </li></ul><ul><ul><li>“ Culture Eats Strategy for Lunch Every Day” </li></ul></ul>
  8. 8. Key Lessons Learned <ul><li>Communication is Key </li></ul><ul><ul><li>Communicate plans with staff upfront </li></ul></ul><ul><ul><li>Executive sponsorship </li></ul></ul><ul><ul><li>Training </li></ul></ul><ul><ul><li>Set staff expectations </li></ul></ul><ul><li>Doing your Homework </li></ul><ul><ul><li>Master File clean-up (charge master, formulary, etc) </li></ul></ul><ul><ul><li>Examine current practices and policies </li></ul></ul><ul><ul><li>Departmental data collection </li></ul></ul><ul><ul><li>Identify Subject Matter Experts and Super Users </li></ul></ul><ul><ul><li>Validate build models against workflow requirements </li></ul></ul><ul><ul><li>Test, test, test </li></ul></ul>
  9. 9. Key Lessons Learned (cont) <ul><li>More upfront work = better outcomes </li></ul><ul><ul><li>Accurate and thorough data collection leads to a build that imitates your actual workflow, process, and expectations </li></ul></ul><ul><ul><li>Verify all build and then conduct end user training </li></ul></ul><ul><li>Know your staff </li></ul><ul><ul><li>Culture </li></ul></ul><ul><ul><li>It’s not personal, it’s business </li></ul></ul><ul><ul><li>Be prepared for a wide range of comfort levels with technology </li></ul></ul><ul><li>Be prepared for… </li></ul><ul><ul><li>Appointing a project manager </li></ul></ul><ul><ul><ul><li>Do it yourself or appoint someone else </li></ul></ul></ul><ul><ul><li>Entering a continuing partnership with your vendor (Cerner) </li></ul></ul><ul><ul><li>Additional staffing - mainly nursing during go live </li></ul></ul><ul><ul><li>Added challenges in maintaining files/accounts for short period of time </li></ul></ul><ul><ul><li>Learning more about your organization along the way </li></ul></ul>
  10. 10. Key Benefits <ul><li>Imperative: Improved Quality of Care </li></ul><ul><ul><li>Increased Documentation of Pain Assessment  </li></ul></ul><ul><ul><li>Increased % of Allergies Documented On-line </li></ul></ul><ul><ul><li>Reduction in Medication Variances (Adverse Drug Events & Adverse Drug Reaction) </li></ul></ul><ul><ul><li>Increased % of Orders Placed Online by Providers </li></ul></ul><ul><ul><li>Decreased Incidence of Falls </li></ul></ul><ul><ul><li>Increased Medication Reconciliation at Each Change of Level of Care </li></ul></ul><ul><ul><li>Decrease Time to Access Patient Chart </li></ul></ul><ul><ul><li>Reduce the Number of Missed Doses of Medication </li></ul></ul><ul><ul><li>Increased Accuracy and Speed in Obtaining Medication History </li></ul></ul><ul><li>Imperative: Operational Efficiency </li></ul><ul><ul><li>Increased Coding Efficiencies </li></ul></ul><ul><ul><li>Reduced Printing Costs </li></ul></ul><ul><ul><li>Decrease Time to Access Patient Results (EMR) </li></ul></ul><ul><ul><li>Reduction in Paper and Form Expenses </li></ul></ul><ul><ul><li>Reduced Time Spent Managing Prescription Renewal Requests </li></ul></ul>
  11. 11. Meaningful Use – 2011 Planned Attestation <ul><li>Partnering with Cerner’s Regulatory Compliance team </li></ul><ul><li>Focused effort and drive to help with attainment of Meaningful Use </li></ul><ul><li>Exposure to what is occurring in the various policy and standards committee and workgroup meetings </li></ul><ul><li>Reporting and Monitoring of key objectives </li></ul>
  12. 12. Summary Observations <ul><li>Limit your Vendor analysis to 3-4 </li></ul><ul><li>Remember you are choosing a Partner for the next 5+ years </li></ul><ul><li>Software is software, make sure your Vendor can make it work in your Hospital and with your unique Interface needs </li></ul><ul><li>Strongly consider the pro/con of using a single solution for both the Hospital and Clinics </li></ul><ul><li>Your Organization can handle more than you think </li></ul><ul><li>Reasonable Implementation time frame is 9-12 months </li></ul><ul><li>Communicate, Communicate, Communicate </li></ul><ul><li>Consider a Vendor that has had success with HIMSS and Meaningful Use Attestation </li></ul><ul><li>We over-purchased our peripheral support equipment, COWS, Scanners, etc. Basic will do just fine. </li></ul><ul><li>You must be Committed to the End Result. It will be Rough Ride </li></ul>
  13. 13. Questions

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