IT key to successful e-health record rollout

Health care pros first need to understand the technology they already have

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As a result, Drazen's advice for facilities hoping to meet the government's meaningful-use requirements is to start with a self-assessment of the systems already in place: Can they be certified as is? And are there any technology gaps that need to be fixed?

Find the technology gaps

Chuck Podesta, CIO at Fletcher Allen Hospital, a 500-bed tertiary care center and teaching hospital in Burlington, Vt., performed a gap analysis prior to choosing his hospital's EHR system, which went live last June. Fletcher Allen uses PRISM (Patient Record and Information Systems Management) from EPIC Systems Corp. in Verona, Wis.

Since the new system went live, the facility has achieved a rating of 6.02 out of 7 points on the Healthcare Information and Management Systems Society's (HIMMS) EHR Adoption Model. On the HIMMS scale, a zero represents a facility that largely relies on paper records and a 7 represents a facility where 100% of the EHR system is in place and fully integrated.

Podesta said there are two aspects to rolling out EHRs, one technical, the other practical.

For example, one objective that's included in the government's meaningful-use criteria is that hospitals maintain active medication and allergy lists for patients. To qualify for reimbursement funds, a hospital must prove that at least 80% of patients it admits have that data recorded in a structured format.

"It's one thing getting an electronic record in, and it's another thing getting clinicians to use it in a meaningful way," he said.

Podesta was able to roll out his hospital's EHR system in only 15 months at a cost of about $88 million. The good news: he expects to see a full ROI and an uptick in productivity. "We constantly get calls from physicians about their productivity, about how this has made life easier for them," he said.

Fletcher Allen's PRISM system will eventually connect virtually every key function in the hospital and has been key to creating a smooth workflow for clinicians and technicians alike.

Rolling out the servers and databases for the EHR system was the easy part, at least compared to training physicians and nurses to use it. Over a 10-week period, Podesta said his unit had to train between 5,000 and 6,000 medical staff members -- and it took anywhere from 16 to 24 hours to train each nurse. That was a priority, he said, because nurses tend to help train physicians.

Some of Fletcher Allen Hospital's training was performed using Web-based tools, but most was hands-on work in training rooms. "One thing we made sure of was that it was all [EPIC] certified. Everyone had to take a test and pass it before they got their certification codes. The day we went live... if someone showed up who wasn't certified, we took them to the training room and trained them first."

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