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EHR SELECTION & IMPLEMENTATION

EHR SELECTION & IMPLEMENTATION. Lessons Learned from the Illinois Patient Health Information Network. Mary Ring, Project Director Illinois Critical Access Hospital Network Kim Larkin, CIO Washington County Hospital, Nashville, IL. LESSONS LEARNED HIGHLIGHTS.

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EHR SELECTION & IMPLEMENTATION

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  1. EHR SELECTION & IMPLEMENTATION Lessons Learned from the Illinois Patient Health Information Network Mary Ring, Project Director Illinois Critical Access Hospital Network Kim Larkin, CIO Washington County Hospital, Nashville, IL

  2. LESSONS LEARNED HIGHLIGHTS • Demonstrated commitment and leadership by the hospital CEO and board of directors are essential to successful EHR and HIT implementations • Use of EHRs and other HIT and the associated benefits for patient care must be a hallmark of your hospital’s culture

  3. LESSONS LEARNED HIGHLIGHTS • Embrace adequate planning time; shun analysis paralysis • Conduct realistic assessment of staff willingness to make process changes and administration’s commitment to project goals  • Recognize that the best predictor of success is prior success with major institutional changes  • Devote adequate attention to workflow analysis

  4. LESSONS LEARNED HIGHLIGHTS • Patience and flexibility are critical skills needed by implementation team leader(s) and member(s)  • Treat “EHR” as a verb rather than a noun (NextGen)  • Communicate/Communicate/Communicate • talk with peers • personally visit other users of software or processes under consideration • view software in use in the clinical and administrative settings • attend national HIT conferences, such as HIMSS • participate fully in user group meetings, forums, and blogs

  5. LESSONS LEARNED HIGHLIGHTS • Take full advantage of nationally available process support resources – many free toolkits available • Take full advantage of the resources of the professional and advocacy organizations such as AHIMA, CHIME, AMIA, HIMSS

  6. Timeline • Preliminary selection : Feb 2006--May 2007 • Funding available: October 2007 • Hired Network Admin: October 2007 • Vendor selected by PHIN: October 2007 • Contracts signed: December 2007 • Hired Nursing Informatics Specialist: January 2009 • Infrastructure requirements completed: February 2008 • PACS/CR live: April 2008 • Patient Scheduling: April 2008 • EHR live: May 2008 • EHR expansion: eRx, Physical Therapy, IP

  7. Preliminary Vendor/Product Selection • Willing and able to interface with existing HIS • Ability to modify the application by hospital staff • Flexible licensing to allow for part-time providers • CCHIT certified (Certification Commission for Health Information Technology)

  8. Final selection at WCH: May 2007 • Presented two vendors/products • Multiple demonstrations • Validated vendor references • Consulted legacy vendors regarding integration • RESULT: Both vendors relatively equal in functionality with no clear favorite • Needed money $$$

  9. Funding • HRSA CAHHIT $1.6M grant awarded to Illinois • Funds administered by ICAHN • Participants included WCH, STH and St. Mary’s Good Samaritan • Creation of PHIN: Patient Health Information Network

  10. Vendor/Product Selection • Vendor/Product Selection • HIE capabilities • Cost to purchase, implement & support • Dunn & Bradstreet • Technology requirements • Purchased via reseller in St. Louis (KIG) • Final decision by PHIN

  11. Legal Review of Contracts • Essential component • Vendor contracts always favor the vendor • Allow time for the legal review and associated negotiations with your vendor(s) • Can be very expensive

  12. Right People * Right Skills • Network Administrator • WCH hired an experienced NA in October 2007 • Previously outsourced this work • Clinical Informatics Specialist • WCH hired a clinician (RN) in January 2008 • STH hired a technician in October 2007

  13. Infrastructure Requirements • Wireless 102.11N • Terminal server • Network components • Slates/laptops/PCs • Disaster/backup planning • Server installation and configuration-virtual

  14. Pre-Implementation • Obtained CEO, board & provider support • Scheduled regular meetings • Offered training options • Offered hardware options • Provided test EHR environment • Strategized the “go live”

  15. Implementation: Go-Live • Scheduled patients at half load • Posted signs in patient areas • Provided vendor support • Provided dedicated support staff • Scheduled regular meetings

  16. Post-Implementation Analysis • Get stronger buy-in from CEO and board • Choose your battles • Know that no product will satisfy everyone • Know that things will get worse before they get better...but they will get better

  17. Post-Implementation Analysis • Address workflow issues prior to implementation • Deal with poor performers during the pre-implementation time • Set expectation and provide time for staff to use test EHR environment • Staff up for the implementation • Scheduled regular meetings

  18. Status • Patient Scheduling-April 2008 • PACS/CR-April 2008 • EHR-May 2008 • EHR expanded (eRx & PT/OT)-Sep 2008 • CHS/HIE- estimated launch date Dec 2009 • IP EHR- pending

  19. CONTACT INFORMATION Mary Ring, Project Director Illinois Critical Access Hospital Network mring@icahn.org Kim Larkin, CIO Washington County Hospital, Nashville, IL klarkin@washingtoncountyhospital.org

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