No longer the culture to rely on paper

Indiana hospital partners with HMS to enhance adoption of EHR

Partnering with HMS for almost a decade, the 25-bed, critical-access Bedford Regional Medical Center in Bedford, Ind., recently made the transformation to an electronic health record (EHR). Together with HMS, the hospital has made significant strides in meeting federal requirements to qualify for EHR incentives, successfully launching products such as Computerized Provider Order Entry (CPOE) and encouraging adoption of these patient safety initiatives.

Since 2008, Bedford has expanded its EHR capabilities, fully implementing CPOE, medication bar coding, Picture Archiving Communication System (PACS) and Transcription. “We are close to a paperless environment, thanks to HMS,” says Tara Williams, RNC-OB, director of information services. “We all continue to work to meet the meaningful use regulations that dictate the standard of practice for EHR going forward.”

Getting on board with electronic health records

Williams oversees an eight-member department, troubleshoots technical issues and serves as a bridge between HMS and hospital staff.

She helped staff members make the transition to Clinical View, which streamlines Bedford’s patients’ medical records into an electronic, browser-based format. The module is integrated with several other HMS solutions, including Laboratory, Radiology, Transcription, Order Communications and Pharmacy. It allows any authorized clinician to gain access to a patient’s chart.

“It gives caregivers the most up-to-date look at clinical information such as a patient’s vital signs, lab tests and radiology results, their pharmacy profile—all from one screen and in real-time,” Williams says.

Embedded within Clinical View is HMS CPOE, which streamlines the order process and increases patient safety by reducing medication and legibility errors. The solution is a browser-based application providing physicians access to real-time results during order entry. Physicians are able to place orders from their office, home or anywhere else a secured connection exists.

Williams says CPOE is a vast improvement over the days of written orders that had to go through many sets of hands, compounding the chance of errors. “With CPOE, a physician’s order goes directly to the lab, X-ray or other ancillary department, cutting down on misreads. Doctors like that they can electronically sign their transcribed documents online.”

CPOE generates savings for the hospital in several ways. “Since everything is housed in the patient’s chart, we don’t duplicate tests,” she says. “If a physician goes to order something, he can see if it has already been ordered or performed. This continuum of care, with any work station having the patient’s record available on it, saves us and the patient money.”

Adoption strategy highlights Leadership support Flexible access to training Super-users lead the way Pocket user guides New hires taught new EHR culture

Encouraging adoption

Making significant technology changes and getting all stakeholders on board hasn’t always been an easy process, Williams admits. The leadership and culture of Bedford provide key support for these initiatives.

“When users pushed back against this new technology, we emphasized the ways it improves a patient’s experience, and how the process ultimately improves the way they work,” she says.

After working with the software, users are pleased with the workflow and the look of the technology, Williams says. “For those so used to a paper system, sometimes the electronic system makes some processes take a little longer, but the built-in safeguards allow the patient’s medical team to stop errors before they happen. Decisions that could cause a patient harm can be corrected right away.”

And when it comes to the care that happens at the bedside, the software increases efficiency. “Doctors can view transcriptions at the bedside,” Williams says. “A nurse uses the barcode scanning module to distribute meds at the patient’s bed, and care can be documented on a computer station right there, too.”

To promote the adoption process, Bedford has offered flexible access to training to get their users comfortable with the system and has used some of their more progressive clinicians to set an example for others. The hospital launched CPOE in stages, letting super-user doctors get comfortable with the technology first. It wasn’t long before other physicians were eager to implement the technology, too. Today, 13 physicians, including doctors in orthopedics, internal medicine, pediatrics, gynecology, and surgery, use CPOE at Bedford. Bedford is in alignment with meeting meaningful use requirements for 2011.

Bedford also has created pocket guides for new hires and physicians with helpful reminders of how to use the HMS software. Bedford’s Clinical View Pocket Users Guide, for instance, gives step-by-step instructions for entering patient information, viewing Transcription and other screens, and signing forms electronically. The IT staff makes it a priority to inform all personnel of the release enhancements for the software.

About a week after new hires start at Bedford, Williams’ team sits down and walks them through the different modules of the HMS system. “When someone new comes into the organization, they are taught the workflow and how HMS functions throughout our entire, in-house hospital system. They come in realizing that we have truly instituted an electronic health record, and that fact alone helps with adoption and acceptance. It’s no longer the culture to rely on pieces of scratch paper.”

The customizable features of the HMS solutions also help enhance adoption. Williams is quick to point out that the product can be tailored to different clinicians’ needs. “If a clinician needs a new template or form structured, or if he needs a new way to write his progress notes, we work with HMS to customize the product for these kinds of important day-to-day work processes,” she says.

Streamlining the process

Williams says Bedford “grew up on” the HMS system, but she applauds the fact that HMS doesn’t rest on its laurels.

“The infrastructure is fantastic,” Williams says. “People go to a big box store because they can get everything in one place, and it’s the same with HMS solutions. It’s a one-stop shop. You can launch one product and function in that product all day. You don’t have to launch another product to get info you need. I believe this ease of use is one of HMS’ strengths.”

Williams is encouraged that HMS takes customer suggestions seriously. “If we see something on our side and have an idea of how it could be better, we submit a user request. Each one of those items is considered. If it is a planned improvement, they tell us the timeline of the update.”

Benefitting from exemplary training and support

One of HMS’ key assets is 24/7 product support, Williams says. “We work with other vendors who are less than optimal in this regard. I know that when I call HMS, I’ll have an answer usually in less than 30 minutes.”

HMS also provides educational webinars and information on updates on a secure website. Williams and her team also rely on an HMS account manager who makes monthly conference calls and visits to monitor technical changes and give the latest on future upgrades. “We’re pleased that HMS is compliant and understanding of our workflow. Their support is fantastic.”