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Migration to an Electronic Medical Record at

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http://www.cpsinet.com/Health Leaders Oct 2004 Article.pdf ... Health Leaders magazine Sept 2005 edition, page RT 9. http://www.bmh.org ... – PowerPoint PPT presentation

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Title: Migration to an Electronic Medical Record at


1
  • Migration to an Electronic Medical Record at

2
Madison West Virginia is Located
3
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4
1999
  • Looked at large market HIT
  • vendor.
  • Plan to merge with tertiary center
  • who was purchasing system from
  • same vendor.
  • Quote of 250,000 system too grand for small
    rural facility

5
January 2002
6
March 2002
  • Reviewed possibilities of expanding current
    information system, which was limited to
    registration/accounting/billing.

7
Spring/Summer 2002
  • Initial HIT vendors reviewed.
  • Deemed beyond expertise of current staff to
    determine appropriateness, affordability for
    all departments.
  • Hired IS consultant a 3rd vendor was added
  • 2 of 3 original vendors invited back to demo
    again allow for staff questions
  • Proposal submitted

8
Fall/Winter 2002
  • Decisions take time and effort
  • Site visits phone conferences with other
    facilities using vendors
  • Multiple large and small staff group meetings to
    discuss pros cons of each vendor
  • Close review of financial and product comparisons
  • Site visit to vendor headquarters by select
    departments, administration and IS consultant
  • Final contract negotiations signing 12/24/02

9
January 2003
  • Selection of implementation methodology
  • department by department,
  • all departments at once or
  • select groups of departments/modules
  • IS consultant recommended designation of
    Implementation Coordinator someone to be
    exposed to all modules

10
April 2003
  • Implemented Financial, Order Entry and Ancillary
    Test Resulting, Pharmacy, Medical Records,
    Registration and Business Office Outsourcing

11
July 2003
  • Implemented Point of Care (POC) documentation for
    nursing and ancillary departments and Bar-Code
    Medication Administration

12
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13
July 2004
  • Was asked by vendor to beta test new module at ½
    cost
  • This was a bad move because
  • Module was not capable of expectations
  • Built staff frustration

14
October 2004
15
Web-based Virtual Chart
16
March 2005
  • Implemented Computerized Physician Order Entry
    (CPOE)
  • BENEFITS
  • Illegibility
  • Reduction of clarifying phone calls to physicians
  • Reduction of medical errors
  • Reduction of duplicate therapy
  • Electronic authentication of orders, no manual
    signature required.

17
May 2005
  • Implemented Physicians Office Module
  • Satellite clinic usage
  • This will connect physician offices and clinics
    to the in-house system

18
Other Electronic Systems Used
  • Quantros Web Based Occurrence Reporting System
    incident reporting
  • Carelearning Web Based Employee Education
  • Email
  • Fast Internet Access Cable internet
  • T1 Circuit for Business Office Outsourcing
  • Fiber-optics from Main Server Room to Hospital
  • Cat 5 cable runs throughout hospital

19
Future Planning Fall 2005
  • Implementation of (EWS) Enterprise Wide
    Scheduling
  • Electronic documentation System with interface
    for ED, or the usage of a paper system that will
    be scanned into a record.

20
Current Modules in Use at BMH
  • Patient Management
  • Registration/Admit, Discharge Transfer
  • Patient Accounting
  • Medical Records/DRG/Transcription
  • Chart Deficiency/Location/History
  • Master Patient Index
  • Electronic Remittances
  • Home Health Administration

21
Current Modules in Use at BMH
  • Clinical
  • Laboratory Information System
  • Laboratory Instrument Interfaces
  • Radiology Information System
  • Pharmacy Clinical Monitoring
  • Pharmacy
  • Patient Drug Education

22
Current Modules in Use at BMH
  • Financial Management
  • General Ledger
  • Accounts Payable
  • Materials Management
  • Executive Information

23
Current Modules in Use at BMH
  • Patient Care
  • Order Entry/Results Reporting
  • Care Plans
  • Patient Acuity
  • Point of Care System
  • Electronic Forms
  • Chartlink
  • Computerized Physician Order Entry
  • Medication Administration Verification

24
Current Modules in Use at BMH
  • Operational Software
  • Electronic Mail
  • Client Ware Networking
  • Ad Hoc Reporting
  • Automated Registration Doc System
  • Code Finder Interface
  • Document Scanning
  • Digital Signature Capture
  • Electronic Purchase Order
  • Archival Data Repository
  • Disk Mirroring
  • Auto Fax
  • Application Training System

25
Current Modules in Use at BMH
  • Service Modules
  • Internet Services
  • Business Office Outsourcing
  • Statement Outsourcing
  • Collection Outsourcing

26
Success Depends on
  • Key Players Board, Medical Staff, Administration
  • Must have buy-in from revenue generating dept.
  • Involvement and participation in every level of
    the process---invite end-users, not just
    managers
  • Seek champion from all departments
  • Seek facility champion
  • Minimum capitol 500,000 hardware/software/insta
    llation/training
  • Annual expenditure - 100,000 maintenance
    contracts, hardware upgrades/replacements
  • Leasing is a good alternative

27
Success Depends on
  • Timeliness of conversion data
  • Involve IT staff for opinions/suggestions
  • Evaluate many different vendors with varying
    capabilities/pricing
  • If needed make changes to the initial vendor
    contract
  • Integrate entire facility into 1 system with all
    capability
  • Choose vendor who sales/supports both hardware
    and software
  • How adaptable is the vendor with suggestions for
    changes to the system
  • Ask about vendor user groups

28
Success Depends on
  • Ask about any hidden costs in upgrades
  • Get list of compatible interfaces from whatever
    vendor you select

29
3 months before install
  • Assess employee computer knowledge and training
    required to be successful
  • Offer basic computer skills training classes if
    needed

30
Additional Facts
  • No grant money used financed 500,000
  • System is mobile Can be moved to another
    building if planning construction
  • 5 10 of net revenues should be budgeted annual
    for a EHR system
  • Medicare Medicaid will require EHR in the next
    10 years for program participation

31
Articles Links About Boone Memorial Hospital
HIT System
  • http//www.cpsinet.com/Health20Leaders20Oct2020
    0420Article.pdf
  • http//www.hospitalconnect.com/ahanews/jsp/display
    .jsp?dcrpathAHANEWS/AHANewsArticle/data/AHA_News_
    050627_Rural_hospitaldomainAHANEWS
  • Health Leaders magazine Sept 2005 edition, page
    RT 9
  • http//www.bmh.org/
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