Health IT Pulse

Jul 28 2011   11:30AM GMT

EMR rollout requires team effort, flexibility

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EHR attestation process
electronic health records

While switching paper records to electronic medical records (EMRs) often brings trepidation among doctors, practices and hospitals alike, a successful implementation out of Wisconsin shows it can be done not only for a few doctors — but for all doctors.

Western Wisconsin Medical Associates, or WWMA, has all its doctors using EMRs. This means that 55 doctors are now using EMRs regularly and it begs the question: how was the transition achieved?

The answer is: a collective effort.

Gregory Young, M.D., a family medicine practitioner at Hudson Physicians, a subdivision of WWMA, said the process involved nearly the entire staff. For such an overhaul, Young projected that 85 percent of the facility’s medical records were maintained by care coordinators, receptionists, medical records workers and other staff. He credited Steve Kronmiller, WWMA’s manager of information systems, for helping spearhead the changeover beginning in 2009.

Christopher Tashjian, M.D., president of River Falls, Ellsworth and Spring Valley Medical Clinics, echoed Young’s sentiments that  it takes an entire clinic to make the transition.

“From the transcriptionists who knew their job would be changing, to the front office, to the nursing staff, to the lab — everyone pitched in to make the process successful,” said Tashjian, who was one of the earliest physicians to attest to meaningful use criteria. Additionally, all staff had to adapt — not just doctors, even though some used paper processes for nearly 30 years.  “This flexibility is what helped us most in our ability to use the EMR to improve care, rather than to just duplicate paper in the electronic world.”

The collective effort goes beyond internal workings and resources, too. WWMA partnered with Cerner Corp. and the Wisconsin Health Information Technology Extension Center (WHITEC) for the rollout.

Equally important to implementing an EMR system is interoperability. With a handful of clinics, Tashjian said that achieving a high level of interoperability is not only imperative for better care and improved communication, but it helps providers who practice in multiple practices.

“Interoperability between WWMA’s five sites was an objective, not a concern,” he said. “We designed the system so that a patient could show up in one site and all their information from the other site would be available at that visit.”

With the new system up and running, doctors are now able to do particular functions on a single computer that can’t be accomplished in paper workflows, such as:

–    Review a patient’s vital signs
–    E-prescribe directly to a pharmacy
–    Check for allergies (an alert will show if patient is allergic to a prescription)
–    Order and review lab test results
–    See radiology reports and X-Rays

These functions play directly into the hands of WWMA’s mission: using an EMR system as the vehicle to deliver safer care. “We needed to start doing some data management; we needed to start really managing our patients and helping them get better care,” he said.

Not bad for an independent group who, in the words of Tashjian, practices under the shadows of the big systems.

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