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How EHR Implementation Challenges Pay Off in the Long Run

“I think that the hardest piece of this is that it infuses an entirely different mechanism into a relationship that has gone on for hundreds of years between a doctor and a patient."

By Sara Heath

Successful EHR implementation is hard work, but the payoff is eventually worth it, according to the CEO of Avera McKennan Hosital & University Health Center.

avera mckennan hospital ehr user

Avera McKennan was recently recognized with the HIMSS Stage 7 recognition, which CEO Dave Kapaska ties to its long history with EHR use dating back to its initial implementation in 1999. Although the hospital implemented its EHR to make documentation and physician workflow easier, Kapaska says it has not always been the easiest journey.

“I think the major goal was to choose a product and implement a product that would make the lives of our physicians and nurses and other caregivers easier on the documentation side,” he told EHRintelligence.com. “I don’t know that anyone that’s entered this realm has found that that was the case. It’s such a major transition from the old paper world.”

Wedging this new piece of technology in the middle of the provider-patient relationship presented several challenges, Kapaska said.

“I think that the hardest piece of this is that it infuses an entirely different mechanism into a relationship that has gone on for hundreds of years between a doctor and a patient. I think that was the greatest obstacle. Honestly, culturally, it really is different,” he explained. “Realistically, it was a challenge. It’s not easy, and I don’t think it will be easy going forward necessarily.”

READ MORE: Physicians Divided on Benefits of EHR Implementation, Use

So how did Avera McKennan achieve EHR implementation success amidst all of these obstacles? By creating physician buy-in by looking toward the biggest EHR advocates within the health system.

“We started a couple of small clinics where we knew we had strong advocates to start with and built it from there. They were our advocates as we moved forward,” he said.

By initially working with physicians who believed in the power of EHRs, Avera McKennan was able to create a ripple effect throughout the health system. To help ease the transition, Kapaska says the hospital worked to provide adequate support for its providers who may have been struggling with the new EHR system.

“We tried to put as much help at the shoulder as we could so they weren’t left swimming at sea with the process,” Kapaska said. “[We] just committed ourselves both as on the administrative side but most of all on the physician side to get this to a point where it was functional and efficiently effective.”

Ultimately, the health system was able to focus on the eventual positives EHR use would bring. Harkening back to their initial implementation goals, Avera McKennan focused on how EHR use could help documentation and make physician lives easier by digitizing all of their records, making the data available to anyone at any time.

READ MORE: 75% of Practices with NPs, PAs Have Adopted EHRs

Specifically, Kapaska and the rest of Avera McKennan remained mindful of its first encounter with digital health – its use of the Pax X-ray system, which made x-rays digitally available to the hospital’s providers.

Initially, providers saw many complications with the program, such as forgetting their passwords or not being able to navigate the interface. However, they eventually saw the payoff of being able to so conveniently access the x-rays.

“And then as we went on, what people found is that my x-rays are always available to me wherever I am. It almost became passé that ‘well sure, that’s how it works,’” Kapaska recalled.

Avera McKennan sought to keep that experience in the back of their minds as they worked to make sense of their EHR.

“That was a reminder that that was our goal for the entire record all the time, that it would be available to you at any time whether you were making a phone call or seeing a patient in a hospital or anything in between,” the CEO said.

READ MORE: Will EHR Optimization Projects Take Center Stage in 2016?

Presently, Kapaska credits many things for the widespread adoption of this kind of technology, including the meaningful use programs. By putting a monetary incentive on EHR adoption, the meaningful use programs have encouraged different providers and practices to face the challenges associated with these technologies and reap the benefits.

“Things like meaningful use – that would be a primary one – infused dollars in. So there was a reward mechanism to move in that direction, and I don’t think we can underestimate that,” Kapaska explained. “The meaningful use program was obviously an infusion of dollars that said, ‘hey, if you don’t do this, you’re going to leave X amount on the table.’ And it helped keep people’s attention, so I would give them some credit there.”

Despite the widespread EHR adoption meaningful use has sparked, the industry still needs to improve how EHRs are used. Providers still face the challenge of seamlessly integrating these technologies into the prevailing relationship between the patient and provider.

“You can’t expect the EMR folks to put all of that into a box and it be perfect on day one,” he told us. “So we have to continue to work together to find a way to more cleanly move the information process because as a physician, it does infuse an entirely different instrument into a relationship between two people. That’s disruptive in its own right, but it has great potential and I think we just have to recognize that.”

Kapaska doesn’t think the job is done at Avera McKennan, either.

“This isn’t like climbing Mt Kilimanjaro and HIMSS Stage 7 means you’re there,” Kapaska concluded. “I think we still have work to do and think we will for a long time, but it’s working well and we’re glad to be where we are and are looking forward to where it can take us in the future.”

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