- EHR implementation can often be such a significant challenge to a healthcare organization that the thought of revving up concurrent programs that further alter the clinical workflow is unthinkable. Installing new medical device integration software during a third try at finding the perfect EHR sounds even less appealing. But at the University of Arkansas Medical Center, retooling both pieces of the health IT puzzle at the same time was a highly successful strategy.
Amy Hester, Director of Clinical Informatics and Innovation at the University of Arkansas for Medical Sciences (UAMS), explains how moving full steam ahead with both implementations concurrently not only helped staff members truly understand what would be expected of them in their new IT environment, but produced immediate and tangible improvements to patient care.
“We have been EHR users for several years, and we were on our second EHR,” Hester said to EHRintelligence. “We were getting ready to implement Epic enterprise-wide as our third system. We were already doing some device integration in our intensive care units, but we were handling that on our own and dealing directly with integrating data from the device vendors themselves. We found that to be a very dissatisfying and fractured process, and we knew that we didn’t have the framework in place to be successful with device integration on a larger level moving forward.”
After two unsatisfactory EHR systems put pressure on the organization to find the best possible fit, “we knew that failure was not an option with Epic,” Hester laughed, well aware that the company’s popular and effective infrastructure can also produce catastrophic consequences if botched. “We did have to push back our go-live date to make sure we got it all right – we had a timeline that we did not meet initially, but we ended up doing a big-bang go-live with the EHR on May 3rd of last year.”
“Device integration had to be a priority during that project, because so many other things start competing for your budget in an EHR implementation, and we didn’t want device integration to get sacrificed for other things that may have been seen as more important,” she added.
Rolling both projects into one seemed to make sense, since staff members would need to receive training on new workflow procedures for the EHR switch in any case. “When we did the training around Epic, we used our simulation center to create real workflows for tasks like admitting and discharging a patient,” Hester explained. “And so we incorporated device integration into that simulation training so that they were getting it all at once, and they would really be able to feel what their reality was going to be after go-live.”
“It was a win-win for everybody. We didn’t have to reengineer our education over and over, which can be very expensive. We didn’t have to sacrifice the staff’s time and work-life balance to get into those classes because, they’re usually doing that on the days that they’re off,” she continued. “It was really viewed by the staff as a thoughtful way for the administrators and decision makers to recognize that just because you’re going electronic doesn’t mean that you’re necessarily streamlining every single workflow, and in fact some of your workflows are going to become more time consuming than what it was on paper.”
Providing staff members with comprehensive and cohesive training allowed them to see that there were benefits to better integrating medical devices into the electronic workflow. “Device integration was kind of like a carrot at the end of the stick. In an EHR implementation, sometimes it feels like you’re getting whipped with the stick. Although we had been on an EHR for some time, we still had paper documents left over. Nursing, for instance, was still half on paper. So it was a nice reward for them that we invested in a technology that wasn’t absolutely necessary. It certainly wasn’t necessary for us to go live with device integration to be successful with our EHR implementation, but it sure did ease the burden on staff to get their work done.”
To learn more about how medical device integration improved data collection and patient care at UAMS, read the second part of this interview with Amy Hester on HealthITAnalytics.