Electronic Health Records

Adoption & Implementation News

Success of a Step-By-Step EHR Adoption Approach at HealthNet

How do you eat an elephant? One bite at a time. HealthNet's Lauren Borgmann tells us EHR implementation is the same way -- one step at a time.

By Sara Heath

HealthNet, an Indianapolis-based health system, has seen enormous success with its EHR use in the five years that have passed since implementation.

Lauren Borgmann HealthNet

Since its EHR implementation, the healthcare organization has managed to successfully transition to ICD-10, attest to meaningful use, achieve a 230-percent return on investment, and maintain and coordinate care for patients across their numerous and diverse healthcare facilities.

Among all of this work, HealthNet has also recently received a HIMSS Ambulatory Davies Award and has managed to accomplish all of this all while providing care for some of the most vulnerable patient populations—children and the homeless.

As the state of Indiana's largest federally qualified health center (FQHC), HealthNet operates a total of eight primary healthcare centers, five dental clinics, one OB/GYN clinic, a maternal-fetal health center, an adolescent and pediatric care center, and nine school-based health clinics.

But how does HealthNet manage to achieve such great results with its EHR while delivering care to typically hard-to-reach patient populations? According to the organization’s Clinical Information Systems/EMR Program Manager Lauren Borgmann, HealthNet does this all one step at a time.

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“I remember talking to our Chief Medical Officer Dr. Donald Trainor about all we had done and all that we had yet to do back in 2011—so approximately one and one half years into our implementation—and he knew the expression, ‘how do you eat an elephant?’” Borgmann told EHRIntelligence.com in a recent interview, putting in common terms the enormity of an EHR implementation project.

“And the answer to that was one bite at a time,” she explained. “He went on to explain that we will complete this project one bite at a time as well. The only difference is that we are facing all elephants in the entire continent of Africa, and so it will take a lot of bites, but we will still do it one bite, or one step, at a time.”

HealthNet’s small bites began in October 2009 when the organization conducted its first eClincalWorks EHR go-live in a primary care clinic. Over the following five years, HealthNet slowly but surely installed EHRs in its various clinics, taking the time to pause and address problems as they cropped up, ensuring that these technologies were adopted with quality.

Borgmann credits much of their EHR implementation success to the organization’s well-prepared team. For example, prior to implementation, HealthNet sent its practice management analyst, EMR manager, and EMR analyst to their vendor’s headquarters for a five-week session which provided extensive training in both practice management and EMR certification.

Borgmann explained that this experience allowed HealthNet to truly understand the full scope of possibility made available through adopting their EHR.

“I would say without a doubt this is the most valuable tool in terms of helping us to understand the whole picture of what was available to us in eCW and put plans in place which has led to better documentation, data abstraction, more satisfied end-users, and ultimately the best EMR implementation possible,” she confirmed.

In addition to their preparation efforts, HealthNet installed their own in-house training areas. By investing in an office space that includes 27 computers designated for becoming familiarized with the EHR software, HealthNet was able to provide a state-of-the-art training experience for its employees, and continues to use it for new hires to ensure smooth quality transitions throughout the entire staff.

“This was huge in that it allowed [providers and staff] not only to develop a level of comfort in using the software, but it gave them the basic system knowledge needed to help develop tools within the system which would later become part of their everyday flow,” Borgmann maintained. “This helps with new employee satisfaction, and it  ensures that they are trained to do their jobs correctly form the very beginning using the EMR.”

HealthNet is still ironing out the kinks, even five years later, Borgmann said. However, the organization manages to implement effective strategies to optimize their EHR. One of these strategies includes provider templates, which standardize data input to help create meaningful data reports.

“[W]e’ve created a number of progress note templates, and have trained providers and staff on how and when to use them,” Borgmann added.

In order to make these templates effective for the end user, HealthNet consulted with providers from each of the organization’s specialties. This step was critical in effective implementation.

“Allowing [the providers] to participate in this process not only increased the usefulness of these templates, but also provider buy-in when it came to actually using the template,” she said.

healthnet mission statement

HealthNet has used all of these strategies to do valuable work throughout Indianapolis by increasing the quality of care for vulnerable populations such as pregnant women, infants, school children, and the homeless.

For example, HealthNet’s EHRs have helped them with their care for the homeless of Indianapolis, a feat that is none too easy for any provider.

Prior to adopting their EHR technology, the organization used paper documents to record health information for the homeless, which not only created a considerable burden for providers, but it hindered the quality of care being provided to this critical population.

“Until 2012, this care had always been documented on paper, meaning that the staff actually had to carry paper records of clients to the shelter with them that they thought they might see that day, not knowing ahead of time who would actually present for care at any individual clinic,” Borgmann told us.

Following EHR adoption, however, these providers were able to simply carry their laptops with them to the care facilities, and would be able to access patient information if they ended up seeing a patient they were not necessarily expecting that day. This also helped properly treat patients and increase quality care.

“Since these clients also routinely travel between shelters for care, once again our teams had immediate access to medical history such as medications, allergy lists, to enhance provisions of safe, cost-efficient, and appropriate medical care for every patient they were seeing,” Borgmann revealed.

Despite its successful implementation and use of EHR, HealthNet’s health IT journey has not yet ended. In order to continue to offer the quality care the organization presently provides, HealthNet will need to make changes alongside the ever-changing healthcare industry.

“We’re still eating our way through elephants. But we’re still marching on through this journey,” Borgmann concluded.



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