News & Events
Ephraim McDowell Health Has an All-STAR EHR Implementation
June 17, 2010
Staff at Ephraim McDowell Health in Danville, KY accomplished something quite remarkable earlier this spring. Just how remarkable, they’re just beginning to realize. In a process that was at least 20% shorter than the standard EHR implementation, EMH staff launched an integrated Electronic Health Record (Medical and Practice Management by LSS and MEDITECH) that now connects six of their clinics with their hospitals – Ephraim McDowell Regional Medical Center and Ephraim McDowell Fort Logan Hospital.
Just as significantly, not only did EMH bring live three pilot clinics on the first day, they rolled out nearly all of the available software functionality at once.
“Three pilot clinics going live at once is an accomplishment,” says Stacey Payne, LSS Senior Applications Specialist and the site’s implementation specialist. “Three clinics going live with so much functionality is even more impressive.”
Since their initial implementation of three clinics in April, three more clinics have gone live, all using a full complement of MPM’s functionality, including documentation (using Zynx Ambulatory templates), scanning, ordering, and, most impressively, Health Maintenance/Disease Management and E-Prescribing. All on their first day of live software use.
“We were fully functional within an hour of opening the door,” says Angela Allen, IT Operations/Project Manager at Ephraim, and MPM team leader. “It really was such a smooth implementation.”
A Strong Core
LSS staff praise EMH’s highly organized and focused core team for their exceptional planning, training and testing. More than a half year before their implementation even began, Allen and her team were engaging physicians and letting them use pieces of the software. Three months prior to their go-live they created detailed process maps to understand the nuances of each clinic’s workflow. Weekly meetings with clinic managers to discuss standardizing processes wherever possible, and a lot of one-on-one time between IT staff and providers, helped maintain positive momentum, gain organizational buy-in and strengthen working relationships.
Jay Dering, LSS Director of Client Services, observes: “All of the staff who have worked with the organization have been impressed by how proactive they’ve been with their implementation of the software. They’re really focused on the end goal, doing a thorough job testing, preparing and getting their providers the training they need to effectively use the system.”
LSS staff also acknowledge the powerful and committed core team Ephraim put in place, which consisted of four clinic managers and their four IT counterparts, along with two provider champions, a pharmacist and a clinical analyst, who, according to Allen, “effectively played the provider when the physician champions weren’t available.”
A STAR Plan
In addition to Ephraim’s own preparation and organization, Allen attributed her organization’s smooth EHR implementation to effective communication between her team and her LSS implementation and service staff – on top of a well-designed MPM implementation plan. That plan, and the corresponding communication, training and on-site visits, helped EMH have a “STAR” implementation.
Specialized Training and Accelerated Response (STAR) is a new approach to clinical software implementations developed by LSS. STAR involves the delivery of “standard content” to customers preparing to implement the software, along with more intensive, hands-on site visits by LSS implementation staff.
Standard Content
Prior to STAR, LSS would install code at customer sites by delivering a “clean” system – that is, a system without any dictionary entries. Core team staff from customer organizations would visit LSS for dictionary training and return to their facilities to begin setting up their dictionaries.
“While there are some benefits to starting with a completely blank slate, we found that customers would sometimes make mistakes after coming to LSS for training and then going back and building their own dictionaries,” says Jacqueline Hager, LSS Senior Applications Specialist and one of the developers of the STAR program. “They would often want to make changes to dictionaries ‘mid stream’ and this could slow things down.”
So Hager and her colleagues began to study how organizations with the most successful MPM implementations approached dictionary building. They looked at similarities across successful sites to create a list of the most common dictionary entries for the most complex dictionary builds.
“The Ambulatory Order Management (AOM) procedure dictionary, for example,” says Hager. “With 800 to 2,000 procedures, this dictionary could take weeks to build. Now we deliver this dictionary with standard entries and we can help customers build it out in two days and cycle test it on the third day.”
Hager says dictionary building in this fashion is more like editing than writing from scratch. Customers can modify entries if necessary but most can simply be supplemented with their own unique entries.
In addition to the AOM procedure dictionary, Zynx Ambulatory template and Access dictionaries come “pre-loaded” with standard content. All standard content goes through a thorough review process that involves LSS physician advisors and a registered nurse practitioner.
“Sites need to get up and running more quickly than ever to meet ARRA requirements,” observes Hager, “And we’re doing what we can to help them implement not just more efficiently, but ultimately more effectively, too.”
On-Site Training
The second element in the STAR approach to implementation involves on-site training and testing by LSS implementation staff. Instead of having customers learn on training software at LSS, customers implementing MPM clinical applications are now trained at their own facilities in their own systems. The result is better retention and ultimately better application of the knowledge.
“Having LSS staff come to us for training and testing was so valuable,” remarks Allen. “We really benefited from working in our own system and having LSS staff on hand.”
Ephraim’s LSS implementation team, which consisted of two implementation specialists, traveled to Danville during the dictionary-building phase, for applications training and during their go-live. This meant they were on-hand and available during key phases in the implementation.
Allen recalls that one provider was struggling on the second day following go live. “Stacey [Payne, LSS Senior Applications Specialist] sat down with him right there to show him the short cuts. It made a huge difference because she could take him through the process step by step,” says Allen.
In addition to on-site training, LSS implementation staff help customers complete their dictionary builds and cycle test the software.
"It takes a little more work up front on the part of our staff,” observes Hager, “But we more than make up for it on the back end when sites have smoother implementations and better trained staff.”
Since Ephraim’s go-live earlier this spring, several other MPM customers have since implemented under the STAR approach, which has become the standard implementation methodology at LSS. Implementation timelines have been further streamlined and are now up to 40% faster. More importantly, they’ve proven even more effective because dictionaries are set up effectively from the very beginning. And what’s not to like about an implementation that’s both faster and smoother, while positioning customers better for long-term success?
Teamwork
Clearly, effective EHR implementations are still a significant undertaking for both the health care organizations adopting the software and the vendors installing and supporting it. But sound planning and project management on the customer side, combined with an effective implementation plan and communications, can help sites implement EHRs more efficiently and effectively.
LSS Data Systems
6423 City West Parkway
Eden Prairie, MN 55344
952.941.1000
www.lssdata.com
