You Can Do It — Using Collaboration to Get to
Meaningful Use By Joe Freudenberger
Chief Executive Officer
OakBend Medical Center
Richmond, Texas
Right now, healthcare leaders are looking at health reform and deciding how to address the many initiatives that are demanding attention and resources. There are a few choices: meet the challenge head-on as an opportunity to make improvements, delay your efforts, or do the minimum to comply with requirements. We chose to be among the first health organizations to attest to meaningful use, and we received our stimulus funds from the Centers for Medicare & Medicaid on Dec. 22, 2011.
Provide an Infrastructure to Support Change
Over time, OakBend’s market has become more competitive as larger health organizations have expanded into our area. We invested in advanced technology to help us provide the best quality care, and to keep and attract physicians and nurses. In 2009, we replaced a hospital information system that we had been on for over 18 years with McKesson’s Paragon® hospital information system. Paragon offered advanced functionality on an industry-standard Microsoft platform that we saw as easier to implement, learn and use. Additionally, we were attracted to the advanced clinical products and the focus on meeting the rapidly advancing standards of the industry.
We took a unique approach to implementation and did a “big bang” replacement that enabled us to go live within 9 months of start of the build. Adoption of the system was swift, with 100% of nurses using it within the first month, and 100% of physicians using it in three months. With this experience, we knew we could adapt to the EHR incentive program requirements and successfully apply for Stage 1 stimulus funds in federal FY2011 through the Medicare and Medicaid EHR incentive programs.
Key Strategies – All Hands Engaged and on Deck
We found there were some key strategies that helped us achieve our meaningful use goal:
As a leader in your organization, even if you don’t have an IT background, only you can show
the way. I chose to chair our IT steering committee meetings so as to demonstrate my
commitment to the initiative and help generate energy and excitement related to this change.
We sought to maintain an atmosphere of complete transparency and honesty by clearly identifying
the challenges we faced and how we could address them. We maintained regular
communications with our employees to reinforce our goals and keep staff informed and motivated.
We engaged all levels of management in the change, from the charge staff to the CEO, making
them accountable for the build associated with their department and incorporating
that into their annual goals for that year.
While some might view it as an IT project, meaningful use is everyone’s responsibility.
For staff to take ownership and adopt change, they must be involved in the design of the
system. Early on, we engaged department leads so they understood how the certified
EHR technology would be implemented across the organization and could raise any
issues upfront.
Before installing an upgrade, our department heads demonstrated its efficiency, tested it to
evaluate the changes and their effect on care and efficiency, and evaluated whether they could be
absorbed into the department workflow. This helped us attain quick adoption.
A key factor in our success was our approach to staff training. Much of what is learned in a
structured training program is forgotten by the time of implementation. We provided a brief
structured introduction to the system, with the bulk of the training done in the department
during slow times. Accountability to ensure that staff were properly trained was vested with
their Department Head, who was required to personally test staff on their competency to use
the system before it was implemented.
Results
In addition to attesting to meaningful use and qualifying for EHR incentive funds, we experienced other benefits:
Our CMS core measures improved with better data collection and analysis to support
process improvement.
Our nursing directors have a better handle on what our nurses are doing and when.
Our nursing documentation has improved significantly.
Our chart completion delinquency rate declined from 15% to 3%.
Our physicians say the technology helps them monitor patient care more thoroughly and efficiently.
Anything Is Possible through Collaboration and Teamwork
For OakBend, the foundation of success is to create a culture of hard work, collaboration and teamwork – a collective “we can do it together.” My perspective is that if you want an “A” you have to put in an “A” effort.
Joseph Freudenberger is the chief executive officer of OakBend Medical Center in Richmond, Texas. He has spent more than 23 years in healthcare — the first 10 as a consultant with Deloitte & Touche, working with major healthcare systems around the country. For the last 15 years, he has worked as CFO/COO and now as CEO for both for-profit and non-profit hospitals in Texas. Over his career, he has at one time or another overseen every department in a hospital, with particular expertise in clinical and non-clinical operations reengineering, revenue cycle operations, and information technology implementation and adoption. He has been a member of the Healthcare Financial Management Association (HFMA) for the last 16 years.
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reached the tipping point for
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As a leader in your organization, even if you don’t have an IT background, only you can show
