Critical Access Hospital Makes Quick Work of EHR Implementation, Meaningful Use Attestation By Nathan Blad, CFO
Renville County Hospital and Clinics
Olivia, Minn.
The implementation of an electronic health record (EHR) system may be one of the most challenging projects a hospital will ever encounter. Add the task of meeting meaningful use requirements to qualify for incentive funds provided through the American Recovery and Reinvestment Act (ARRA) and the endeavor becomes even more daunting. As a small, rural hospital, we saw stimulus dollars as a way to fund the implementation of an advanced health information technology to deliver better care to our community.
Looking Beyond Conspicuous Challenges
Here at Renville County Hospital and Clinics, which serves as a critical access hospital, we knew we had quite a challenge ahead of us. Our goal has always been to implement an EHR that could help us achieve the expected clinical and patient safety benefits associated with the technology, but resources and funds were a hurdle.
Despite the conventional wisdom that small rural hospitals would struggle to attest to Stage 1 meaningful use, we decided not to delay our attestation, but to target qualifying for funds in 2011. Fortunately, we discovered we could quickly and successfully achieve EHR implementation and adoption success, despite limited time, financial and human resources. In fact, we were able to go from signing the contract for our new EHR to attestation in under 20 months.
We started by developing a comprehensive plan that included implementing the technology, training and process redesign required to meet the goals and objectives of the initiative.
Lessons Learned Along the Way
With the plan providing a roadmap, we set about our journey and discovered some unexpected lessons that may help other hospitals move more expediently toward meaningful use:
Lesson #1: Focus on long-term goals. Many industry prognosticators predicted it would be easier to demonstrate meaningful use with a hospital’s existing system instead of implementing a new solution. However, with the help of a third-party consultant, we realized that despite the fact that our legacy system might have been able to lead us to Stage 1 attestation, it simply would not be capable of helping us comply with the more advanced reporting requirements anticipated in subsequent stages. And, it did not provide the functionality that ultimately would be required to bring about improved clinical care and patient safety.
Lesson #2: Create a “common vision.” As part of the evaluation process, we invited four companies to provide demonstrations to all of our system users. Staff members provided both qualitative and quantitative feedback used in making our final decision.
Including all of the staff members in the decision-making process proved to be a great advantage during the implementation and meaningful use attestation. Because every member of the staff bought into the decision to go with McKesson’s Paragon® hospital information system, they had a vested interest to see the system succeed. We believe this “common vision” was the single most important factor attributable to our successfully swift implementation and attestation.
Lesson #3: Communicate often. During the EHR implementation, we held weekly roundtable luncheons where supervisors and super users talked about their successes and hurdles using each module of the system. These meetings enabled various users to work in concert instead of approaching the implementation in silos. Such transparency led to a smooth implementation of the interdependencies inherent within a robust health information system such as Paragon.
Lesson #4: Develop a meaningful use team. Due to the aggressive Paragon installation and meaningful use attestation timeline, we chose to call upon a small team of our most advanced users to implement our core objectives. This small, three-person team brought a level of objectivity that enabled us to effectively analyze progress and move the project along expediently. Isolating this team from the traditional challenges within an immediate post go-live environment allowed them to efficiently prioritize the initiatives required for a successful attestation.
Small Hospitals Can Find Success with Health IT
Our EHR and meaningful use journey proves that critical access hospitals can quickly achieve success with advanced information technology platforms.
Consider the following: We replaced our legacy information system with a new solution, going from signing the contract to go-live in just 15 months. Within just one month after go-live, we met the core objective requirement that 30% of medication orders be entered via a computerized physician order entry (CPOE) system. A mere four months later, we attested to meeting the government’s Stage 1 meaningful use requirements. It also was the first big step to bringing our quality and patient safety goals to fruition.
Now we’re looking toward our Stage 2 journey. And, with the incentive funds supporting our efforts, we are more open to implementing other technology solutions — and ultimately staying on the right side of the digital divide.
Nathan Blad has served as the chief financial officer for Renville County Hospital and Clinics for the past five years. In this position, he is responsible for the oversight of all financial functions, business office, materials management and health information management for the 25-bed critical access hospital. In addition, he leads the hospital’s information systems strategic planning and implementation efforts. Mr. Blad holds BS degrees in Economics and Accounting from the University of Minnesota-Twin Cities and Southwest State University, respectively, and recently earned an MBA from the University of Minnesota. Mr. Blad is a member of the Hospital Financial Management Association.
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