By Golly, It Works! EHR Success Story: Part 1
MARCH 02, 2010
Beyond Implementation: Using Electronic Records in Innovative Ways
So far I’ve sat in on EHR horror stories, implementation procedures, and all other sorts of ideas and advice for choosing an EHR. However, many physicians have already taken the step to implement a system, and some have actually not failed at it…yet, anyway. So, for those out there who are either chugging along with an EHR or who have failed once and have since gotten back on the horse, this one’s for you.
In the past few years, I’ve attended several conferences that either specifically focus on EHRs or at least dedicate a portion of the session to the topic. In consecutive years could honestly say that not much had changed—EHR implementation was being complicated by shady vendors, and physicians were frustrated by their failed attempts or totally disinterested in implementing because of hearing about the failed attempts of their colleagues. Legislation and the words “meaningful use” certainly did not simplify anything about the procedure. However, something is different this year. Success stories are popping up. And resolve is higher than it has ever been before. Perhaps physicians have accepted the inevitability of implementing and EHR and have resigned themselves to figuring it out one way or another, while also accepting that there might be frustration at certain points along the way. Either way, the mood has shifted, and this afternoon I heard two of these stories, and they are both worth sharing.
In the first scenario, Timothy Baker, Chief Medical Officer, Heart of Texas Community Health Center, shared a remarkable story about using an EHR to improve a lackluster childhood vaccination rate. Not too long ago, the Heart of Texas Community Health Center was not only below the national average in this, and he found an EHR that he believed would be able to accomplish his goals.
First, processes were put into place. Baker set up certain functionalities within his EMR to help focus on children’s vaccination due dates, and in-person processes were formed. No matter what the reason of the visit, children’s records were checked to see if they were up to date. Most of this responsibility was placed upon the nurses of the facility, and in instances where they failed to capitalize on bringing a child up to date, providers were notified via the EMR data, and in turn would approach the nurse to inform her of the miss. Baker also set up a functionality where he could produce a monthly report on which children were due for immunizations and could auto-generate a letter to the parents. He even had the capability to produce the letter in Spanish, as 15% of this particular subset of patients could only understand Spanish.
Within six months, the Heart of Texas Community Health Center rose above both statewide and nationwide averages, going from 72% to 83%. However, one month on the chart stood out; after the initial surge of success as the health center, one month saw the rate drop to the baseline. The reason? Turnover at the nursing position and an improper training in which the new nurses were unaware of the new procedures. This was quickly rectified, and the Heart of Texas Community Health Center now proudly boasts a childhood vaccination record that was helped in large part by the implementation of an electronic health record.
Story number two to come…