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EHR Training and EHR Go Live Video from Via Christi Hospital

Posted on June 5, 2014 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve seen a number of creative EHR go live videos from various hospitals, but I was really intrigued by the following two EHR training and go live videos for Via Christi hospitals. I found them really interesting because you could hear the first person perspective on what was happening. Certainly people see a camera and say things a little bit different, but I think these videos did a pretty good job capturing the mix of emotions that happen when someone moves to EHR.

Via Christi is part of Ascension Health, and it’s the largest health system in Kansas. It has about a dozen hospitals across the state, several more clinics and senior centers. They had 15 different EHR systems they turned off when they switched to Cerner’s EHR. The Kansas paper reported that the new EHR cost $85 million.

This first video talks about the EHR training that occurred and got comments from a lot of doctors about the change. I found it interesting that they say each doctor got 14 hours of training.

This video talks about the go live. I like the idea of celebrating events like an EHR go live. This felt a little too “made for TV” for me, but there are some really interesting perspectives including the project manager who’s watching the timelines, the IT person who’s just ready to flip the switch, and the nurse that’s not sure what to do with paper while they do the cut over.

Thanks to Via Christi for sharing a bit of their experience moving to Cerner!

Jan Patterson, Office Manager of West Broadway Clinic – Force Behind its MU Implementation and Attestation Process

Posted on June 29, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

West Broadway Clinic has three physicians and two PA’s – all three physicians successfully attested to Meaningful use on April 20, 2011. The practice encompasses multiple specialties including family medicine, internal medicine, endocrinology, diabetes, women’s healthcare and offers onsite x-ray, dexa scan and vasectomies. The following interview is with Jan Patterson, the Practice Manager who drove the MU process and attestation.

1.    How did you learn about and select Cerner as your EHR?

At West Broadway Clinic in Council Bluffs, Iowa, we learned about Cerner Corporation through a local hospital. After extensive research into Cerner and several other vendors, we made the decision that the integration of Cerner’s Practice Management System and Ambulatory EHR would be the most beneficial to our organization.

2.    What’s your take on EHR certification and did that influence your EHR selection process?

The EHR certification is a vital piece for being able to meet the CME incentive requirements, and we feel that we are practicing better medicine and using our EHR solution more efficiently after receiving certification. We selected our EHR well in advance of the reporting process, so it was not a major influence in the selection process. Still, we have been very pleased with how efficient our EHR solution has been with assisting us in reaching certification.

3.    How long has your office been using an EHR?  Is this your first EHR?

West Broadway Clinic started using an EHR in May of 2008 when our office opened. Prior to the clinic opening the providers were not using an EHR – but the providers made it an initiative to start the clinic on an electronic solution. We knew we would be up and running with an electronic solution on day one. This included an EHR and practice management solution.

4.    Would you walk us through the process you followed to meet the meaningful use requirements and how did Cerner assist you in the process?

In order for West Broadway Clinic to be able to meet the Meaningful Use requirements an extensive amount of time was spent by the practice administrator attending webinars provided by Cerner Corporation regarding Meaningful Use, as well as researching the CME website and examining materials available through Medical Group Management Association, MGMA. In addition, Cerner arranged a Meaningful Use summit at our office for our office along with several of the Cerner user groups in our area – this consisted of several Cerner associates highlighting important parts of Meaningful Use, answering questions and making suggestions to assist with the process to successfully attesting. Upon compiling the requirements, time was spent one-on-one with both the providers and the clinical staff to ensure that everyone fully understood the requirements and how to use the EHR to meet the requirements.

5.    How many of the meaningful use requirements were you able to meet with little or no effort because you were already doing them? Did the Cerner EHR affect this?

West Broadway Clinic was able to meet 9 of the meaningful use requirements with little or no effort since as were already conducting several of these requirements through the use of our EHR. The use of the Cerner EHR and the elements that were already built into the EHR were the major factor we were able to meet these requirements so easily. Additionally, as we ran into any issues – we were able to contact Cerner’s Meaningful Use team (a group of designated associates) to assist, which eased the process.

6.    Which meaningful use requirements did your clinic find most challenging to meet and why?

Probably the most challenging Meaningful Use requirement for our clinic was encouraging all of the providers to use the electronic prescription function. However, once they understood the necessity of using electronic prescriptions and became comfortable with the function they have continued to increase the number of electronic prescriptions they are sending to the pharmacies.

7.    How long did the actual process take for you to fully comply with the meaningful use requirements?

West Broadway Clinic worked in earnest to be fully complying with the Meaningful Use requirements as quickly as possible after the beginning of 2011. These efforts allowed us the opportunity to be able to attest on April 20, 2011 – two days after attestation opened.

8.    Is meaningful use of a certified EHR helping your patients receive better care? Why or why not?

West Broadway Clinic has seen many positive changes in patient care with the use of a certified EHR. With the use of Cerner’s Ambulatory EHR our staff has the ability to have the most current visit information and patient history at our fingertips. Patients receive more continuity of care due to the fact that regardless of what provider they are seeing within our office the provider can quickly and easily track what services and/or medications a different provider has provided the patient. We deliver a better quality of care and we’ve enhanced safety measures through our use of the EHR. Components such as eprescribe, medicine/drug interactions, allergy checks, complete documentation, immunization schedules, growth charts, etc., have made us more efficient throughout the office from billing to practice management to prescribing medications and providing more thorough care in the patient’s room.

9.    What was the driving motivation for your clinic to show meaningful use?  And why be one of the first to show meaningful use?

West Broadway Clinic is committed to providing excellent patient care and providing patient’s with the opportunity to benefit from the latest in technology. With meaningful use of an EHR our patients are afforded these opportunities. By being one of the first groups of providers to meet the Meaningful Use requirements and report on them successfully, we are further able to show our commitment to our patients and their healthcare.

10. As a practice manager, what techniques did you use to get your physicians on board with meaningful use and EHR?

As a practice we had been discussing Meaningful Use for over a year and as the time grew near to implement the process the physicians were fully aware of the expectations and requirements and the benefits that would be provided to our patients. A lot of communication went into ensuring that all of the physicians were on board.

11.  Would you recommend that every health clinic show meaningful use and adopt an EHR? Why or why not?

After being on an EHR for more than three years I cannot imagine trying to function efficiently with a paper system. While the training period was stressful at times and it took the physicians a while to adjust, the benefits far outweigh any of the pain points. In addition, the opportunity to be able to transmit and receive patient information from other facilities in the future will only continue to enhance our patient care and the delivery of quality patient care is why we are practicing medicine in the first place.

12.  For all healthcare professionals reading this interview, what advice would you give them in starting the meaningful use process?

For anyone starting the Meaningful Use process, my advice is to first gather all of your information and facts. It is vital to be clear on the direction you need to take in order to ensure that all of the requirements are being met. In addition to thoroughly explaining all of the requirements to your physicians/staff and gaining their buy-in communicate with your staff and ensure that they fully understand the benefits and the necessity of meeting the Meaningful Use requirements, which is primarily to use your electronic records in a successful, meaningful way that will enhance the delivery and quality of care that your office provides. Remember the main reason why you are attesting, the money is a great incentive – but the biggest factor in successfully attesting is the benefit to your patients. Anyone can purchase an EHR and use it unsuccessfully or at its minimal functionality – to use it to it’s very best ability and to meet the requirements set forth by the Meaningful Use standards is to practice better medicine for your patients and to encourage others in your field to make quality care the highest priority.

13.  What remains your greatest EHR challenge post EHR implementation and meaningful use?

The greatest challenge for EHR and Meaningful Use continues to be the necessity to ensure that all the physicians and staff are continuing to maintain their high level of entering the correct and necessary data in patient’s charts to enable us to increase our reporting requirement levels far after successfully attesting. I have continued to monitor my staff’s levels after attestation and I’ve found that their numbers continue to increase – which is a positive realization for our staff and for our patients. It will also be imperative that we continue to monitor any new information coming out of CME and Cerner regarding meaningful use requirements especially as we gear up for Phase 2.

14.  What’s been the biggest benefit to your clinic of having an EHR?

West Broadway Clinic has benefited from having an EHR in multiple ways from never having to track down a paper chart to the continuity of care it provides for our patients. Having an EHR that integrates with our Practice Management System has reduced the amount of time it takes for charges to be entered and then forwarded to insurance companies. The adoption of an EHR has enabled West Broadway Clinic to become more efficient and be able to focus more upon the patient as a person. The increased benefits of safety cannot be undersold. With the assistance of the EHR, we are practicing better, safer medicine than we could on paper records.

Interview with Meaningful Use Physician #23

Posted on April 19, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yesterday morning, River Falls Medical Clinic (RFMC) of River Falls, Wisconsin, attested for Meaningful Use at 7:30 a.m. CT. The clinic was one of the very first – in fact, #23 to attest to meaningful use under the Medicare program. The following is an email interview I did with Dr. Tashjian about RFMC’s experience in the meaningful use attestation process.

Christopher H. Tashjian, MD is the president of River Falls, Ellsworth & Spring Valley Medical Clinics in Wisconsin. The three clinics provide primary care services as well as specialty consults.

How long have you been using EMR? Which EMR do you use?
River Falls Medical Clinic, RFMC, implemented Cerner’s Ambulatory EHR in March of 2010 after several years of working with Cerner’s PWPM solution.

Did you have to upgrade your EMR to meet the certified EHR and meaningful use requirements?
From day one of EHR implementation, our staff has made it a priority to utilize our EHR solution to its full extent to benefit the care we deliver to our patients and to enhance our workflow. From the time Meaningful Use was announced, our staff was quick to realize that the proposed criteria would help us to better utilize our EHR and to enhance the care and delivery of that care our patients. We made it a goal to not simply attest for Meaningful Use for the monetary benefits that the stimulus dollars provided, but to more importantly enhance patient care. Therefore, we did not upgrade our EHR to solely meet the certified EHR/Meaningful Use requirements. We did add several pieces into our daily routines including Cerner’s departure summary and patient education –even though this piece isn’t required this year, we know that it will be in stage 2 and beyond. We also continued to improve our eprescribing procedure. We will also be upgrading to include Cerner’s IQHealth® solution to provide a patient portal that enables patients to review their own information and interact with us within a secure platform.

How much did it cost for you to do that?
There is a cost to move to an electronic record from paper – RFMC’s physicians feel it is vital to recruit today’s top medical students/residents. We felt if we did not have an EHR, we were at a serious disadvantage. More than 70% of the physicians in our area have gone electronic– we had to stay up-to-date. Patients in our area want to see a physician who has embraced technology and made the commitment to enhance patient care and safety; they want a physician who is moving forward with technology, not one who is still using paper when a better option is available. There is a cost associated with being a provider of choice and RFMC, like any other physician office, wants to attract new residents (physicians) and new patients. Providing better care is one way to do this. There is no way we could stay competitive in the marketing place if we did not choose to go electronic. The cost of not doing so was too high.

Why was it important to you/your office to be one of the first physicians in the nation to attest?
We wanted to make sure we were doing it right – we looked at the Meaningful Use requirements and said, “These things all appear to provide measurably better care.” Our physician’s felt that meeting Meaningful Use requirements would point our focus in the right direction. Most importantly, we wanted to follow the steps to enhance care. There is value in being one of the first physicians to attest and in being able to tell our community that RFMC is up and running at the first opportunity. This is of significant value to us. Additionally, our physicians literally put their own dollars into the HER; we made a personal investment in this. Many private groups owned by physicians have followed the same suit. This is not a situation where we just said, “Okay, we can rearrange some dollars.” If we don’t succeed – we don’t take our money home. It’s very personal to us as individuals and meaningful because we practice medicine to help our patients. Additionally, we wanted to be able to assist our fellow physicians in the process. By being one of the first physicians in the nation to attest, I can provide feedback and suggestions to assist others in the field.

How many hours of extra effort do you estimate it took for you and your staff to meet the meaningful use criteria?
We were committed to meeting Meaningful Use requirements already, so it’s difficult to say exactly how many hours we put into this initiative specifically. There were many hours spent making sure we met the requirements. We felt the requirements were so valuable and worthwhile that we began working on them day one because we felt they would enable us to deliver better care for our patients. Instituting an EHR required significant effort to change the way we document and the way we take care of our patients, but we saw this as part of the natural cost of doing business and we chose to do it in real time rather than seeing fewer patients. Our staff simply worked more hours – longer hours –so we did not interrupt the care to our patients. Within 6 weeks we were back up and running at full speed – this really is a fairly rapid adoption.

What were some of the changes you had to make to your practice style or documentation methods to meet meaningful use?
We aim to have all notes completed the same day. For us, this was a huge transition from the dictation world. Our team had to learn to document electronically and have things done by the time the patient left the room. This is vital for our patients incase they find themselves visiting the ER that night or seeing another physician that day. In these cases – the information on their visit with our physicians is complete and available. We also completely transitioned from writing prescriptions and went all eprescribe.

There were several changes in the way we practice. For example, now, every visit ends with the patient summary, which I never did before. Now, I sit down with the patient and whoever is with them to discuss, “Here is what we did, here are the tests we conducted today, the labs we completed and prescriptions written.” I provide a full, comprehensive overview of their visit. Incorporating the patient summary into the exam has enhanced my relationship w/my patients and they feel more confident walking out the door. Before, visits ended with a physician writing a prescription and saying goodbye.

We’ve also decided to put printers in every room to provide the after visit summary to our patients. We want everyone to receive their after visit summary and to get the appropriate patient education. We’ve gone to two-sided printing for all documents, so we aren’t printing anymore than what is absolutely essential for each situation. This is helpful for our elderly patients who are on multiple medications, which can get confusing. It’s easier to keep track of everything if it’s written down. We’ve also received feedback that this is valuable for their caregivers who may not have been in the exam room with them. On the other end of the spectrum, this is incredibly beneficial to parents of children, particularly newborns. Parents want to track progress and they want to be able to easily recall information. As we adopt Cerner’s IQHealth®, we anticipate moving the majority of this information into the patient portal for easy accessibility and storage in one central location. We also regularly utilize the immunization registry, which we did not engage with previously.

What steps did you take to ensure you were ready to attest?
To ensure we were ready to attest, we used the reporting capabilities within Cerner’s solution to extract the appropriate data. We used weekly reports to note where each physician was in regards to meeting the requirements for attestation. We also enlisted the support of WHITEC, The Wisconsin Health Information Technology Extension Center, to make sure we covered every base.

Were there any surprises in the meaningful use attestation process?
I was overall impressed that the process was put together so meticulously. There were multiple forms that needed to be filled out as we went through the process, and our staff truly did their due diligence prior to “pushing the button” to ensure we were ready. Thanks to the staff’s preparation, we were prepared when the numbers were requested. It was very easy for us.

Who helped you through the process (your vendor, a consultant, your REC, etc)?
Cerner played a large part in our success. Early on, we began working with Karen Berg, a Cerner Ambulatory director, who came to our clinic to meet with our quality physicians and walk us through the process of getting signed up for Meaningful Use. Berg worked through our questions to help physicians get ready to attest. She highlighted the need for us to prepare for Meaningful Use and beyond and laid out foundational steps for us to focus on patient care beyond Meaningful Use. We have been pleasantly surprised by the wealth of resources available through uCern, a collaborative website for Cerner clients, and we use them regularly. Additionally, our office manager receives regular emails from a group of people at Cerner who are dedicated to help their clients attest and prepare for certification. On our behalf, Cerner also works hand-in-hand with WHITEC, a health information technology extension group that our peer review organization put us in touch with. WHITEC has been very helpful for directing us through the Centers for Medicare and Medicaid Services website and doing research around questions that arise.

What benefits are your patients seeing from you showing meaningful use of an EHR?
Overall, our patients are receiving better quality of care as a result. They’re receiving patient education as well as after visit summaries and their information is tracked for accuracy. Their immunizations, which are one of the most complicated things for parents of minors to track, are recorded in the immunization registry and interfaced with the Wisconsin Immunization Registry. We’ve eliminated errors through eprescribing, there are simply no more errors due to handwriting legibility. They don’t have to worry about losing a prescription, because we send it directly to their pharmacy electronically. Eprescribing also conducts side effect checking and keeps record of the time and date a script is written and sent. Interoperability is a huge benefit for our patients – there is now no need to transfer things to other physicians in our 5 sites, which saves the physician and patient time.

What efforts are you taking to progress towards meeting meaningful use stage 2 and beyond?
RFMC is excited to move forward towards Stage 2 and beyond. We’re already working on next year’s goals; that is, giving diagnosis related patient education to my patients.” We have implemented Patient Education within our practice. We’re moving ahead to continue to deliver the best to our patients.

What do you say to your fellow doctors who are concerned about implementing an EHR in their practice?
I have never met a physician (who has moved to electronic records) say they would like to go back to paper. True, it requires a concerted effort to move to the EHR but the gains in patient care are worth it.

What do you know now about attesting for meaningful use that you wish you knew prior to attesting?
Be organized, choose the right vendor and all will go smoothly. If you actively work to do what is in the best interest of the patient, meaningful use will naturally follow.

What can you share with other physicians who are getting ready to attest in the next weeks and months?
There is very little way to prepare other than to prepare your attitude. Meaningful Use is the way the industry is going and we’re on board with a focus on our abilities to better our care – it’s a job standard to move in this direction. So, jump on board.