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Patient safety drives new electronic medical recordFlipping the switch on new software, a new process, and, in fact, a whole new way of doing business isn’t easy. But, when it involves health information for thousands of patients who rely on their healthcare facility to maintain the accuracy and integrity of that data, well, “daunting” just doesn’t quite cover it. Such was the case when New Ulm Medical Center implemented its new automated medical record, Excellian, in September and October (two phases) in the clinic and in December in the hospital. The implementation of Excellian at the medical center is part of a larger Allina Hospitals and Clinics initiative and the goal behind this massive project was rather simplistic at its core: patient safety. “Patient safety was the number one reason we went to an automated medical record,” said Kathleen Bauer, New Ulm Medical Center site lead for the project. “We used to have one paper chart for each patient. If the patient was seen in one area of the clinic and then had to see another doctor the same day, it was difficult to be sure the chart was in the right place at the right time. Now, we can all be looking at the chart at the same time. Information, including test results, are real time and don’t have to wait to be filed.” A reduction in medication errors is another safety-oriented facet of the new electronic medical record. When a physician orders a medication for a patient through the new medical record system, he or she is prompted to review the patient’s allergies if they haven’t already done so. It gives an “alert” if there is a contraindication to giving the medication and it provides a generic medication option if it is available. Because all prescriptions are now typed instead of handwritten, there is significantly less room for error in that area, too. Area pharmacists no longer struggle to read prescriptions. “On the inpatient side, if a doctor has ordered that a medication be given every four hours, there is an alert that comes up if it is more than 60 minutes past due,” Bauer said. Quicker turnaround for lab and radiology results is also a benefit of the new system. Physicians get an “in basket” email message within the automated medical record when the lab and radiology results are back. The physician can easily click on these results and document the follow-up care that is needed. Improved communication and education between physician and patient is another aspect of the new system. After a patient has visited their physician in the clinic, the physician may print out an after-visit summary, including a list of the patient’s medications. “Physicians can also link right to the internet from their computer in the exam room to access some wonderful educational sites for various conditions, and then print out the information for the patient right on the spot,” Bauer said. In the nine months of preparation for the Excellian implementation, staff put in approximately 8,300 hours of training and almost 200 new electronic devices were installed throughout the medical center, including computers, scanners and other such hardware. There are now computers in every exam room in the clinic and every inpatient room in the hospital. New wiring was strung throughout the building so the infrastructure existed to support Excellian and for six months all the meeting rooms in the facility were transformed into training rooms for staff education. Twenty-five percent of the staff in each of the larger departments of the medical center were defined as “Super Users,” which meant they were available to help other staff with questions and problems when Excellian went live. It also meant that these individuals went through double the training. In smaller departments, most of the staff went through Super User training because they would be working alone. Bauer attributes the success of the medical center’s automated medical record implementation to one major factor: the people. The physicians, the Super Users, and the staff were all critical to the accomplishment of the project and without the full support of these groups, Bauer said, the story could have ended less successfully. “If it wasn’t for the ownership that the physicians have taken with this, we wouldn’t have been successful at all. They had to do the most training, because they had to learn both the clinic and the hospital side of the system,” Bauer said. “New Ulm has been the most successful of all the Allina sites that have gone live to date. Epic (the company that produced the Excellian software) has also considered us one of the most successful sites they have dealt with.” The Super Users were also an instrumental part of the overall success of the implementation, said Bauer. Helpers from other Allina sites that had already gone live on the system were brought to the New Ulm to assist in the transition. These Allina employees were amazed at the New Ulm Super Users knowledge of the system and ability to answer questions the first day of the go-live. “The other Allina staff was supposed to be here for three weeks for support,” said Bauer. “After two weeks, most of the support people were gone. That is a direct tribute to how well our staff did as well as how much our Super Users knew. You can’t simply understand how Excellian works and insert it into a department. You have to fully integrate it into the workflow of that department.” Daily communications also helped staff during the important first days of the go-live period. “Tip sheets” were an essential tool for staff as they navigated their way through the system. Countdown calendars posted throughout the facility prior to the go-live date kept staff in tune to the timeline. |
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New Ulm Medical Center
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