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As the
first hospital in South Dakota to achieve Stage 6 EMR
Adoption recognition, Brookings Health System
(Brookings, SD) has set an impressive example for its
peers to follow. Certainly, they've come a long way
since receiving a level 2 ranking from HIMSS Analytics
in 2008. Even Director of I.S. Brian Sterud was
surprised about how quickly their fortunes changed,
once they secured the right HCIS tools.
"Stage 6 was accomplished relatively easily after
we completed our MEDITECH implementation in December
of 2009," he says. "But taking the time to
prepare and ensure the success of our I.T. system was
more than half the battle for us."
So, what steps did Brookings take, to effectively
implement their I.T. system, and go all the way from
level 2 to level 6 in such a short time? Sterud and
his staff recently sat down with us, and shared five
key recommendations for other hospitals pursuing EMR
adoption, based on their own successful journey.
"Our
organization embraced I.T. early on—we were actually
one of the first MEDITECH shops to achieve Stage 6,
and the first in all of South Dakota. But this
accomplishment speaks volumes about the quality of our
senior-level leadership and board of trustees. It's
true that system buy-in will change your organization
and cause more stress than normal, but it's imperative
to have on all levels. Without buy-in, you can't even
start down the path of Stage 6, much less achieve
it." - Brian Sterud, director of
information systems
"The
selection of a strong and committed core team is
critical for this project. An I.T. implementation is a
dramatic commitment, both financially and of your
support resources. Many of our staff members played
dual-roles while we were making the transition; it's a
necessary sacrifice that pays off in the end." - Brian
Sterud, director of information systems
"As nurses, we worked on implementing all the
clinical order entry and documentation modules. We
built the dictionaries and documentation templates,
held training sessions for the physicians, and were
the on-site support for them when we went LIVE. It was
good to be involved in more than one module because we
were able to easily incorporate our knowledge from one
implementation to the next." - Lynne
Thompson, RN, core team leader
“All of our staff members were a part of this EMR
implementation. For instance, the workday for the
Nursing staff changed in a dramatic way—mostly with
order entry and documentation—and they all worked
with us to make these changes happen. Lab, Radiology,
and Therapies all experienced changes in the way they
bill, receive orders, and document results. We needed
the help and cooperation of all the staff and
clinicians to have a successful implementation.” - Lynne
Thompson, RN, core team leader
"Planning
and knowing what you need to do ahead of time is so
important. Realistic timelines are necessary, but I
realize with the stimulus money out there for meeting
Meaningful Use by 2015, many are going to push their
implementation timelines to the limit. Just know and
understand the risks involved with undertaking an I.T.
project, when you're not fully prepared." - Brian
Sterud, director of information systems
"Numerous
training sessions were offered before we went LIVE,
including review sessions and both group and private
tutorials. We believe repetition worked well for us.
We exposed bits and pieces of information gradually,
so we didn't overwhelm the staff. We also designed a
menu of training sessions available, and left the door
open at all times. By encouraging perseverance and
acknowledging clinicians' frustrations, we were able
to get everyone on-board." - Richard Hieb,
MD, physician champion
"Once we went LIVE, power users Beverly Cotton
and Lynne Thompson were available 24-7 for over two
weeks, for problem solving and answering clinicians'
questions. They were always very visible to the
physicians, and if a problem arose, we always knew
where to go for help. Whenever we asked Beverly or
Lynne a question, we knew that we would get answers
and not be pushed off to someone else." - Richard
Hieb, MD, physician champion
"Being involved throughout the implementation
armed us with a vast knowledge of the entire system.
We understood all the modules and how they worked
together—how certain pieces of information fit
together and affected other pieces. This knowledge
allowed us to problem-solve more easily when issues
came up." - Beverly Cotton, RN, core team
leader
"CPOE
is not easy . . . it's a huge, dramatic change, but
our physicians have handled it well. We were able to
accomplish the physician buy-in and adoption with help
of our physician champion, Dr. Richard Hieb. He did a
great job working with all the physicians, and
validating and preparing all the order sets to get us
ready for go-LIVE." - Brian Sterud,
director of information systems
"Choose a champion early, and if you're the
champion, involve yourself immediately. I wasn't asked
to go to MEDITECH for training, but I believe taking
the initiative to do that was valuable time spent for
me. I was acclimated early on, which made it easier to
keep track of the different modules. Also, be sure to
always engage the medical staff as part of the
process. Gather as much of their input as possible,
and create and modify the order sets accordingly, to
fit your organization. The more your physicians invest
in the I.T. system up-front, the better things will be
for everyone in the long run." - Richard
Hieb, MD, physician champion
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