Critical
Access Hospitals Cut Costs, Advance Technologies through SISU
Membership
(9/11/2008)
Back in June, MEDITECH
highlighted Minnesota-based SISU Medical Systems in an
article titled I.T. Consortium SISU Helps
Critical Access Hospitals Share the Wealth of Advanced
Technologies.This
month, we take a closer look at how two Critical Access
Hospitals benefit from their SISU membership.
When those of us in other states imagine Central and Northern
Minnesota, we tend to think of an outdoorsman's paradise,
rather than a hotbed of health care informatics. As a matter
of fact, both are true. Most members of SISU Medical Systems,
a 16-hospital I.T. consortium, are concentrated in these
rural areas of the North Star State. To learn more about the
benefits small and rural hospitals experience through SISU
membership, we recently spoke with CEOs and administrators at
two of the 11 SISU members designated as Critical Access
Hospitals. Mercy Hospital & Health Care Center (Moose
Lake, MN) holds the distinction of being one of the first two
consortium members, and Kanabec Hospital (Mora, MN) joined
the organization in 2002.
MEDITECH: Why do you think your licensing
arrangement with SISU works so well?
Jason Douglas, CEO, Mercy Hospital: The
licensing agreement gives SISU members the power of a
collaborative group, allowing us to purchase software that
would have been out of our financial reach as a rural,
independent hospital.
Randy Ulseth, CEO, Kanabec Hospital: It's
also more affordable in terms of support. We've been able to
achieve a high level of local, expert support which we couldn't
afford as an independent facility. Also, we're able to
collaborate not only with SISU staff, but with peers from
other member hospitals as well.
MEDITECH: A recent survey of CFOs revealed
that financial viability was the number one reason for small,
rural hospitals to convert to Critical Access Hospital status.
How does SISU make an HCIS a more viable option for Critical
Access Hospitals?
Douglas: This goes back to your first
question. SISU members as a group have much more leverage
when buying software than small, individual hospitals. In
addition to the economic plusses, there are intangible
advantages to working with similar-size hospitals facing
similar challenges. Having contact through SISU means one
hospital's solution may be a viable solution for many.
Exchanging that information and experience is something you
can't put a price tag on.
Gordy Forbort, CFO, Kanabec Hospital: Most
Critical Access Hospitals have limited cash and borrowing
ability, as well as limited revenues to support a complete
HCIS. In addition to the software and staffing resources,
expenses such as PACS storage and interfaces with physician
clinics factor into the bottom line. A joint solution to
these issues equals substantial savings for each hospital.
MEDITECH: How does sharing a MEDITECH HCIS
contribute to your ROI? Have you done any ROI-related studies,
such as AR days?
Douglas: We haven't done any ROI-related
studies.
Forbort: We haven't
done any studies either, but we're confident in a couple of
areas. Auditors have recognized our AR days as "gold
standard" when they assess Critical Access Hospitals.
Also, although we haven't yet done a study to determine the
percentage I.T. costs are of our total facility costs,
preliminary numbers indicate our solution will prove to be a
very positive approach for a high quality HCIS with a very
manageable ROI.
MEDITECH: How did Mercy Hospital handle the
implementation process, particularly in regards to staffing
your core team and recruiting super users? How did you
overcome these challenges?
Trina Lower, director of quality and health
information, Mercy Hospital: SISU was invaluable to
us during implementation. They kept us on a timeline, which
is so important during implementation projects. They also
tested functionality, speeding up problem solving and
networking to answer questions.
Liz Ames, clinical applications specialist, Mercy
Hospital: Historically at Mercy, application "owners"
and alternates comprise the core team. Application
owners—typically the department managers—build
their applications' dictionaries and train end users,
responsibilities that put great demands on their time. With
the Advanced Clinicals software, integration is more
extensive and complex. Owners need to understand and be aware
of changes within their own applications, and how these
changes have an impact on other applications. When Mercy
Hospital implemented Operating Room Management (ORM), the
hospital created a new Clinical Applications Specialist
position. As the specialist dedicated specifically to
implementation, I'm able to increase awareness and facilitate
communication among all the application owners. When we
implemented Patient Care System (PCS), I played a more active
role in identifying and planning for the effects a new
application would have on the applications we were already
using.
MEDITECH: What were some of Kanabec Hospital's
challenges during implementation?
Rose Ryan, business office director, Kanabec Hospital:
We have encountered some staffing challenges for
implementation, post-implementation updates, and maintenance,
because the system does require staff resources. We've had to
either increase staffing or go short-staffed for periods of
time to build the dictionaries and implement the applications.
MEDITECH: You mentioned implementing PCS at
Mercy Hospital. Are you prepared to implement any other
MEDITECH Advanced Clinicals?
mes: We'll implement Physician Care Manager
(PCM) later this year and Emergency Department Management (EDM)
in 2009. The knowledge we gained communicating with other
application owners during the PCS implementation will be a
great help.
Ulseth: As we move forward, after a few
implementations without adequate staffing, we made sure we
had enough staff budgeted for our PCS implementation. We also
increased by our clinical I.T. staffing by .5, which will
help ensure timely application rollouts in the future.
MEDITECH: Some might argue that a complete
solution such as the MEDITECH HCIS is too robust and complex
for Critical Access Hospitals. How would you describe
employee adoption and system usage, and would you say they've
benefited from its functionality?
Ames: At Mercy Hospital, the
percentage of employees utilizing or being affected by the
system increased markedly when we added ORM and PCS.
Caregivers' initial adoption of these applications followed
the anticipated curve. Although they're sometimes nostalgic
for paper, clinicians realize the advantages to documenting
electronically.
In terms of functionality, a facility our size really has to
consider employee time, knowledge, and effort when weighing a
best-of-breed system versus an integrated software solution.
Implementing and maintaining interfaces among multiple
software vendors would be difficult and costly. A fully
integrated product such as MEDITECH enables us to avoid that
time and effort.
Ulseth: Hospitals still do the same work and
offer the same care, regardless of size, so we can use all
the functionality available. In general, employees seem to
adapt very well to the system. Some applications have been
very well received, while others have taken a little more
getting used to before staff feel comfortable with the
software. However, as Kanabec Hospital grows, new employees
require training and seasoned employees need software
refreshers. I.T.'s educational component is continuous, which
needs to be considered from the beginning.
Sue Belford, health information manager, Kanabec
Hospital: The more we use the MEDITECH system, the
more benefits we see. Now that our Enterprise Medical Record
(EMR) spans departments and we've rolled out the Scanning and
Archiving software, clinicians are able to pull up a patient
record in seconds to view the data they need. They no longer
waste time looking for a paper chart, filing it, or pulling
records for outpatient departments or Release of Information
requests. In fact, we encourage all departments to retrieve
patient information through the EMR.
Ulseth: Our Laboratory, Imaging, and
Scheduling software provide similar benefits. Automation has
improved staff efficiency, helped eliminate potential errors
associated with paper processes, and paved the way for
Picture Archiving and Communication System (PACS)
implementation.
MEDITECH: SISU's Web site indicates Mercy
Hospital is approaching its 25-year anniversary as a member
of the consortium. Have you been using MEDITECH applications
since 1983?
Lower: Yes, we have. In the early years, we
primarily used the infrastructure for business support.
MEDITECH: What are some of the ways in which
you help newer SISU sites to maximize system usage?
Lower: While networking and a supportive
team approach is used within the consortium, SISU serves as
the hub for managing and solving problems.
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com