To assess the productivity of its EHR, Citizens Memorial Healthcare (Bolivar, MO) gathered data during its implementation of the Medical and Practice Management (MPM) Suite, and what they uncovered was astounding. As a result of their successful planning, training, and implementation, Citizens experienced a significant increase in revenue per visit, net income, and net income per visit.

Citizens conducted their study in preparation for a grant funded by the Agency for Healthcare Research and Quality (AHRQ), which provided $500,000 per year for three years to assist Citizens in the implementation of the MPM Suite and other MEDITECH products—including Emergency Department Management and Physician Documentation. As part of its Transforming Healthcare Quality Through Information Technology program, AHRQ committed up to $7 million in FY05 to fund 14 new implementation grants, with up to $5 million of these funds reserved for efforts involving rural and small community hospitals as the lead entity.

"Funding is a huge concern for many hospitals, especially the rural hospitals, so it's a blessing to receive a grant and achieve benefits such as increased revenue and improved documentation," says Denni McColm, CIO at Citizens. AHRQ believes health care information technology contributes to measurable and sustainable improvements in patient safety, cost, and overall quality of care, as demonstrated by Citizens during its study.

Making Improvements and Measuring Progress
Over a two-year period, fifteen Citizens clinics went LIVE with MPM—an ambulatory EHR and practice management suite of applications developed by LSS Data Systems and MEDITECH. Aside from receiving the grant, each clinic experienced individual benefits depending on the area which needed the most improvement.

"The system often exposes your weaknesses," explains McColm. "There is no 'magic bullet' for every site; each clinic noticed benefits in different ways. If their written documentation was lacking, then they saw the immediate improvements in coding of visits using electronic documentation in MPM."

Prior to the implementation, the physicians were most concerned with how the new system would affect their productivity. "The increase in revenue per visit and decrease in expense per visit directly correlates with work output," says McColm. "Our physicians were happy to see positive results in productivity within the first 12 months after go-LIVE."

Citizens found the new MPM solution also significantly improved documentation, raised code levels, and helped facilitate patient care through its integration with Citizens' MEDITECH HCIS. "Our clinicians believe the integration has increased efficiency by providing more services to our patients," says McColm. "For instance, a patient schedules an appointment for an MRI at the hospital. Days later, the MRI is performed at the hospital and the data automatically flows to the physician's list, who can view the report and look at the image."

McColm adds that this level of integration also improves the quality of care delivered at Citizens. "Without integration, delays in the treatment or orders simply never being completed are common problems," she says. "Our system allows for proper follow-up, so clinicians can offer a more complete episode of care with patient discharge instructions, as well as follow-up calls and appointments."

Driven by Results
Although Citizens concluded its I.T. research in 2006, leaders continue to feel the impact their I.T. solutions have made on the organization, both financially and clinically.

"Even though we love seeing the improvement in revenue per visit or expense per visit in each clinic, that's not necessarily what inspires us," says McColm. "It's the ease of the system implementation, increased standardization, more fluid work processes, and overall integration which really keep us motivated and looking forward to the future."