Each year, HIMSS recognizes exceptional achievement in healthcare IT implementation, through its Nicholas E. Davies Award of Excellence. Find out what the healthcare IT leaders at Sentara Health System, Nemours Health System, and Miramont Family Medicine have learned on their path to clinical and operational transformation, and the lessons they have to share with the industry.
Every year, the Chicago-based Healthcare Information and Management Systems Society (HIMSS) salutes exceptional achievement in healthcare IT, through its Nicholas E. Davies Award of Excellence. By taking a look at the organizational winners, Sentara Health System and Nemours Health System, and ambulatory winner Miramont Family Medicine, some commonalities emerge that undoubtedly speak to common approaches to innovation. Not only do the organizations create a culture for change, they also embrace clinicians each step of the way to galvanize their information revolutions.
HOME SWEET MEDICAL HOME
Miramont Family Medicine in Ft. Collins, Colo., the ambulatory winner, is the very model of a modern-day patient-centered medical home (PCMH). “They really get the patient-centered medical home concept, where they try to perform as many services as they can at a one-stop shop for the patient,” says David Collins, director of health information systems at HIMSS.
The six-physician Miramont is always in the state of expansion, opening three new offices in 2008 and 2009. Not only does the four-clinic practice have an onsite dispensary, but they have a portable X-ray and state-funded labs in three of the four sites to limit return visits for patients.
Miramont needed increased clinical data and registry functionality to become a PCMH pilot practice in Colorado. So in 2007, its physicians went for broke and started using Austin, Texas-based e-MDs' EHR and practice management system, after using an inferior “DOS”-like product for a few years (it was the legacy IS of a nearby hospital system). Miramont had a relatively smooth go-live by scheduling the first three days at 50 percent to leave time for using the new system. The practice also had studied the software previously and selected a super user on staff to help as issues arose.
As a part of the transition to the new system, Miramont decided, against the advice of e-MDs, to go totally paperless since square footage for off-site storage was getting more expensive. This Herculean feat involved the scanning and subsequent shredding of 10,000 pages of medical documents. The shredding was done incrementally, and to encourage the process after each 1,000-page milestone the staff would have a celebration.
SHAKING OFF THE ‘70S
John Bender, M.D., believes one main decision that led to his practice's success was taking the calculated risk of investing $200,000 of personal capital in technology. Bender sought to combat what he said was the outdated '70s healthcare model-paper-chart practices that were inaccessible to patients (early closures, no after hours). “No one likes that anymore, and it's not convenient,” he says. “And patients are abandoning the model to go to retail clinics and emergency rooms. Consumers are revolting.”
With the generous IT investment, the practice has doubled its census to nearly 14,000 patients in the last three years, and has effectively paid off the cost of the IT closet. “The payback was a very robust return on investment that made us more efficient, safe, and faster, so we could see more volume,” Bender says.