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‘EHR within an EHR’ accelerates workflows

By Julie Larson and Amanda Hill T

he momentum surrounding adoption of electronic health record (EHR) systems in the ambulatory surgery center (ASC) setting is accelerating as more examples emerge of their far-reaching benefits, in particular improved patient care and revenue cycle management. The challenge St. Vincent Healthcare’s outpatient gastroenterology (GI) center and other ASCs face as they seek to transition to an electronic environment is iden- tifying solutions that address their unique workflow needs. St. Vincent Healthcare (SVH) is a not-for-profit organization in Billings, Mont., consisting of a 286-bed hospital and 30 clinics. When SVH set out to open a gastroenterology (GI) center, we looked to advanced EHR technology

Julie Larson is nurse manager for peri-anesthesia services, St. Vincent Healthcare. Amanda Hill is the Epic ambulatory technical support director for St. Vincent Physician Network. For more on Wolters Kluwer: www.rsleads. com/209ht-212

and automation to form the foundation of a paperless environment. This strategy proved to be a positive step forward as the center is now benefitting substantially from streamlined workflows, increased patient volumes, improved diagnosis and enhanced care delivery.

Successful deployment of our IT strategy hinged on a discovery that was made early in our analysis of the center’s system needs – that the inpatient EHR would not adequately address the specific needs of outpatient GI workflow. Instead of trying to force-fit technology designed for hospital workflows into the ASC setting, our team developed a strategy that would essentially construct “an EHR within an EHR.”

Facing the challenge

Modernization of health IT has been a core value of SVH in meeting the needs of our patients. We offer a cutting-edge telemedicine program and continuously seek out new ways to improve patient care through efficiencies and automation.

24 September 2012

One of the first steps as the business plan for our new GI center began to unfold was to assign a project team to review potential vendor products and identify critical system elements needed. The team was tasked with looking for an application that would efficiently and effectively address workflow needs from registration through the clinical process and discharge.

Digital imaging was identified as a core component for any system to be a viable consideration. However, we also wanted an application that would eliminate the inefficiencies inherent with paper-based processes. A focal point was eliminating the need for our physicians to write out and then dictate their notes, a process that created a costly budget line item for transcription services. We also wanted to automate the time- consuming manual processes required for report building. It became clear that the inpatient Centricity EHR deployed in the hospital would not be adequate, first and foremost because it did not offer digital imaging. It was also not designed to address the documentation and process needs of physicians in the ASC setting – a workflow that is much different than that of physicians in the hospital setting. After careful consideration, we decided to move forward with the deployment of two applications designed specifically for the outpatient GI environment – ProVation MultiCaregiver and ProVation MD for Gastroenterology. Our project team did its homework before making the decision, completing a site visit with another ProVation client in Salt Lake City and also comparing it to products from other vendors. We discovered that, in addition to addressing the center’s identified needs, the technology provided interfaces into the Centricity EHR. This essentially created an “EHR within an EHR” platform across which the center’s staff can more efficiently and fluidly manage its workflow without impacting interoperability with the main health system.

Why it works The benefits of using software designed specifically for HEALTH MANAGEMENT TECHNOLOGY

Julie Larson

Amanda Hill

As it transitioned to an electronic environment, St. Vincent Healthcare’s outpatient gastroenterology center had to identify solutions that addressed its unique workflow needs.

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