Deaconess Health System

• 450,000 patients per year
• 845 physicians and 5,700 support staff
• Affiliated with Indiana University School of Medicine and Kansas City University of Medical and Biological Sciences (KCUMB).
• Level II Trauma Center certified
• Women’s Hospital awarded the 8th best place to work in US healthcare
• Annual revenue - 675 million

Stage 7 Award
Validated hospitals in 2011: 4

Overview and Challenge
Deaconess began its EHR conversion in 2007 as part of a larger initiative to provide the best patient care in the Tri-State area. Overall, the reaction was positive - with growing concern that the new system would slow down care delivery. The solution was comprehensive training long before the official ‘go-live’.

The biggest implementation challenge was resource allocation followed by project management efforts including assigning accountability, scheduling support and controlling costs. The importance of “planning the work and working the plan” was magnified by the very aggressive implementation timeline. Training coordination alone proven to be a monumental task on a scale never attempted before. The “big bang” launch was in November 2009 followed with CPOE in February of 2010.

Implementation – system flexibility and required training

• Design a system that could accommodate care quality, workflow and cost efficiency upgrades after implementation.
• Created a Clinical Information System Visioning Team including IT, Clinical Informatics and executive leadership.
• Signed a contract with Epic in July, 2008.
• Brought all ambulatory clinics live by September, 2009.
• Launched the “big bang go-live” in 4 out of 6 hospitals, November of 2009.
• Required training and exam completion for all EMR users was the key to project success:
• Physicians – 8 EMR training hours; 4 additional for CPOE
• Nurses – 22 EMR training hours

Recognizing the ROI of EHR Implementation:

Financial ROI:

• It wasn’t all related to Dragon but our dictation volume and expense has decreased by 60% since we went live with our EMR (estimated savings to date $1,188,904). We have virtually eliminated regular dictation expenses in our ambulatory practices.
• Estimated savings to date - approximately $1.2 million.
• Dictation expenses have virtually disappeared in ambulatory practices.
• 50% decrease in medication errors.
• Improvement to Heart Failure clinical process scores have increased from 71% to 86% since 2008.

Patient Care:

• Patients receive treatments faster than before with an improved turnaround time in the ER.
• Barcode medication administration provides patients with a higher level of safety assurance.
• Discontinuation of post-op antibiotic measure in SCIP improved from 86% to 97%.
• The EMR system alerted ER staff to a severe reaction to sulfa drugs for a boy being treated for an infection.
• Thanks to the patient portal (MyChart) patients can interact with providers from any location.

Lessons Learned

• Don’t let perfect get in the way of going fast and getting live.
• Everyone has to use the system…everyone who uses the system has to go through training.
• Make sure you have enough resources in advance and plan far ahead for shortfalls. You can’t fix it after you go live.
• Identify a core group of nurse, physician, and leadership champions. Train them all to use the system as early as possible so they can support their peers.
• Devote great amounts of time installing and testing your hardware (especially printers) early as possible. Even the best EMR doesn’t work if the computer doesn’t.