Since the American Recovery Reinvestment Act (ARRA) of 2009 mandated all U.S. hospitals move to EHRs to qualify for federal incentives, providers have had their doubts. In fact, according to an AmericanEHR Partners survey, only 34 percent of physicians reported they were satisfied or very satisfied with their EHR system last year, down from 62 percent in 2010.
By Amanda Griffith, Contributing Writer
Early EHR adopter Springhill Medical Center has seen improvement in all revenue cycle metrics — including a lower discharge net final bill and an improved accounts receivable collection cycle from nearly 100 days to 38 days — since implementing the technology.
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Since the American Recovery Reinvestment Act (ARRA) of 2009 mandated all U.S. hospitals move to EHRs to qualify for federal incentives, providers have had their doubts. In fact, according to an AmericanEHR Partners survey, only 34 percent of physicians reported they were satisfied or very satisfied with their EHR system last year, down from 62 percent in 2010.
The survey of 940 physicians found the main sources of dissatisfaction with EHRs ranged from no decrease in their workload to higher operating costs to impeded productivity.
In contrast, Springhill Medical Center, a full-service private hospital serving southwest Alabama, started its own EHRimplementation journey in 2003 and has never looked back. Springhill’s story actually starts three years earlier when the organization entered into a partnership of sorts with Allscripts. Since that time, the organization’s association has grown from a typical outsourcing arrangement into a much broader relationship.
“Understand our situation,” explains Jeffrey M. St. Clair, president and CEO of Springhill Medical Center. “We’re a 252- bed, for-profit hospital in an over-bedded market. We’re solely owned and may even be the largest hospital in the U.S. owned by one entity. It’s like we’re the mom and pop drugstore with Walgreens and Super Target on the other corners.”
Advanced IT Needs Lead To EHR Partnership
Springhill realized it had to be more nimble, as its legacy systems — initially designed for how Springhill operated — could no longer keep pace with changing times. Health IT initiatives began to outpace its abilities from a financial and human resource perspective.
With nine other hospitals in a 75-squaremile area, Springhill Medical Center took the lead and became the first in the community to start using an EHR system because the hospital saw the importance of keeping pace with — and moving ahead of — an ever-changing healthcare environment.
“Our IT department was composed of a technologically savvy group — several of whom later formed a company that became the second or third largest claims clearinghouse in the country, but we needed help,” said St. Clair. “We wanted a bigger player on our side, someone who had the resources, talent, deep bench, and money for R&D, someone in front of the coming wave.”
Facing the same obstacles as others looking to integrate an EHR for the first time, St. Clair knew the leadership might face resistance to change from the medical staff, particularly as Springhill progressed through the process of moving from paper records to a hybrid solution to a fully electronic system. After conducting its due diligence, the organization selected Eclipsys — now Allscripts — because its creativity, affordability, and culture matched well with Springhill Medical Center’s.
“We installed our EHR system in the years when the government was just beginning to think about mandating its use, and we haven’t looked back,” noted St. Clair.
Springhill Medical Center first implemented the Allscripts Sunrise solution in 2004. It now also uses Allscripts Managed IT Services, outsourcing its entire IT department. The partnership between the two companies is so strong it earned Outsourcing Center’s Best Outsourcing Partnership award for the past three years.
“We have a great team using Allscripts Sunrise,” said St. Clair. “Our EHR is a critical component in our work to continuously improve the quality of patient care.”
CPOE Eliminates Paper, Improves Data Integration
The hospital has made great strides in its EHR use since its early days of implementation. In fact, the provider became 100 percent CPOE-compliant and paperless last year. Paper charts are no longer a fixture in the nursing units, and the only residual paper is monitoring strips for cardiology and obstetrics. Springhill’s progress is a great example of how a stand-alone hospital in a competitive market can implement a complete EHR that is well received by the medical staff, nursing staff, and patients. Report writing and systems background monitoring of processes are well supported by scripting tools that judiciously warn physicians without “pop-up overload.”
“To truly maximize the potential of the EHR system, it had to work for all of the caregivers, doctors, nurses, therapists, phlebotomists, etc.,” explains St. Clair. “Initially, it was difficult for all of them to put away pen and pad and place their trust in technology. Now it’s part of who we are.”
Not only has the system helped define Springhill, but it also contributed to their becoming the first hospital in Alabama — and one of only a very few nationally — to reach HIMSS Stage 7. That distinction validates the progress and impact the technology had in improving patient safety and outcomes and the move to the paperless records and health data integration.
EHR Use Improves Infection Rates, RCM
“We’ve achieved so much that wouldn’t have been possible without our EHR, including building modules to prompt, remind, and alert our clinicians — items that have allowed us to lower our infection rate to 2.25 percent and enabled us to automate 80 to 90 percent of the work required to achieve core measures,” explains St. Clair. “In addition, The Joint Commission allows a 50 percent medical record delinquency rate, and ours is two percent, meaning all of the information necessary for practitioners is immediately available for the care of patients. That’s a big deal.”
On the financial side, Springhill has seen improvement in all revenue cycle metrics since implementing its EHR. These included a lower discharge net final bill and an improved accounts receivable collection cycle from nearly 100 days to 38 days on average. That equates to more days of cash on hand and also means that RAC audits and malpractice claims are easier to defend because electronic charts are more comprehensive.
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Furthermore, the hospital recently switched its entire new financial platform to Sunrise Financial Manager, so its clinical and financial integration are now on one platform. Springhill Medical Center is also the first customer in the country to use Allscripts Emergency Department Information System (EDIS) to automate emergency operations and improve access to clinical information. The solution integrates with existing hospital information systems to provide enhanced communication, better management of high-risk patients, and improved access to critical patient information both inside and outside the hospital.
“I can’t think of a single operational metric or area where we aren’t much better off with the EHR than we were with our previous system,” notes St. Clair. “Our EHR went from being our biggest heartache and headache to a feather in our cap.”
Since the American Recovery Reinvestment Act (ARRA) of 2009 mandated all U.S. hospitals move to EHRs to qualify for federal incentives, providers have had their doubts. In fact, according to an AmericanEHR Partners survey, only 34 percent of physicians reported they were satisfied or very satisfied with their EHR system last year, down from 62 percent in 2010.
Furthermore, the hospital recently switched its entire new financial platform to Sunrise Financial Manager, so its clinical and financial integration are now on one platform. Springhill Medical Center is also the first customer in the country to use Allscripts Emergency Department Information System (EDIS) to automate emergency operations and improve access to clinical information. The solution integrates with existing hospital information systems to provide enhanced communication, better management of high-risk patients, and improved access to critical patient information both inside and outside the hospital.
