Changing scripts: a no-glitch EMR transition
In 2010, Einstein Medical Center, Philadelphia\’s largest independent academic medical center, began implementing stand-alone labor and delivery electronic medical records (EMRs) for its obstetrics and gynecology department. The overall intent of the EMR was to reduce risk and malpractice exposure typically associated with OB/GYN through better documentation and continuity of healthcare information. Greencastle Consulting was called upon to aid in the transition to the EMR software purchased from E&C Medical Intelligence, Inc.
Greencastle’s first approach was to identify the primary benefit of the transition: to enable physicians within the department to meet difficult and sometimes restrictive regulatory requirements while collecting and efficiently disseminating patient records and information. This would allow real-time exchange of information leading to improved patient care and the elimination of double data entry. To address this, they utilized EMR delivery software from E&C, a leader in healthcare industry innovation.
Team members from E&C and Einstein worked together to facilitate project meetings, which ensured goals were met in a timely manner. Established timelines allowed team members to troubleshoot any issues that could emerge with project testing and script-writing. The team was aware of the pitfalls of switching information systems, and realized that a problem-free rollout was contingent upon input from hospital staff, including office administrators and those who would be actually using the system on a day-to-day basis. With support for a new EMR on the ground level there was less resistance to the system change, creating a smoother learning curve. They developed a “reverse pyramid” input strategy to get as much testing during the beta phase from office administrators and others who enter data manually into the system.
Project sponsors and committee members were periodically updated with the EMR project status and were informed of any decisions that needed to be made. These open lines of communication between Einstein\’s IT administrator, project manager and E&C allowed Greencastle to manage the project scope as information was gathered between the aforementioned parties and changes were made to the rollout strategy. Greencastle also developed test plans to include scheduling time, potential EMR users, and additional resources. Test scripts were reviewed to ensure that they would be properly written and executed. The test schedule was managed to keep the project on track and organized, including formalized documentation of the test results.
Training plans were refined throughout the 14-month process and an efficient schedule went into effect. During the go-live stage, new EMR users were paired with outside experts in their respective field who had prior experience with the system, creating a sense of camaraderie and reducing the chances of any problems or feedback getting lost in translation. This allowed a safety net to make up for any productivity loss Greencastle accounted for once the EMR was in its beginning stages.
Constant review and revision by Greencastle ensured a successful closing out of the EMR project, and the database went live successfully. Following the go-live, system administrators and project managers met to discuss progress made with the EMR and to troubleshoot any issues that arose. This meeting also ensured that clinicians, data managers and other users were utilizing the EMR to its full potential. The operation was then handed off to Einstein\’s Greencastle-coached systems administrator, who had the tools to ensure future staff would document workflows and contribute to the development of test scripts as dictated by future needs.