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Remembering Things Before They Happen January 25, 2012

Posted by Darla in Adventures.
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Last night Cerner managed a major upgrade to its Community Works clients. As our brave employees huddled over their computers, validating the upgrade at 1:30 a.m. this morning, it occurred to me that we are a lucky crew to have selected the ASP model for our EHR solution.

Yes, sharing the domain can be frustrating when we request a change that impacts other clients in the shared space … but it is also nice when other clients have suggestions that benefit us.

Yes, it would be nice to have an IT department onsite to handle all this folderol and hoopla instead of our registration clerk, lab manager, financial manager and night nurse … but then we would have to recruit, pay and keep happy a highly skilled employee in a very rural area of the country.

Yes, frustration levels increase when changes are implemented in the domain … but then again, our software is up to date on Cerner’s dime, all the time. We don’t have to keep current on patches and updates to the system like we would if we had the software installed on our own servers.

We recently participated in our 21st reference event since going live January 2011. These events can be phone calls, emails or site visits from other health care organizations considering Cerner as their EHR partner. We answer questions, connect their employees with peer employees at Syringa, and share the good and the frustrating with them.

Syringa’s employees focus on providing quality patient care and service, so it is sometimes hard to see how far we have come on this journey. With HIMSS 6 and Stage 1 Meaningful Use Attestation under our belts, we are a model implementation; but now we have the basics under our belt, we strive for ways to better serve our patients.

Dare I mention our old friend, Alice in Through the Looking Glass? She spent some time with the White Queen – the Queen who practiced believing as many as six impossible things before breakfast. This Queen had a fantastic memory, one which roamed toward the past, but also into the future. She could remember things that had not happened yet, and found Alice’s memory “a poor sort that only works backward.”

If backward memory is experience, then forward memory is anticipation. We must anticipate what our patient’s need, the health care sector will require of us, and the economic factors that affect the bottom line.

This is where we are now. We have plenty of backward memory. It is time to move into forward memory mode: anticipating improved patient outcomes by making use of our EHR experience and information.


Onward and Upward – The Adventure Continues May 6, 2011

Posted by Darla in Adventures.
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Now that the adventure of EHR implementation is in the past, we are moving into the next Adventure in EHR Land: proving that Syringa Hospital and Clinics meets the standards of Meaningful Use.

What is Meaningful Use? According to the U.S. Government, Meaningful Use (MU) requires that medical providers show that they are “using certified EHR technology in ways that can be measured significantly in quality and in quantity.”

The current MU definition includes an extensive list of objectives which hospitals and physicians’ offices across the nation are required to meet. Each subsequent year, the criteria increase or additional are added so that, once on the MU track, an organization continues to make significant strides in improving patient care.

Syringa, now live with a fully integrated and certified EHR, intends to meet Stage 1 MU by October 1, 2011. To do this requires significant care and feeding of the EHR, the employees who are responsible for using the system, and the team spearheading the effort.

To make Stage 1 MU by the deadline, we will need to meet 14 Core objectives and 10 additional “menu” objectives. Not to bore you with these but they include collecting demographic data, placing medication orders electronically, plotting BMI, checking allergy and medication interactions and a whole lot more.

Luckily, Cerner, our EHR partner, is on the leading edge of this work. We have a MU team from Cerner that meets with us weekly, advising us in the development of policies and procedures, demonstrating the best ways to use the EHR to provide required measurement data, and keeping watch on this fluid area of Federal legislation.

Once we make MU, we will be eligible for significant incentive funds from Medicare to pay for the implementing the EHR.

All this just to document that Syringa Hospital and Clinics is an excellent healthcare provider in Idaho County, which WE already knew.

The really good news in all of this? Everyone wins, and personal health and wellness is improved for everyone who comes through our doors.

The Adventures of EHR Implementation March 25, 2011

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by Scott Bailey, Cerner Engagement Leader during Syringa’s Implementation

At the time of this narrative, Syringa has been live with Cerner for about ten weeks. All of the planned clinical and financial solutions have been implemented. Syringa is remote-hosted in Kansas City, MO and has an Application Management team that coordinates and performs adjustments to the software build for the Syringa team as they are identified. The original project team continues to manage some remaining issues and to address some needs that pre-date the support team.

As an Engagement Leader who has had the privilege to manage projects overseas and in the US over the last four years, the project at Syringa has provided me an opportunity to reflect on several levels of detail and performance. While many small hospitals may be intimidated by a project of this magnitude, the level of preparedness and the overall ‘we can do it’ attitude at Syringa has been fantastic. The hospital team listened to the experiences and Best Practices of others and incorporated relevant pieces into their newly transformed way of working. The staff at the hospital are a hard-working and knowledgeable group, and it’s common for each staff person to perform multiple functions (‘wearing many hats’). They also have a sense of humor about such things as the ‘Night Before Go Live’ poem can attest.

As with all projects of this type, it has been a learning experience for everyone involved, including the Cerner team. The town where Syringa is located (Grangeville, ID) is the county seat and serves as a hub in their area. A project of this type requires a lot of person-to-person coordination and communication; the fact that Cerner and Syringa are located 1,592 miles apart can make that a difficult process. Weekly calls with each specialty area to verify specifications, details, and to transfer solution knowledge kept the teams in contact with each other. Periodic onsite events (known as a ‘Cerner Invasion’) formalized many of those decisions and provided face-to-face opportunities to adjust course where needed.

There were bumps in the road—the financials portion of the project did not go as quickly as everyone would have preferred and decisions to delay implementation (Go Live) were ultimately the correct ones. In the end, Syringa had one of the smoothest conversions that I’ve been associated with. While it would be nice to take some credit for that, it’s not a reflection on the Cerner team—it’s a reflection on the Syringa team. Testing, testing some more, and testing (yet some more) helped them to not only have a better-prepared build but also to have a better-prepared team. Those results are evident each day as they become more proficient with their use of the EHR, as their questions become ever-higher quality, and as they identify the ‘next direction’ that they and their Critical Access Hospital colleagues need.

It will be a bit sad to move on to other assignments, but it certainly has been an enjoyable experience with the team in Grangeville. And we (the Cerner Syringa team) are confident that there are future chapters in learning and growth both for the client team and for our team. Congratulations to the entire Syringa team, you should be very proud of your achievements.