January 04, 2012

Clinician involvement key to a successful health IT program

In any company, making a change in the way day-to-day operations function can be a daunting task. The right IT solutions must be identified, quickly implemented and adopted by the employees. Each part of this process presents its own specific challenges. In a health care setting, when the change affects the way clinicians practice medicine, these challenges are magnified. This is the situation Somerset Medical Center (SMC), a 355-bed regional medical center in Somerville, N.J., faced several years ago when it decided to upgrade its clinical information system.

From the beginning of the system design process, SMC’s leadership made it a priority to involve their clinicians as much as possible, taking steps like creating an EHR steering/oversight committee to help guide the transition. These efforts were successful, as SMC boasts high clinician satisfaction scores with its new system.

“We were in a unique position in that our clinicians were the driving force behind the decision to go down the IT path and get a better solution,” said Dave Dyer, CIO at Somerset Medical Center. “They wanted an integrated EHR system, so we found Cerner was the best partner to help us create that system.”

The medical center worked with Cerner to replace its existing, best-of-breed software and implement a new system integrating laboratory, scheduling, medical records, pharmacy, radiology, surgical and nursing. According to Dr. Lloyd Davis, medical director of informatics at Somerset Medical Center, open communication between administrators, clinicians and IT staff was vital during this process. “We worked hard to bring a lot of doctors into the decision-making process and just be very open with everyone involved. The biggest positive here was that the code was flexible enough to translate a lot of our wants and needs into reality.”

“The integrated system greatly improves access to patient information,” said Dyer. “Better access to patient information means our clinicians are able to make faster, better care decisions for our patients.”

In addition to the integrated records system, SMC is among a small percentage of community hospitals in the United States to have implemented CPOE. “We’ve seen medication orders processed twice as fast using CPOE as they were before,” said Dyer. The medical center’s CPOE system also includes clinical decision support.

“We worked with our clinicians to make sure our clinical decision alert system was as fine-tuned as possible, and there’s no doubt in my mind that the intelligence in the system has been hugely important,” said Davis. “I’d say we’ve been successful. Alert overrides are well below our baseline and we have low alert fatigue stats which, means the appropriate person is receiving the appropriate alert.”

Clinician involvement from start to finish was a key factor in developing high clinician satisfaction with the medical center’s new IT systems. Another key factor was SMC’s use of a web-based platform, called an MPage, to create a custom summary view of a patient’s information within the EHR system. Enhanced clinician access to the EHR system was also important. “Our EHR system has been the solution to multiple problems here,” Dyer said. “The system is available when our clinicians need to access it, even remotely, and they definitely see value from the time savings generated by the integrated system.”