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Clinic Implements Allscripts TouchWorks EHR, Seamlessly:
Global Works Senior Clinical Consultant Sherri Atchley helps St. Vincent's Achieve Success
"The Family Medicine Practice go-live was one of the best I have ever participated in, Instead of trying to make the technology fit the practice, they took a hard look at their processes and what the new technology offered and changed what they were doing to take advantage of the new system."
Sherri Atchley, Global Works Senior Consultant and Certified Allscripts Consultant
Client Profile
St. Vincent's Family Medicine Center, part of St. Vincent's Health System in Jacksonville, Florida, serves as a family practice physician office providing care for private pay, managed care, Medicaid and commercial patients. It is one of the main vehicles by which St. Vincent's fulfills its mission of compassionate, available medical care for all patients in Jacksonville.
St. Vincent's Family Practice Residency Program provides primary and obstetrical care through the Family Medicine Center. Approximately 2,500 patient visits per month are provided by 30 Family Practice Residents who are supervised by Board Certified Family Practice, Pediatric, and OB/GYN physicians.
Background
Ensuring reliable and efficient office communications is central to the Family Medicine Center's mission of providing holistic health care with respect and compassion. However, the paper chart system used by the practice had serious limitations and was causing concern. The entire staff depended on one paper chart to document notes, review diagnoses and answer patient questions. Finding client information quickly and easily, tracking changes to patient charts, refilling medications and messages going through many different hands all created significant burdens for physicians and staff. It was clear that something had to be done.
Implementing an EHR to Ensure Quality of Care
A team was assembled to evaluate electronic health records systems (EHRs) with the goal of improving the efficiency and effectiveness of the health care delivery system. David McInnes, MD, Duaine Murphee, MD, Mary Gray, Senior Systems Analyst, Gwen Lloyd, GME Director, Randall Hartley, Family Medicine Practice Director, and Robin Potts, MD worked together to gather input from clinicians, administration and IT staff. "Under the guidance of Senior Systems Analyst, Mary Gray, we put together a list of specific requirements that would work in a residency practice," offers Project Owner, Dr. David McInnes. "We needed to see an EHR successfully implemented in a situation similar to ours."
After careful review and consideration the team selected Allscripts TouchWorks EHR V10.2 from Allscripts in December 2005. "We were looking for a system that fit a practice and residency program," confirms Mary Gray. "We had a check list of needed functionality and things that were imperative for a residency program—and Allscripts TouchWorks fit the bill." TouchWorks EHR automates vital clinical functions that directly affect a patient's health including writing and refilling prescriptions, ordering tests, viewing results, documenting care and checking for harmful drug allergy interactions. Family Medicine Center implemented seven Allscripts TouchWorks modules including Base, Document, Scan, Rx+ (including SureScripts), Result (Outbound/Interbound with Quest and Lab Corp), Note and Charge for all clinic practitioners and staff, in October, 2006.
After the application selection process, the focus became implementation. Allscripts partner in implementation, Global Works Systems, Inc., provided support during the deployment. Global Works EHR Implementation Services are designed for Allscripts clients who are beginning their implementation and are ready to roll out the solution to their physicians and departments. Global Works Certified Allscripts Clinical Consultants deliver a full spectrum of support across the entire deployment —managing and building vital clinical content, training the project team and physician early-adopters, working hand-in-hand with physicians to ensure their mastery of the technology, and showing up in person to support each go-live event.
Leveraging Technology to Improve Processes
Sherri Atchley, Global Works Senior Consultant and Certified Allscripts Consultant has been involved in a number of Allscripts EHR installations. "The Family Medicine Practice go-live was one of the best I have ever participated in," affirms Sherri. "Instead of trying to make the technology fit the practice, they took a hard look at their processes and what the new technology offered and changed what they were doing to take advantage of the new system."
Working in concert with team leaders, Family Medicine Practice Director, Randy Hartley began reengineering the practice to leverage the new technology and improve the processes. At the time, Family Medical Center was using GE Healthcare Business Services (IDX Flowcast), Cerner Classic, Cerner Millenium and Siemens MedSeries 4 systems. Beginning in the summer of 2006, Mr. Hartley created the initial flow chart to capture existing baseline flows and then developed cross-functional groups to review existing processes and understand TouchWorks processes. His goal was to refine internal processes and leverage the software's new flow. He gathered input from all areas of the practice, including physicians, patients, nurses and lab technicians. "Creating an efficient practice flow is a two-step process," mentions Mr. Hartley. "Doing the two things simultaneously is sort of like building an airplane while you're
flying it", he adds.
Valuable Training Before Go-Live
An important aspect of the Family Medicine Center EHR implementation that Sherri Atchley noticed was the enthusiasm for the project. "The entire staff was upbeat and excited about the go-live. I didn't see any of the resistance or objections to new technologies that I've seen during other implementations." Sherri attributes this to staff involvement in the process to thorough training well before the actual go-live. "My sense was that physicians and staff alike were eager to start using the new EHR and were excited about the changes."
Several months before the go-live, Physician Champion Dr. Duaine Murphee started meeting with staff on a one-on-one basis to give a system overview before training. "We wanted to provide a continuous loop of training," offers Dr Murphree. "We would often meet during lunchtime and look at demos of the product so that everyone was familiar with the idea and on the same page with the plan and the timeline." The staff also attended functional training with support that included integrated testing on weekends. According to Mr. Hartley, "the integrated testing helped lower the fear factor of the support staff."
Global Works Assistance Provides Seamless Integration
Global Works supplied invaluable assistance, according to the team members. The expert on-site support provided seamless integration. Mary mentions, "We would progress to a certain point and start to feel unsettled. Then Sherri would arrive, explain the ramifications of the design changes we were making and everyone would feel that it was possible again. Sherri provided great continuity during the lifecycle of the project."
Impressive Changes in Work Flow
Family Medicine Center is the first of St. Vincent's outpatient clinics to move to a completely electronic format. The team is extremely pleased with the results of the Allscripts EHR implementation. The clinic now enjoys 100% medical record availability—visible throughout the practice, with messages and prescriptions handled in a timely manner. Authorization approval is a one-step process with attached documentation. "The change in workflow is pretty amazing," says Dr. Murphee. Mr. Hartley agrees: "The new system really impacts the quality of care, The EHR enables safer, personalized care that is easily accessible and more reliable."
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