A complete EMR system for half the money
Midland Memorial Hospital is finally ready to brag about its Medsphere EMR system, installed for $7 million when other vendors were asking at least $18 million.
Director of IT Systems David Whiles and his 30-person staff removed the hospital's patient charts a year ago and are now calculating their return on investment from the system.
Midland is a community hospital with an elected board, which uses tax money to serve the indigent. A foundation also helps the hospital meet financial obligations.
HIMSS Analytics recently certified Midland as having a Stage 6 EMR adoption, one of only 9 hospitals in the U.S. to achieve this. No hospital has yet reached the 7th Stage, Whiles noted.
Last year Midland was also recognized as one of the "Top 100 Performance Improvement Leaders" among American hospitals by Thomson Healthcare.
So this was already a good hospital before the EMR purchase was made. Whiles' first charge was not to muck it up.
(This picture of Midland Memorial, from the McGovern Library at the Texas Medical Center, was taken around the time George H.W. Bush and family lived in the city.)
Before installing Medsphere's OpenVista in early 2005 "we didn't have an EMR. We were paper-based." The purchase process began in 2003, when the hospital was told its existing financial and lab systems would no longer be supported.
"By forcing us to replace some of our core systems, we decided it would be an opportunity to look for a long range solution," he said. The Medsphere system replaced the hospitals' lab system, pharmacy system, order entry, and added the EMR component.
Whiles explained that hospitals are being pressured by both the government and insurance carriers to use EMRs, with Medicare moving toward a pay-for-performance model and the Leapfrog Group, representing large insurers, offering higher reimbursements for those institutions which automate.
Still, training was a long process, Whiles said. "We have over 800 patient care staff as well as a couple of hundred physicians. We rolled it out to one nursing unit at a time. We would train for the two weeks before the roll out. We did that continuously for 3-4 months."
One immediate benefit is Midland now has a bar code system for administering medications."The medication has a barcode, the patient has a barcode, and when you administer you barcode both. The computer makes sure it's the right dose for the right patient at the right time, then gives a green light. If it doesn't match there's a red light."
While Medsphere's system runs under Linux, it was integrated with a Windows-based Quadramed Affinity system for billing and admissions, Whiles said. Since OpenVistA is based on VA code, billing remains one of its primary weaknesses.
"Entry cost is the biggest barriers to hospitals in implementing electronic records," Whiles concluded, and Medsphere cut that cost in half. That's how you really get hospitals into EMRs, by lowering the barrier to entry and proving it works.