Skaggs Community Health Center shows the practical side of going digital

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This was a case of moving an existing hospital to digital. All of the hospital's leaders felt it was the right thing to do for the patient, says Crystal Stallings, MA, RHIA, chief information officer. It would also provide operational competitiveness and would build on the facility's success-100 percent use of EMR in physician offices and three consecutive years of "Most Wired" honors.
   
Due to its tourist attractions, the 177-bed facility in Branson, Mo., has the unique challenge of having a population swelled by an extra eight million people for about three months of the year. Its IT strategies have been implementation of electronic records, which includes enterprise imaging as of 2001, office electronic records as of 2002, and voice recognition as of 2003. This year, the facility provided online access to results and images through PACS. The access is not just for radiology. "We rolled it out to every physician and all PCs, tablets, and other equipment," says Stallings.
   
Implementation considerations included enterprise accessibility-wireless, a thin virtual patient network, and virtually any device in any format. "We said to our clinicians, 'What fits your workflow is what we'll do,' " says Stallings. They used a phased-in approach, implementing in physician office systems first. That strategy worked because the physicians could see how well it worked for them and so created greater demand for widespread implementation.
   
Stallings attributes her facility's success to several factors, two of which were "great support that never wavered" throughout the facility and having great standards in place. Also, she had the added benefit of a director of nursing operations who had already worked at a facility that had gone digital. Another help was framing the implementation not as an HIM or IT project, but as a clinical/digital project for the whole enterprise.
   
Physicians received one-on-one training and the IT team was careful not to neglect the office and nursing staffs. After group nursing training, the training system was available on all workstations so that they could practice in their spare time. Follow-up refresher courses are available for anyone needing more help. The IT team provided total coverage for the first week after the go live date and continued rounding, finding and solving small problems before they became big problems.
   
Stallings emphasizes the importance of awareness and education. "Things were moving so fast it was hard to keep everyone aware of what was going on," she says. "We could have done more," she admits. However far she fell behind, she points out that an essential strategy was making sure management is never surprised by timeline changes or any problems.