A Community Hospital’s Journey toward a Complete EMR

Healthcare News | August 2, 2009

Newport Hospital, founded in 1873, is a private, not-for-profit community hospital 30 miles south of Providence, Rhode Island. The recipient of numerous awards such as the prestigious Magnet and Baby-Friendly designations, Newport was recognized for its information technology (IT) accomplishments — reaching Stage 6 on the HIMSS Analytics EMR Adoption Model.

So how did a 129-bed facility become only the sixth hospital nationally to achieve Stage 6?

The answer: a good plan, staff dedication, and a technology partner to help fulfill its vision.

What is the HIMSS Analytics EMR Adoption Model?
In 2005, Healthcare Information and Management Systems Society (HIMSS) set out to establish a seven-stage hierarchy to IT implementation and achievement called the HIMSS Analytics EMR Adoption Model. In ascending order, each of the seven stages marks a new IT milestone on a journey toward Stage 7, which represents a fully electronic medical record (EMR) being used in a healthcare system that enables the sharing of information among caregivers across the continuum of care — whether onsite or remote.

Developing the Mindset
Newport Hospital’s road to Stage 6 was given direction by a well-defined, facility plan and driven by a steadfast commitment from its leadership — both at Newport and Lifespan, its parent health system.

At the root of its ambitious, 10-year IT journey was the desire to provide the highest quality patient care possible for the residents of Newport County.

"In truth, if a healthcare provider doesn’t want to do it, there are hundreds of reasons why it shouldn’t,” says Newport President and CEO Arthur Sampson. “The ROI for me is seeing the benefits of a closed-loop system and knowing that we’re measurably reducing the likelihood of patient harm. We couldn’t afford not to do it."

Six Tactics to Achieving Stage 6
1) Develop a well-defined and documented IT plan — supported by an organizational mindset of “We can’t afford not to advance our IT systems”
2) Maintain an unwavering commitment to the project, despite setbacks or resistance
3) Establish a committee from all disciplines that meets regularly to monitor existing activity and prioritize implementation projects
4) Have faith in your staff to take ownership of projects — without this trust, buy-in and support will diminish over time
5) Select the appropriate people to be involved with each project from the onset — ensuring all concerns are acknowledged
6) Develop a long-term relationship with a strong IT partner that will help shape the vision and offer the technology and implementation expertise to see it through

The First Step
The first order of business was implementing the foundation for its electronic nervous system — INVISION®, a health information system from Siemens. From there, however, the first major clinical IT implementation was Computerized Physician Order Entry (CPOE). CPOE was rolled out in 2003 in the intensive care unit, which had the most variables to consider — but offered a more manageable, limited-scope deployment area. Within the first year, 90 percent of all physicians were actively using the system.

The initial success of CPOE was paramount in generating buy-in from clinicians and energizing the staff for subsequent rounds of IT implementations over the next five years.

In the End
With a clear mission to leverage integrated IT systems to enhance patient safety initiatives and introduce efficiencies across the entire facility, these are some of the more significant achievements at Newport:

• Faster access to results: Turnaround times for images have been reduced from more than 24 hours to under 2 hours — and all studies are available electronically.
• Enhanced responsibilities: The medication order-to-administration cycle was 45 minutes. Today, the same process takes less than three minutes.
• Improved cash flow: Accounts receivable days were reduced from over 70 to 36.
• Widespread adoption: More than 90 percent of all inpatient medication orders by physicians are completed using CPOE (not including those that can’t be ordered through the system, such as intravenous adriamycin).

So what’s next for Newport after wrapping up its first 10-year plan? The healthcare system will continue to work with Siemens on its migration from INVISION to Siemens newest HIS offering, Soarian.

"IT initiatives are much like the stock market," says Todd Cipriani, vice president of professional and support services at Newport. "If you’ve got the short-term view, you’re going to have rides and get discouraged. Without a long-term view, you’re really wasting your time."