The intersection of technology and health care has long benefitted the patient, from use of diagnostic imaging tools like MRI and CT scans to heartrate monitors. Now, health information technology (HIT), on the recordkeeping side of health care and involving the processing, storage, and exchange of health information in an electronic environment, likewise has the potential to revolutionize health care.
According to the U.S. Department of Health and Human Services, “widespread use of health IT within the health care industry will improve the quality of health care, prevent medical errors, reduce health care costs, increase administrative efficiencies, decrease paperwork, and expand access to affordable health care.”
Here at Gifford, 2023 was largely consumed with preparation for and integration of a new electronic health record (EHR) and single Gifford Patient Portal—go-live was in October—replacing the previous hospital and clinic portals and providing patients with greater flexibility in accessing their health information and other resources. The new system, Meditech, is used at Gifford Medical Center and in all Gifford clinics across the region.
Vice President of Support Services Doug Pfohl, who took the lead on the EHR transition, told our local paper, The Herald, “We couldn’t have had a better start.”
“The change to a new records system, besides cutting down on complexity,” reported The Herald, “also gives a single place for Gifford leaders to look at vast amounts of data and try to discern where the organization’s efforts are really working and where they are not.”
“Where are we seeing the most patients, where are we helping the community most? Population health is a big component to this upgrade,” said Pfohl. “We can narrow down now a lot of information … so we can see the similarities within our community and then help direct where we should be focusing the care that we provide.”
CHQR Badge for Achievement
A few months after launch, the Health Resources & Services Administration (HRSA) presented Gifford a 2023 Community Health Quality Recognition (CHQR) badge for achievement in Health Information Technology. To earn its CHQR badge, Gifford met the following criteria: adopted a new EHR system, offered telehealth services, exchanged clinical information online with key provider health care settings, engaged patients through health IT, and collected data on patient social risk factors.
“Your health center’s efforts are central to advancing a model of coordinated, comprehensive, and patient-centered care,” said HRSA Associate Administrator James Macrae in a letter announcing the CHQR badge. “Thank you for your commitment to providing quality primary health care services to your community.”
“Our new electronic health record is a great step forward for Gifford and our patients,” said Gifford President and CEO Dan Bennett. “This Community Health Quality Recognition badge from HRSA recognizes that, and shines a light on the good work of our colleagues who saw us through this transition to advance access to health information for our community.”
Provider Perspective: Q&A with Hospitalist Michelle Wade
Here, Michelle Wade, APRN, a hospitalist at Gifford Medical Center who from the early days of the EHR project (dubbed SOLE, or System Optimization to Leverage Evidence Based Practice Learning) has served on its Core Team, offers her perspective on the change in systems.
How is the new EHR a step forward for Gifford providers/staff? Patients?
It’s brought three EHRs into one. We now have the Emergency Department, the inpatient world, and the outpatient world all in a single EHR. It’s a patient-safety, patient-first documentation system now where providers don’t have to take time to go look in multiple systems to try to understand what’s going on with their patient.
Likewise, it’s a step forward for our patients, in the sense that they now have only one portal instead of the two, one for the inpatient world and one for the outpatient world, that they’d previously had to use.
Ultimately, when we finish optimizing everything, it’s also going to provide the ability for our patients to do a lot of the necessary but sometimes tedious paperwork and questionnaires prior to coming in for their appointments, which is going to help provide extra face-to-face time for patients with their providers, and that access is what it’s really all about.
Did you learn anything surprising/interesting in preparing for the transition? During the transition? In the aftermath?
One thing we learned was that there were different functions going on within the existing EHRs at our outside clinics, versus here in Randolph, versus what went on in the inpatient world, that we were actually further apart than we thought we were. There were a lot of silos. We identified areas that needed to be consolidated, refined, and streamlined to better serve our providers, and therefore our patients.
Also, in preparing for the transition, I don’t think people fully understood what a big change it would be for our providers, nursing, front-office staff, accounting and billing, materials management, or for our OR and Birthing Center, areas that were using a lot of paper.
With such a big change across our organization, of course there are challenges. Our core team continues to examine how best we can support our staff and providers as they work in the new system. In my provider champion role, I’m here to support providers with the little day-to-day nuances. For example, being stuck on a certain screen and not knowing what to do next. I might be able to help with that really quickly and simply because I work in the system, or I might be able to say, hey, that’s a Meditech problem.
We also have a new clinical informatics provider position, who closely understands the challenges associated with record-keeping for our outpatient world.
How is the EHR customized for Gifford?
Meditech is very customizable. During the building phase, we brought in each of the specialty departments, representation from Primary Care, representation from the front offices, representation from nursing and the ED, really every department, and had them look at what the system was out-of-the-box and determine whether or not they felt Meditech would work well here at Gifford. We also considered our uniqueness: being in a small community yet having a large FQHC [Federally Qualified Health Center] with clinics spread across multiple locations.
We were able to tweak and change things within the EHR to make it work for our structure, but also be an improved system that is financially more interconnected. This was significant, a driving force when we left the multiple EHRs to go to one as we needed a better accounting system and better tangibility on billing and coding. Meditech gives us that.
How can the EHR be optimized?
We are currently in the stabilization phase. Once we’re done with stabilization, we will look at optimization—those things that make your workday easier, those things that make a provider’s access to patients quicker because we’ve changed a screen to meet the provider’s need.
It’s going to be setting up those extra, most-frequently-used features or functions, and having somebody with skill within the EHR come around and spend time in your office and say, if you now have to click here, here and here, the next time you want that, it’ll be just one click and you have it. Optimization is also where we can add things that we did not include in the original build, outside of the patient safety- and finance-related items that we’re finetuning now during stabilization.
Anything else you want to tell us?
We’re continually improving. We share periodic updates with our team to communicate what things are going well, what perhaps isn’t going as well, and how we’re addressing issues. This is an evolution, one that benefits our patients and Gifford.
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