NASHVILLE – Regional Health in South Dakota advocates standardized electronic charting system as a means to improve care coordination while reducing legal risks.
The five-hospital group is the largest healthcare system in the Black Hills region of the state. In 2009, Regional Health got the green light to transform its paper charting system into a client/server electronic system uniting all the hospitals.
The paper charting system was a cumbersome, 26-step process that required two full-time employees just to traffic the charts.
“We started the transition to electronic charts with a readiness assessment,” said Jennifer Gholson, a clinical analyst at Regional Health, told an audience at the Premier Breakthroughs conference in Nashville last month. “We wanted to standardize the naming conventions at all five hospitals. Then we weighed our storage needs, estimating that we’d need 3 terabytes of IT storage. In actuality, we only needed 2 terabytes – but that’s still a vast amount of storage.”
“Early on in the process, we found some physician champions, and we partnered closely with our legal and risk management departments to get their approval for our Electronic Legal Record (ELR) format,” said Heidi Tennyson, a Regional Health programmer analyst. “We also made it clear to our physicians and nurses that the electronic chart is the legal record, not the paper chart.
In the two-year span since going live with electronic charting, Regional Health has achieved numerous goals. “Our chart retrieval time is now measured in seconds, whereas it sometimes took two days at our smaller hospitals,” said Gholson. “And our chart completion rate went up dramatically.”
The electronic system almost instantly reduced staffing needs – enough to eliminate two full-time employees within 18 months. The two former traffic managers are now used more productively to prep and scan charts into the new system.
“Our coding turnaround time is much faster now,” said Tennyson. “And because it’s a client/server model, our coders can share the workload system-wide. That helps our accounts receivable situation.”
Christopher Lovering, Premier’s senior regional director based in Minneapolis, added that it’s the consistency, not the size, of an electronic charting system that makes the difference. “Some EMRs are massive, but it’s the consistency of electronic charting that’s the key. And Regional Health made standardization one of its primary goals.”
“Of course, some providers and nurses didn’t want to give up the colored paper and yellow highlighters they were accustomed to using on the paper charts,” said Gholson. “But the savings are so great, everybody’s on board now – even the physicians who aren’t tech champions.”
