Finding and implementing an electronic medical record system proved to be both an undertaking and an accomplishment for Cardiovascular Institute of the South. Serving south Louisiana for more than 25 years, CIS is one of the most respected groups of cardiologists, representing every specialty in heart and circulatory medicine. With 10 locations throughout south Louisiana and more than 30 physicians and nearly 500 team members, CIS averages about 190,000 patient visits per year.
CIS consistently positions itself at the forefront of technology by providing the most up-to-date technology coupled with compassionate care. To stay consistent with this mission, CIS purchased a traditional EMR system in 1999 to replace its original paper-based chart system. Thirty days later, after CIS underwent a lengthy transitioning process, the product was discontinued, leaving CIS back at its starting point. Unfortunately, CIS purchased a second product that led to the same result.
CIS chose a third product in the hopes that it would be the right fit. The vendor had a product in another specialty but was interested in developing a cardiology-specific product. Though the collaboration was successful, CIS hit a roadblock; the system became too cumbersome and time-consuming to maintain. It was unrealistic to expect physicians to slow down their processes to input such detailed information into the system. The whole nature of the EMR system did not fit CIS' processes. A consultant suggested that CIS consider a hybrid EMR system.
CIS found a hybrid EMR system that seemed to be a perfect fit. However, to be sure that it was the best choice for CIS, each employee had a chance to view and comment on the system. After a vote to determine whether or not CIS should purchase the hybrid EMR system, an overwhelming 95% of employees were in favor of purchasing it. “We learned that a robust, intuitive, easy-to-use solution is what's important for staff and physician buy-in,” said CEO David Konur.
A hybrid EMR is a high-performance EMR solution specifically designed for high-performance, high-volume and high-revenue practices. It does not require complex physician data entry but has a robust document management engine that works simultaneously with powerful data management and workflow modules. These modules address messaging, e-prescribing, PQRI, reporting and reminders, outcomes tracking, order management, or simple chart access.
The hybrid EMR creates a 100% digital practice, with universal access to all patient information. It also increases quality of care and maximizes efficiency without hindering the way physicians practice medicine. Physicians can also document patient visits in a variety of ways, whether it's through handwriting, voice dictation, or voice recognition while still receiving the benefits of a completely digital office.
Once the software contract was signed, CIS created an internal steering committee to drive the project forward. The committee was comprised of individuals from different departments within the practice, including medical and nonmedical personnel, IT, practice administrators and champion physicians.
In March 2008, CIS began implementation of the hybrid EMR system. During the initial implementation, CIS increased its medical records staff with temporary employees. This increase allowed CIS to maintain its current workflow volume while transitioning into the new system. Within a year, all 10 CIS clinics had implemented the new system.
CIS has elected to participate in the CMS reimbursement incentive by utilizing the physician quality reporting initiative and the e-prescribing incentives. However, the cost of CIS' hybrid EMR was substantially lower in price compared with other traditional EMRs. The total cost was less than $1 million dollars and included hardware, software, implementation and training for all locations.
Since adopting the new system, CIS has seen huge improvements in workflow, office efficiency and response time to patients and referring physicians. Data are immediately entered into the digital system, and employees can instantly access charts anytime from anywhere. Charts can even be accessed while physicians are on call or away from the clinic. This improves physicians' ability to make informed decisions about each patient, and therefore significantly increases the level of care that CIS offers.
The new system also allows employees to provide results, prescribe medicine, and address problems and concerns with a quick turnaround time. Patients are receiving better service because their questions and requests are handled more quickly and efficiently. CIS is also seeing a decrease of errors in clinical information because charts, documents and test results are now stored electronically at all times. And as long as employees follow the proper documentation procedures, the system's automated process pulls the charts from various departments and assigns them to the appropriate patient files.
CIS is in the process of interfacing the hybrid with external systems such as catheterization lab images, CT images, electrocardiogram data and laboratory data, as well as nonclinical procedures. “A huge asset of the software is that all diagnostic-testing documentation and images can now be stored and accessed in one place,” said Jason Hebert, CIS' CT Team Leader. “The software is customizable to fit the needs of any medical practice.”
Overall, the new system increases efficiency in all of CIS' workflow processes. It allows staff to spend more time with patients, and the electronic process does not slow down physicians. This efficient flow of pertinent information, communication and collaboration gives CIS the ability to provide world-class patient care—now and in the future.
Nick Benoit
Director of health and information management
Jon Walker
Chief information officer
Cardiovascular Institute of the South
Houma, La.
