North Nation Healthcare consists of three critical-access hospitals and an affiliated residence well being and hospice company situated in northern New Hampshire. Healthcare Innovation just lately spoke with the well being system’s CIO, Darrell Bodnar, about unifying all three hospitals on Meditech’s Expanse EHR and being named to CHIME’s Digital Well being Most Wired 2023 listing in each ambulatory and acute-care classes.
Healthcare Innovation: What are a number of the largest challenges you face as a CIO of a smaller rural well being system nowadays? What’s prime of thoughts for you?
Bodnar: Prime of thoughts for me is at all times staffing. I’ve 31 IT staff. We’re liable for information analytics. We’re liable for a number of the the ancillary providers inside imaging. We have now boots on the bottom in any respect of our places, which spreads us out thinner. So staffing might be my largest concern, and never simply IT staffing. I imagine the answer to bettering the general scarcity of medical workers is expertise, automation, and innovation. I believe it is the one manner we’ll get there, and it is overdue. There are lots of processes, whether or not they’re pushed by regulatory compliance or not, that have to be improved. We have now a lot of alternative.
HCI: In addition to automating sure duties, do you suppose whether or not the EHR is perceived as user-friendly by the clinicians is vital to medical staffing?
Bodnar: Completely. In my private opinion, EMRs had been initially not designed for the doctor however slightly as a monetary software that was pushed to physicians and clinicians. Right this moment clinicians are documenting an encounter with the affected person and that has successfully made them coders and billers, too. Doctor workload is one thing that we actually have to be cognizant of. So, although there may be some resistance to AI and a number of the automation that we’re placing in, I at all times say it permits the suppliers and clinicians to be their finest. It is not there to interchange them. It is there to interchange that work, however allow them to be their finest. We appear to have gotten fairly a little bit of traction in doing so by presenting it to them that manner.
HCI: I perceive that North Nation got here collectively in 2015. When did the deployment of the shared Meditech Expanse EHR occur?
Bodnar: In the midst of COVID so, December 1 of 2020 is once we launched it. And we’re developing on three years. Beforehand, we had a complete of 5 EHRs excluding residence well being. We had three for major services, after which we additionally had an ambulatory module for a kind of organizations. After which there was one other separate ambulatory module for one of many different associates, so we had a number of EMRs.
HCI: What had been a number of the largest challenges concerning the transition interval?
Bodnar: We had not completed lots of the legwork it could take to break down that many organizations right into a single EMR. I’m speaking about defining finest practices, defining order units. So within the 12 months previous to the go-live as a part of our construct, we began to work on these. This was not only a technical course of. As a company, we weren’t prepared for it culturally. So there was lots of negotiation that went on post-go-live that most likely ought to have been completed prematurely.
The opposite lesson I discovered was that typically it is simpler to construct a brand new home than renovate the one that you just’re dwelling in. We collapsed all of those organizations into one of many EMRs that was at present in place, which was in Androscoggin Valley Hospital. They had been a Meditech buyer for a few years. It was the perfect platform to maneuver to, however they’d 25 years of bags that got here with that EMR. There are at all times issues which can be leftover or residual within the EMR, that we have now launched to the others. Possibly it could have been wiser to begin model new, after which go from scratch to our migration. However we determined to attempt to reap the benefits of it. It made sense on the time.
HCI: It’s essential to have seen fairly just a few advantages from having all three hospitals and ambulatory settings on the identical platform. You had been named to the CHIME’s Digital Well being Most Wired 2023 listing in each ambulatory and acute-care classes.
Bodnar: It’s evening and day, even with the challenges we nonetheless have. We have now a single pane of glass over acute and ambulatory throughout our total continuum of care. That was one thing we did not have earlier than. We have now that visibility now. The processes of how we do care transitions are seamless. Our physicians work in a number of locations. They might not even have what they might name conventional residence anymore. With a number of EMRs, it was virtually not possible for them to operate And for our sufferers, if we had 5 EMRs, they wanted to have 5 affected person portals. Now they will use one single affected person platform to have the ability to entry data.
HCI: You talked about analytics and reporting earlier. Is that made a lot simpler with a unified well being IT system?
Bodnar: Our aim is excessive reliability. We’re seeking to be a simply tradition the place we are able to enhance our processes. We have now employed a chief high quality officer who’s actually driving these efforts. Each ounce of that effort is predicated on information that three years in the past was utterly disparate and was not out there to us. Now, it is only a matter of mining it, it and decoding it to get to the purpose that we wish to perceive. And we’re uncovering lots of cultural and workflow points. Having information and analytics offers us the perception to get to that.
HCI: What about interoperability points? I don’t suppose New Hampshire has a powerful statewide well being data change. Are you utilizing CommonWell and different nationwide well being data networks?
Bodnar: In New Hampshire, the motto is ‘Reside Free or Die.’ Attributable to legislative efforts, we do not need an HIE and we weren’t permitted to below regulation as a result of we couldn’t retailer that data. It i manifests itself in horrible methods like with an immunization registry that was not current throughout a pandemic, which made it actually difficult. However interoperability with Meditech has been nice. We have partnered with lots of our organizations for point-to-point VPN tunnels the place we’d do HL7 exchanges of data as a part of our workflows and continuum of care. And we’re in a position to make use of CommonWell throughout the board. We are likely to get lots of vacationers we’ve got snowbirds who used to dwell right here, and go to Florida or come again.
We even have individuals who come right here to ski. Having these information are available in has been instrumental in us with the ability to present care shortly. And surprisingly a few of it pertains to the ED however lots of it has been in major care.
HCI: Did your group transfer to lots of telehealth through the pandemic and has that continued since?
Bodnar: We did transfer to telehealth. We had leveraged Zoom like lots of people did and acquired the safe licenses after which constructed workflows round that and it truly labored pretty properly. Now we’re implementing a Meditech module to assist us with that. We noticed the uptick and and we noticed slightly little bit of a drop-off. However the space the place it has caught is behavioral well being. We have now a reasonably vital behavioral well being inhabitants, they usually appear to choose that platform, and actually the clinicians delivering care do as properly. We’re working with Meditech now and a third-party vendor referred to as Phreesia to be sure that we facilitate the documentation, the onboarding of these sufferers and consents by means of an digital format in order that they could by no means must step foot in facility until it is for some some blood work or one thing alongside these traces.
HCI: Is there the rest in your well being IT technique on the drafting board for the subsequent 12 months?
Bodnar: We’re positively shifting ahead with with Microsoft’s relationship with Nuance. I believe it is gonna be Nuance DAX Copilot. That is one of many applied sciences that I believe that may allow our clinicians to be their finest. We have now quite a lot of automation tasks on the medical aspect in addition to the monetary aspect. We’re scheduling an optimization overview this coming 12 months, focusing rather a lot on the income cycle aspect, however we’re additionally acute and ambulatory providers. We constructed it throughout COVID. Rather a lot has modified since then.
I believe the most important factor that I am seeing is a transfer towards automation, a transfer towards the the sluggish however methodical adoption of synthetic intelligence and machine studying the place relevant, and ensuring we have a look at mature distributors, not these promising issues that might actually put us in a susceptible place. There’s a partnership between Meditech and Google that’s extraordinarily thrilling for us, notably whenever you have a look at the depths of the medical report and what that search functionality would seem like.
