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Strategies Stick in Lengthy Deployment

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Though it began deploying electronic health records in January 2004, Elmhurst (Ill.) Clinic still considers itself in the middle of system implementation. But the 74-physician group practice still is relying on strategies created more than four years ago to help move the project along, said Joseph Kaliski, M.D., chair, internal medicine and EHR medical director for the system, from NextGen, Horsham, Pa. Kaliski spoke Monday at Health Data Management's Clinical Automation Summit: Strategies for Electronic Health Records conference Sept. 17-18 in Chicago.

For example, Elmhurst Clinic deployed simple applications in the system first, such as electronic messaging and documentation so it could garner physician buy in out of the box and ensure their support for future changes, Kaliski said.

"The EHR is a living thing that you need to manage," he said. "You must have a force pushing it through so things don't get stalled."

Since implementation, Elmhurst Clinic has reviewed this initial goal when deploying other more complex applications, such as electronic prescribing, clinical staff documentation and lab ordering.

Also, before implementation began, Elmhurst Clinic assembled a physician advisory committee comprising varying clinician personalities to get differing opinions on how the system should be used in each practice. Now, the multi specialty group practice is again using that initial group strategy to help get the other practices it's recently purchased live with the system, Kaliski said.

"Each department and physician has their own operating style, so you need to work with them," he said.

Elmhurst Clinic plans to revisit these and other initial implementation strategies as it plans to go live with other EHR applications over the next six months, including patient self-registration, a patient portal, voice recognition and electronic capture of vital signs, Kaliski said.

EHR

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A major success factor for accountable care organizations will be linking caregivers across the spectrum of care delivery. If history is any indication, that's going to be an industrywide struggle.

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