Eight months ago, Intermountain Healthcare was facing the task of making more than 200 interfaces to support its migration from a homegrown electronic health record to the Millennium EHR suite from Cerner, which began with signing a contract in 2013.

The plan called for building the interfaces over a 2.5-year period, recalls CIO Marc Probst. The job was done in seven months after Cerner introduced Intermountain to an “agile methodology” to develop interfaces and complete other technology projects.

An agile methodology is a process that is repeatable and can be copied across an enterprise, sets no boundaries, assigns no blame and facilitates rapid feedback, says Jeff Townsend, executive vice president at Cerner. Doctors and other clinicians on Day One of the new EHR initiative were invited to be part of the design teams, brought in to play around in a basic EHR, assess the system and suggest improvements, which were demonstrated and deployed within six weeks.

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No boundaries, Probst says, means “anyone with ideas can help solve a problem. We sit down and we can solve problems incredibly fast, with no pointing fingers.” All configurations are repeatable across the enterprise and streamlined—a master patient index can be loaded one time enterprisewide rather than being reloaded with each implementation. More than 320 role-based workflows are standardized and integrated with how the EHR and ancillary systems operate. Consequently, treatment at one inpatient or ambulatory facility informs future treatment at other facilities where a patient receives care, as the other facilities almost immediately receive information on the care.

Three weeks ago, two of Intermountain’s 22 hospitals and 24 of its 185 clinics went live on Cerner in the first of several regional implementations, and the organization expects the entire enterprise to go live during 2016.

Intermountain started go-lives across the northern region of Utah, with 146-bed Logan Regional Hospital and 16-bed Bear River Valley Hospital about 30 minutes away. Next up is 321-bed McKay-Dee Hospital—the second largest within Intermountain—and 25-bed Cassia Regional Medical Center in Burley, Idaho, three hours away. These facilities are a good test, Probst says, because support issues given the increased distance will be different and four times more clinics as well as a handful of new specialties will be involved.

Intermountain is integrating its Care Process Models package of decision support and workflow tools into the EHR, called iCentra, to identify and track medical costs, services and outcomes specific to different care processes.

When Intermountain started looking to change EHRs, the organization expected to take four or five years to complete the task at a cost approaching $2 billion. Now a couple years have shaved off that estimate and the cost will be substantially less, Probst says.

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