Productivity Up, Stress Level Down
Campus Profile: Montana State University (MSU), Swingle Student Health Center (48 employees)
Total enrollment: 12,400 students; 27,000 annual clinical visits
Services: Outpatient medical & dental care, pharmacy, lab, x-ray, nutrition, health education
Medicat EHR Benefits
- Acute care patient productivity is up 30 percent
- Instant availability of patient data enhances clinician workflow
- Common, high-volume triage tasks go faster: consent form signatures, allergy review, vital sign capture, vaccine lot number recording, etc.
- Nursing care tasks like wound care, allergy shots, immunizations, wart treatments, etc. are streamlined
- Templates significantly accelerate provider charting for common medical issues and eliminate the need for transcription
- Medicat's Online Student Health portal connects students 24/7 for self-scheduling, completing medical history and pre-visit intake forms and secure messaging with providers
- Medicat's Self Check-In eliminates the clipboard as students enter most of their own subjective data for clinical review in the EHR
- E-mail appointment reminders dramatically reduce no-shows
- No more encounter forms, lab/x-ray orders, or charge tickets for patients, providers or cashiers
Quality of Care & Patient Safety
- Medicat EHR greatly facilitates communication among providers regarding patient care.
- More time for Nurses to interact with patients for behavioral screening (ex. alcohol/tobacco use)
- Clinical protocols are systematically aligned
- Improvement has been noted in patient and referral follow-up
- Medicat's Clinical Protocol Manager automatically tracks and delivers appropriate messages to patients and providers depending on clinical practice and results (ex. Pap Smear follow-up).
- Staff has immediate access to complete and updated patient histories
- Current medications and allergies are reviewed and modified rapidly
- Symptomatic e-forms for URIs aid in both case processing and consistent application of protocols in the event of an outbreak
- Students appreciate secure, confidential messaging for medical communications like test results
The MSU nursing staff is very pleased with the impact. Bonnie White, RN, reported "since we started using Medicat EHR, the stress level in my job has gone down about 90 percent! The immunization process and the lab results are excellent, easy to access and use when giving patient care. I could not imagine going back to the way we were." Using EHR means fewer nuisance phone calls, less running around to gather data and no searching for charts since all patient data is immediately available. Most importantly, it has improved team collaboration and provided an easy and secure way for clinicians to consult each other - a much more concise and organized way than a "call me please" sticky-note posted on an office door.
Jim Mitchell, Director, reports that Medicat EHR and the Online Student Health portal enhanced the health center's reputation among a tech-savvy patient base. In his opinion, "students tend to have the view that if you're still using paper you're basically a twentieth century operation. They perceive that you are up-to-date if you are using EHR. Perception in healthcare is important. It provides confidence that you are staying current."
MSU's Implementation Process
The Goal: Montana State's vision was not only to be paperless, but to systematically align clinical protocols and raise the quality of care. It was essential for health service employees to recognize that everyone has an important role to play, not only in the successful EHR implementation, but also to boost organizational performance across the board.
The Process: In late 2007 and early 2008, the MSU and the Medicat EHR implementation team developed a task list and timeline. Clinicians and key administrators reviewed patient flow processes with staff at all levels, giving everyone a "hands-on" sense of ownership. Workflow and clinical processes were analyzed step-by-step and re-engineered, when required, including how the most common manual forms would translate into EHR templates in practice. (Templates from MSU and others are readily available to all clients in Medicat's Template Clearinghouse Library). Built-in decision points assessed changes to tasks and activities.
A team of 'super users' began to put Medicat EHR into service in early 2008. EHR went "live" at the beginning of the summer session, with all patient visits documented only in the EHR. During the summer the super users conducted half-day, peer-to-peer training sessions. The staff began using EHRs with test patients to learn the new encounter documentation, plus added a few live cases to document real-time visits. As scheduled, full usage by the entire staff commenced seamlessly at the start of the fall 2008 semester. MSU believes it has achieved its goal of aligning clinical performance goals with overall process improvement!