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 Implementing EMRs At Warp Speed

A nursing home provider describes how it implemented electronic medical in record time.


As today’s competitive health care market evolves toward a model of episodic bundled payments, those producing the highest quality outcomes, the lowest cost per episode, and the lowest readmissions back to the hospital will have a significant competitive advantage.
Contracts will be negotiated with providers willing to be held accountable for superior, data-driven outcomes. As a result, the rush is on to drive electronic medical records (EMR) as deeply as possible into operations to increase visibility and access to reportable information on which accountability will increasingly depend. 
Diversicare Management Services, Brentwood, Tenn., recognized in May 2010 that it would need an EMR program focused on driving higher quality care. Diversicare provides rehabilitation and long term care services in 46 nursing centers across eight states, but at the time, had just one nursing center running EMRs.

The Secret Sauce

The real question was how could they get the rest of their nursing centers quickly up-to-speed with full EMR? The answer: Assembling a team that would leverage internal staff with institutional knowledge and a committed software partner with deep expertise in workflows and training. The result: Diversicare collaborated with a technology company to develop a plan to deploy EMRs across the remaining nursing centers.
With amazing speed, Diversicare deployed a full EMR across 45 centers in less than 18 months. While other EMR systems would have resulted in complexity, cost, and extra staff needed for integrations, Diversicare utilized an integrated EMR application and received a clean database for connecting all types of systems, from therapy and pharmacy to health information exchanges.
But what was the “secret sauce” for rolling out the full EMR so quickly? People fear what they don’t understand, so they must be continuously sold on the value, celebrate each milestone of success and have the end-game in mind. This keeps the rollout true to driving quality outcomes.

Tips For Quick Implementation

The following five principles will help guide providers in rolling out an EMR quickly:
  • Standardize the application and best practices for workflows: As the key ingredient for success at both the facility and corporate levels, standardizing the application and best practices reduces waste and ensures consistency across the resident experience.  
  • Leverage existing staff to minimize transition costs: Empower staff to provide training in their own facilities and establish a champion in each center.  
  • Create a seamless project team: Assemble a project team that includes software professionals with deep product and clinical expertise.
  • Celebrate success at each major milestone: Promote the program early to build excitement and momentum so that by the time a team arrives, the staff cannot wait to get started.
  • Get an integrated application with a single, robust database: The future of the industry depends upon being able to respond to evolving integration models; an integrated application should safely and easily integrate with many systems in the increasingly connected world of health care.  
“As the industry grows more connected, we positioned for future integrations without introducing cost and complexity by using an integrated EMR application and database, ” said David Houghton, chief information officer for Diversicare.
For more details about these five steps, be sure to check out Provider's November issue, out in late October.
David Houghton, chief information officer at Diversicare Management Services, Brentwood, Tenn., can be reached at Lisa Martens, vice president of quality management & clinical services for Diversicare, can be reached at Teresa Chase, president of American HealthTech, Ridgeland, Miss., can be reached at  
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