Critical Access Hospital Taps Cerner Cloud-Based EHR Platform

Experts at North Country Hospital (NCH), a critical access hospital in Newport City, Vermont, think the hospital has found its cloud-based EHR platform for the long-haul in a Cerner product, but it was a years-long process to get to the new system.

After all, just three years ago, NCH was implementing a different EHR that, ultimately, didn’t work out.

“We had gotten to a point where our IT cost was running over 30 percent of our capital spend,” Kate Pierce, the CIO and CISO at NCH, told EHRIntelligence in an interview. “We set a goal that we were going to get out of the data center business and get back into the healthcare business.”

However, Pierce noted that just three years after leveraging the EHR system, the hospital began a search for a new EHR platform.   

“Our recent decision to go to market to look for a new EHR system mostly had to do with our legacy system changing course,” Pierce said. “The system that we're currently on got bought by a venture capital company, and their mission and goals no longer aligned with our goals.”

NCH went through an extensive search process to evaluate different EHR products.

“We put together a selection committee and set basic goals for what is it that we were trying to achieve with the selection process,” Pierce said.

For example, NCH wanted to maintain health IT cost at sustainable levels, operate on a single platform for hospital and ambulatory care, and boost user satisfaction through system efficiencies—all aims that Pierce said most community hospitals would align with.

Additionally, NCH’s search emphasized choosing a vendor with staying-power.

“We were surprised with our current vendor that their direction changed, and we wanted to ensure that we selected a product that was going to be for the long term with us,” Pierce said.

While NCH’s relationship with its previous EHR vendor was cut short, the organization did see some benerfit during those three years. Having a cloud-based EHR saved NCH money, she noted, and those cost savings informed the hospital’s next purchasing move.

“From that move in 2018, we established that moving our system off-prem really drove down our IT overall cost and spend,” she said. “When we went back to market, we only looked at vendors that would give us an opportunity to stay off-prem in a viable way with their product.”

Pierce noted that NCH took an organizational approach to the EHR selection process.

“Everyone had the ability to comment departmentally,” she explained. “As each department viewed the demonstrations of the products, they were able to set goals and then score each vendor on how they met the departmental goals. All of that information was fed up to a selection committee that aggregated the goals and measured those goals against our organizational goals.”

NCH ultimately decided to implement Cerner CommunityWorks, a cloud-based deployment of Cerner’s traditional health IT platform that aims to meet the needs of community, critical access, and specialty hospitals.

“It was a pretty unanimous decision,” Pierce continued. “I think there was maybe only one department that was deviating from our selection of Cerner.

NCH signed a contract with the EHR vendor at the end of March 2021.

“What we really embraced about the product is that this is an opportunity for a community-based hospital to take advantage of all the functionality and features of a much larger system, but at a cost that's affordable and sustainable for our environment,” she explained.

“This is going to be a win for our patients,” Pierce said. “Cerner is going to allow us to truly be a single platform, so that means that we're going to be able to understand the whole picture of the patient at every point of care within the facility.”

Pierce also noted that the EHR vendor’s connection to interoperability networks, like CommonWell Health Alliance and the Vermont state health information exchange (HIE), will help boost care coordination.

“Being able to bring in information from other systems is going to allow us not only to understand the patient and what's happened at North Country, but also what's happened in other venues across the state and potentially across the country where the patient's been treated,” Pierce said. “That really allows us to see the whole picture of the patient so we can make informed decisions at the point of care.”

While EHR workflows are still in progress, Pierce said that NCH has been able to add key pieces of functionality that are set to mitigate clinician burden.

“Some of the things that were paper-based or were being done through a ton of effort of our staff are now being automated,” she said.

For example, the full functionality of bedside devices such as vital sign monitors will integrate with the EHR on the hospital side.

“We're hoping to take North Country to a center of excellence for endoscopy in our ORs by really improving those workflows,” she said. “There are a ton of workflows across the organization that people are really getting excited about. There's a lot of momentum and excitement around the product, and a lot of that comes from everyone's love to try to provide the best patient care possible in our facility.”

As the CIO of a community-based hospital, Pierce considers the selection of an EHR product a monumental task.

“It's a great responsibility because when I look across the community, these are our families,” she expressed. “They're our neighbors. They're the people that we know and love. I look at it as my opportunity to do the best I can to improve the care North Country provides to them. I am excited to work with Cerner to move us to that next level.”

Pierce said NCH kicked off its EHR implementation in the beginning of August 2021 with a visit to Cerner’s headquarters in Kansas City.  

“We anticipate a conversion day of mid-May of 2022,” she said. “It's a pretty fast implementation as implementations go, but I think we're on a good path right now.”

NCH has been named a most wired hospital for six consecutive years by the College of Healthcare Information Management Executives’ (CHIME) Digital Health Most Wired survey, coming in at a level seven, the entry level to the accolade.

Pierce expects that the new EHR implementation will boost NCH’s Most Wired performance, not just for the accolades, but for what that really means when patients present at the facility.

“That's what gets me excited about moving forward with this,” Pierce emphasized. “I think Cerner sees that vision and is going to help us get where we would like to be.”