How Value, Interoperability Sway Hospital EHR Implementation Picks

EHR implementations are significant health IT investments that often require years of market research to determine which solution is the right fit for an organization’s interoperability goals.

Unity Health, a small multi-hospital health system in north central Arkansas, began the process of selecting a new EHR system five years ago.

The health system was looking for a long-term solution that would help increase care coordination across its acute, ambulatory, and emergency care settings, Phil Miller, assistant vice president and CIO of Unity, noted in an interview with EHRIntelligence.

To begin the search, Unity Health brought in a consulting group that identified vendors that could be a potential fit. From there, health system executives investigated different offerings and selected several options before bringing proposals to employees for feedback.

“There were very few groups within the hospital that were not involved with the purchasing decision,” Miller noted.

The health system brought vendors on site for two to three days each and scheduled time so that different groups of employees could come in and see product demonstrations.

Health system executives also had two site visits to the two EHR vendors the organization was deciding between. Executives had the vendors come do “a day in the life” scripted demo which looks at how providers could utilize the EHR system to help take care of a patient across all parts of the organization.

The search didn’t end there. Unity Health’s chief medical officer then took another group of physicians to a local hospital that was using an EHR system from one of the vendors left in the running: MEDITECH.

“Providers got to see the system live following physicians around in an emergency setting, in a clinic setting, and in the hospital setting,” Miller explained.

The health system gathered survey data from physicians where providers could rank system, particularly noting benefits or drawbacks for certain products. In the end, Unity Health tapped MEDITECH’s Expanse EHR platform as its top choice.

“As we were looking at MEDITECH, we saw that we would have the ability to have information in one place that would let us be able to care for the entire patient, no matter where we were in the continuum of care at the time that we were encountering them,” Miller explained.

The health system is coming from a legacy environment of three distinct EHR systems in acute, ambulatory, and emergency department settings which led to a lack of interoperability across the care continuum, Miller said.

He emphasized that this lack of interoperability not only hinders patient data sharing for care coordination, but it also amplifies clinician burden.

“From a clinician standpoint, there's value in having an integrated system,” he said. “If you're looking at multiple systems, information is never in the same place. While you may have information available, it's not easy to find. We believe that being able to have all of our patients’ information in the same place will enhance our ability to give great quality care.”

Miller pointed out that value was a large factor in the health system’s EHR implementation decision.

“We have a growing pool of patients we have to care for, and we have a decreasing pool of dollars to be able to take care of those patients,” he said.

Miller explained that MEDITECH offered a cost-effective solution that fit into the health system’s budgetary needs.

“In some cases, vendors will roll out a new product and you've got to change over to a completely new product, and there's costs involved in that,” he noted.

But partnering with MEDITECH gives Unity Health license to that product, which ensures the organization will not have to make another large health IT investment. 

“You may have some costs to implement and train, but long-term, you're not going to have to purchase that product again,” he said. “As we were plugging in those long-term costs, we found MEDITECH to be a very cost-effective solution five, 10, 20 years out.”

Miller emphasized that the health system went all the way to the 20-year mark to assess costs since this was an investment to support long-term change.

“Our current EHR that we've been on for our hospital settings, we've been on for 31 years, and we've been on our current EHR for clinic settings for about nine years,” he pointed out. “We don't make changes very rapidly. We don't make them very often. When we made a solution change, we knew we were going to keep it for a long time.”

Miller noted that visiting a larger healthcare organization in Arkansas that was utilizing MEDITECH and hearing rave reviews was helpful in making the final decision.

“That spoke volumes to us and gave us a lot of confidence that we are going to be able to take this platform and allow it to grow with us as we add either other hospitals, or other specialty care settings and clinics along the way.”