Web-Based EHR Implementation Boosts Clinician Satisfaction, Cuts Costs

A web-based EHR implementation at a Mississippi hospital has significantly improved clinician satisfaction while also cutting down on health IT costs and saving valuable clinical time.

King’s Daughters Medical Center in Brookhaven, MS integrated MEDITECH’s Expanse Patient Care product in December 2020. The web-based tool provides nurses and therapists full, mobile access to the enterprise-wide EHR.

King’s Daughters CIO, Carl Smith, noted that the healthcare organization has been a customer of MEDITECH since its 1995 go-live with the MAGIC platform. After almost 20 years, it was time for a system update to improve efficiency, Smith noted.

The Smith and his team evaluated a variety of solutions before selecting MEDITECH’s offering, he explained.

King’s Daughters entered an early adopter partnership with MEDITECH well before the pandemic began, Joe Farr, BSN, RN, clinical applications coordinator, noted.

Farr explained that the hospital’s relationship with MEDITECH and prior success in other early adopter projects gave the organization confidence to move forward with the large-scale project, this time again as an early adopter.

As an ED nurse, Farr applauded the platform’s ability to push relevant information to clinicians without getting in the way of clinical workflows. 

“From my personal experience, as well feedback that we get from our nurses, you can easily invoke, review, and dismiss the information without interrupting your workflow,” Farr said. “Beginning on day one, we immediately got feedback that the look and feel was desirable. We found across the board easier to access information, which translates into more quick and efficient care for patients.”

The medical center conducted testing on a control group of users in partnership with MEDITECH to measure user satisfaction using the industry standard SUS (system usability scale) scoring tool, Farr noted.

King’s Daughters first measured baseline clinician satisfaction with the old system. Then, the hospital gathered responses 30 days and 120 days post-live.

The 120-day post-live results exceeded every prior satisfaction score from the baseline study, Farr said.

For instance, the healthcare organization’s average time per task decreased by four minutes between the baseline to the 120 days post-live.

“It doesn't take long for those numbers to begin to add up into significant efficiency gains and time recapture for our already very busy staff,” Farr pointed out.

He also noted that the care organization observed a 33 percent decrease in clicks per task, indicating that clinicians are more efficiently gaining access to clinical information. Clinicians averaged 68 clicks per task 120 days after the EHR implementation. The baseline study found that clinicians were averaging 101 clicks per task, Farr noted.

“If it takes less time or clicks to do things, that translates into recapture of staff time which gives opportunities for clinicians to spend more time with patients,” Farr said.

Additionally, the 120-day post-live assessment found that a particular group of med-surge users had 60,000 fewer pixels of mouse movement to complete the same task. To put that into perspective, Farr noted that a medication reconciliation took about 55,000 pixels.

“If we save 60,000 pixels, we're basically saving the time of entire medication reconciliation activity, which is significant,” Farr explained.

King’s Daughters has also enjoyed cost savings from the EHR implementation. Farr noted that prior to the integration of the web-based platform, King’s Daughters used a software called Citrix to access its EHR, which requires licensing costs.

With web-based access to the EHR, the healthcare organization was able to quickly reduce its license count by about 75 percent, which has translated into thousands of dollars’ worth of savings, Farr said,

The EHR system went live on December 8, 2020, during the third surge of COVID-19 in the organization’s area, Farr noted.

Completing the project with existing pandemic related difficulties posed logistical challenges, Farr explained. For instance, King’s Daughters could not follow traditional training models or go-live support models due to social distancing requirements.

“We had to be very nimble about how we carried out tasks that are typically associated with a new implementation in an environment that is nothing like prior implementations,” Farr explained.

He noted that with MEDITECH as a partner, King’s Daughters was able to overcome those challenges related to environmental factors with creative solutions.

Additionally, Farr said that some of those creative ideas could be used to support future health IT implementations.

“There are some good outcomes there that could inform future best practices with regard to implementation, support, training,” Farr said.

“I think there are some approaches that we developed together that could certainly be repurposed for future similar situations, or just as a general best practice of implementation in a world that has suddenly gotten much more comfortable with virtual interaction,” he continued.

Farr noted that as a nurse, he has had the opportunity to participate in development discussions with MEDITECH representatives.

“It's really encouraging to see clinicians who will actually be using the product integrated into the development process,” Farr said.

Michelle O’Connor, MEDITECH president and CEO, told EHRIntelligence in an interview earlier this month that insight from practicing physicians is extremely valuable in the health IT development process as it helps ensure that the EHR system is designed in a way that is beneficial to end-users.

Through a user-centered design and implementation approach, the EHR vendor aims to mitigate sources of clinician burnout due to EHR usability issues such as burdensome documentation processes, cluttered interfaces, or a high number of EHR alerts, O’Connor said.

“We've learned that we have to understand what physicians do and how they do it,” O’Connor said.