Pushing Back the Frontier: URMC’s eRecord Adventure

Arnold Wagner, M.D., chief medical information officer and an obstetrician at the Illinois-based NorthShore University HealthSystem, visited URMC on Nov. 30 to share the good, the bad and the ugly realities NorthShore faced while implementing a single, system-wide electronic medical record (EMR).

NorthShore, which adopted an Epic EMR solution (the same vendor being used by URMC) back in 2003, is one of only two organizations nationwide to earn the Healthcare Information and Management Systems Society “Stage 7” rating – the pinnacle of EMR achievement, indicating that NorthShore models the very best record-keeping practices in a virtually paperless environment. Wagner passed the following advice on to the more than 400 faculty and staff who will help to roll out eRecord (URMC’s new EMR system) at Strong Memorial and Highland hospitals in 2011.

Don’t just “pave over the cow path.” Wagner recommended that our twin goals in creating eRecord should be to become both the best place to receive care and the best place to work. He challenged us to think of our eRecord project as much more than mere modernization – instead, he suggested we approach it as a chance to adopt an EMR system that prompts us to work smarter and safer by using the same best-practice workflows across hospitals (e.g., agreeing on Epic’s model “best practice” workflows for clinicians admitting a patient). Today, as more patients seek help from multiple caregivers across a variety of settings, Wagner said that consistency in care delivery is critical if clinicians want to “be on the same screen.”

Expect to spend some time “walking through the wilderness.” Wagner warned that our shift to eRecord will be a transformational, evolutionary, sometimes even uncomfortable journey – much like the pioneers experienced as they braved the western territories. We should expect a learning curve, he said, but should also be motivated by the hope that, in the end, we’ll be doing a significantly better job for our patients.

Learn to love data. Clinicians, Wagner said, are trained to operate quickly – and if necessary, on minimal information. With eRecord, however, the pendulum is swinging toward more and more information-sharing and team play. Wagner said that providers must learn to love data; it’s absolutely essential in today’s compliance- and quality-report-oriented universe.

Remember that go-live is the start, not the destination. This detail can’t be emphasized enough, Wagner said. Perfect functionality at the moment we pull the trigger for eRecord (March 2011 for Strong Memorial, October 2011 for Highland) probably isn’t realistic, simply because staff and faculty can’t possibly appreciate all of their optimization wishes for the system until they’re knee-deep into actually using it. Nevertheless, it’s critical that projects like this move at a brisk pace and that strict deadlines are met, he said. After go-live is the time to tackle important tweaks.

For more about eRecord (and to view Wagner’s talk and the Nov. 30 kick-off session presentation in its entirety), visit http://inside.mc.rochester.edu/sites/ctp/pages/erecord.aspx. (Please note: You’ll need to be on a URMC network to view this page).

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