Publication EHR Intelligence   |   Author Kyle Murphy, PhD   |   Date June 17, 2014

With a health IT market historically focused on primary care, specialty care providers have had few options when selecting systems and services tailored to their needs like EHR and diagnostics. As a result, some specialist practices have adopted a hybrid approach when setting up their infrastructure.

EHR_LogoFor the Cardiovascular Institute of the South in Louisiana, this reality has led to the implementation, integration, and adoption of three separate health IT systems for managing the administrative, clinical, and imaging workflows of close to 60 providers spread over 14 locations.

As the organization’s Director of Health Information Management, Nick Benoit has had the responsibility of interfacing these different systems prior to the availability of EHR system designed specifically, which now has the Cardiovascular Institute of the South eyeing a more integrated infrastructure.

In the following one-on-one interview, Benoit explains how the organization has managed a hybrid health IT and EHR approach and the benefits of moving toward a more integrated and hopefully streamlined platform.

What is the current health IT infrastructure at your organization?

We use NextGen as our practice management system throughout all our clinics. We also use a hybrid EHR called SRSsoft and we use Objective Medical Systems for diagnostic, report writing, discrete elements for all of our cardiac tests.

How are these systems currently integrated?

We have a tight integration between those three systems and it’s broken down into three components. NextGen strictly deals with scheduling and billing, SRS is for our clinical workflow (i.e., the provider seeing patients), and OMS handles diagnostic imaging studies such as ultrasound, nuclear medicine and telemetry.

Obviously, the goal is to have all three of those main systems talking to one another and that’s what we have done. We have interfaces between all three systems. We’re to begin at the starting point (i.e., NextGen) where the patient is scheduled and it flows to both SRS and OMS, so once tests get interpreted in OMS they become available in SRS for viewing capabilities. Going forward, our goal is to become more tightly integrated with all of our systems to allow for a more efficient way to share data across the spectrum.

How much of a motivating factor did integration play in your choosing to implement the OMS EHR in the next few months?

That was certainly a factor. Another driving factor is that it’s purely specific to cardiology. That’s what we wanted — something tailored and customized for our practice — but also taking it a step further we needed something robust and scalable because we are a high-volume organization and really want to have all of that developed as part of a single package customized for us as a group.

Why is moving toward an electronic and more integrated infrastructure important at this time?

Annually, we see more than 200,000 office visits throughout our clinics, so we’re a busy practice. So it’s very important for us to put a system like this in place because we feel as organization by going fully electronic that it will make us more streamlined and more efficient. To able to exchange data you need a tool like this.

What was it about the OMS EHR made it a logical choice for your organization?

We all know that the electronic format is a paradigm shift, so we want that change to be as seamless as possible. If we’re going to go through the motions, then we want the best out there. This particular program is developed by a cardiologist. It’s a very unique situation to have a cardiologist who has the mindset of a computer programmer who can intertwine the two. Something simple like minimizing the number of clicks or trying to make the workflow as efficient as possible from a physician’s perspective — that was a huge thing for us as well.

A lot of the other systems out there were focused on primary care. I know that’s cliché these days, but it really is true — it’s reality. You lose much of that granularity when you’re dealing with some of the other EHR systems because they have to encompass everything. We wanted to delve straight into cardiology and get as specific as possible because that is going to lead to better outcomes for us.

What is the rollout strategy for the organization: phased or big bang?

We’re going to do phased-in approach. We’re not going to go down the big bang path. It’s too labor intensive. There are too many points of failure based on my experience rolling out that way. We’re going to start off at one of our newest practices. It’s a smaller practice that doesn’t have the volume today because it’s new. It has a young staff and new physician fresh out of school who is used to that electronic process and has that electronic mindset. We’re going to start out small, work out the bugs and tweaks, before we scale it out. It will take a good month for that initial rollout.

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