NorthShore University HealthSystem

Evanston, Illinois

• Annual revenues of $1.5 billion
• Staff of approximately 9,000
• More than 2,000 affiliated physicians with more than 75 office locations
• Significant capabilities in a wide spectrum of clinical programs, including oncology, cardiology, neurology, neurosurgery and orthopedics

Stage 7 Award
Recognized hospitals in 2009: 3
Recognized hospitals in 2010: 1

Challenge: NorthShore University HealthSystem had a clear business purpose with the introduction of its EMR in 2003: The health system wanted a centralized data source that could be shared across more than 75 locations where care is provided. In addition, the organization had clear direction to closely tie together the patient care given in the hospitals with the physician office setting, including both the system’s employed and independent physicians.

Implementation Solutions: NorthShore University HealthSystem was recognized by the HIMSS Davies Committee as the first health system in the United States to connect hospitals and physician offices with one database. NorthShore’s executive management decided upon this strategy in 2001 with strong support from the board and the professional staff. In 2003, the then three hospitals and 68 employed physicians’ office locations went live on the EMR and removed all paper charts.

The health system has 50 independent physicians in 25 office locations now using its systems in their offices, which adds to patient convenience and helps grow the database to better serve all patients.

In addition, NorthShore’s Professional Staff passed a bylaws revision in effect stating: “If you are going to treat patients in our hospital, you must use our EMR.”

EMR Solution: Epic

Recognizing the ROI of EMR Implementation

Decreased time for test results: Turnaround-time for test results has been dramatically reduced – in a number of cases decreasing from 2-3 days to one.

Remote access to imaging: Radiology images are available throughout the 75 care locations and remotely for physicians from their home or travel location.

Virtual rounds: Some physicians conduct “virtual” rounds on patients. After conducting their customary morning rounds in person, they check on their patients electronically at the end of the day by handling any care needs on the computer.

Improved access: Physician practices have evening, weekend, and walk-in hours. This is driven by the demand of the patient. Nearly 40 percent of appointments in NorthShore’s Medical
Group practices are made on a same-day basis. Patients are willing to go to another physician because all of their information is available to all physicians through the EMR.

Better documentation: With improved documentation, billing and reimbursements are more accurate. Documentation is available at the fingertips of staff who need it. Coders can review the documentation to ensure billing is accurate before the claim goes out the door, resulting in far fewer denials. The coding denial rate is ~2 percent. When insurance companies request additional documentation to support claims, the request can be turned around on the same day because the chart is readily available, an advantage that has helped in lowering AR days in the Medical Group to 35.

Dictation savings: Dictation costs are significantly reduced, and in most cases, eliminated at up to $1,000 a month per physician.

Clinical pathways care plans: All the orders are appropriately categorized and accessible. Nurses caring for post-operative patients used to deal with 3-4 pages of orders. Now, templates with standard orders streamline the process.

Fewer medication errors: Following the implementation of CPOE and bar coding at the bedside for medications, reports of medication errors have dropped by 80 percent.

Patient portal: Over 100,000 patients use NorthShore Connect, the patient portal that allows them to schedule appointments, check for test results, e-mail questions or concerns to their physicians and access parts of their own medical records. More than one third of these users access this electronic health record in a given month.

Improved screening: MRSA infections were reduced by 70 percent, in part, by an alert built into the EMR that prompted nurses to do the screen.

Enhanced communication among physicians: If a primary care physician sees a patient in the office and refers for labs/ ancillaries, etc, he or she has access to the results as soon as they are released. If the patient is then referred to a specialist, the specialist has immediate access to all of the patient’s history – eliminating the need to fax progress notes, etc. As soon as the specialist sees the patient, their notes are available to the primary care physician. If the patient is later seen in the Emergency Department or hospital, again all history is there. All of this facilitates NorthShore treating the patient sooner to provide better care since physicians have access to all of the patient’s information to use in developing a care plan.

Lessons Learned

Faster is better than slower.

• With all the other demands for IT assistance in other areas of the organization, the staff remained focused on the EMR implementation.
• Many of the advantages of the EMR are gained only once there is widespread use and information can be shared easily.

Always provide in-depth training.

• All clinicians receive 16 hours of classroom and online training and must pass a test to get their ID for all new installations.
• NorthShore offers more than 86 unique classes for the different users of the EMR system.

Introduce the EMR implementation as a corporate-wide strategy.

• Clinicians and top management must lead this type of transformation.
• IT is still essential for the project and must deliver a user-friendly system and one that is robust and reliable.

 

If you are a healthcare provider and would like more information on how to obtain your hospital’s EMR score, e-mail us or call us at 866-546-2900.