University of Wisconsin Hospital and Clinics

Madison, Wisconsin

• 961 physicians
• 25,450 inpatient admissions in FY09
• 493-bed tertiary care hospital and regional referral center with major programs in organ transplant, heart and vascular care, cancer care, neurology and neurosurgery, pediatrics and orthopedics.
• It includes American Family Children’s Hospital (AFCH), a 61-bed state-of-the-art pediatric facility located adjacent to the main hospital. The hospital’s community clinic locations offer both primary and specialty care to patients throughout the Madison area.

Stage 7 Award
Recognized hospitals in 2010: 2

The hospital is staffed by the UW Health faculty physicians of the UW Medical Foundation. In addition to pediatric care at AFCH, it offers cancer care in conjunction with the UW Carbone Cancer Center, and Level One trauma care for both adults and pediatric patients, including a verified burn center and UW Med Flight critical care air transport.

Operating since 1996 as a public authority, UW Hospital and Clinics is the largest non-governmental employer in Madison. It is both independent and non-profit and receives no state funding except Medicaid reimbursement.

Challenge: UW Hospital and Clinics could not successfully implement a two-way interface from its legacy EMR to its legacy pharmacy system, which was required for implementation of computerized provider order entry (CPOE) of medications. Faced with this challenge, operational and information technology leaders decided the only solution was to select a vendor that offered an integrated pharmacy application as part of its EMR solution.

The UW Medical Foundation (UWMF), the UW Health physician group, had already begun installing EPIC in its clinics. Epic offered the pharmacy integration UW Hospital was looking for, as part of its comprehensive set of integrated business and clinical applications. The hospital’s decision to use Epic for its EMR made it possible to have a single patient record for both the hospital and the physician practice. The decision presented its own challenges as it caused UWMF to have to re-think many of its installation decisions and choices in order to accommodate the needs of the hospital. This was successfully accomplished during the 48-month installation of all but one module of the suite that EPIC sells. UWHC was also the alpha site for Epic’s mobile medications product, anesthesia product and now the transplant module.

Implementation Solution: The hospital has more than 109 clinics in eight locations and the physician practice has more than 30 clinics throughout south central Wisconsin. The availability of a single integrated database made it possible for the hospital to realize an 85 percent or greater rate of orders entered electronically by providers by December of 2009.

EMR Solution: Epic

Recognizing the ROI of EMR Implementation

• Reduction of outside transcription service by more than 60 percent realized in the first 18 months.
• Reduction in the use of pharmacy technician staffing.
• Reassignment of hospital unit coordinators.
• Significant reduction (more than 85 percent) in volume/cost of paper forms.
• Higher percentage of “clean claims” because of better editing available at the point of service.
• Reassignment of registrars due to the installation of patient self-check-in kiosks for registration.
• Closure of multiple remote clinic building medical record rooms and significant reduction in space required for storage in the main medical record space.

Communication Improvements

• Rollout of the Epic Care Link module has resulted in improved communication to community referring physicians.
• The patient information is delivered via the electronic record only, allowing all care team members access to the record from any location at any time.
• Rollout of the patient portal for our primary care clinics has resulted in quicker availability of lab result data to patients and the ability to schedule appointments online.
• Implementation of the Care Everywhere module in Dane County, Wis., provides instant availability for caregivers of patients using multiple health care entities in the area.
• Reduced labor for caregivers by putting in place electronic download of patient vital signs data and ventilator data directly to EMR flow sheets (bio-medical instrument integration).
• First in nation to implement electronic download of anesthesia cart data directly to the EMR. (UWHC was the alpha site for Epic’s mobile medications product, anesthesia product and now the transplant module.)

Lessons Learned

• “Big bang” inpatient implementation for provider order entry and online clinical documentation (physicians and nursing/patient cares services) provided a more seamless experience for the patient.
• Ambulatory should have been installed as a single phase rather than multi-phase and in a shorter period of time.
• Executive sponsorship is critical to success; at UW Health the install of Epic remained the number one priority for four years.
• The existence and use of the skills and knowledge of a nursing informatics team and a medical informatics team were critical for the UW Hospital and Clinics installation.
• Physician Champions played a major role in support and “morale building” for the various specialties.

 

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.