Rebecca R. Craig, RN, CNOR, CASC, CPC-H, is chief executive officer and Cassie Seiler, RN, CSHA, is quality resource director for Harmony Surgery Center (HSC) in Fort Collins, Colo. Harmony Surgery Center is a multi-specialty ASC that averages about 65 patients a day and provides procedures in specialties including general surgery, orthopedics, ENT, urology, plastic surgery, ophthalmology and dental, gastroenterology and pain management. HSC has been an AmkaiSolutions partner since 2012 when it went live with AmkaiCharts.Q: Why did HSC want to make the switch to an electronic medical records system?
Rebecca Craig: It was for a number of reasons. We really try to look at every way to improve our care and to focus on quality, and thought an EMR would help us do this. In addition, we wanted the capability to data mine. We also feared that we would "miss the boat" to be interconnected, whether it was with our health system partner or our big GI group since their offices had moved to an EMR. We wanted to electronically converse with them and find efficient processes, so we needed to be able to interface easily. Lastly, we wanted the capability of participating with the Colorado Regional Health Information Exchange (CORHIO) in the future.
Q: How did you identify AmkaiSolutions and its AmkaiCharts EMR as a system to consider for HSC?
RC: We had been looking for an EMR for at least three years. We were searching for something that could handle our multi-specialty volume and specialty mix. We wanted a product that would enhance our performance and keep us efficient. During our research, we narrowed down the choices of what we thought could meet our needs and goals between AmkaiCharts and another EMR.
Q: How did you decide to select AmkaiCharts?
RC: We really wanted to make sure we did our due diligence. We put together a spreadsheet with EMR criteria information from the American Health Information Management Association (AHIMA). This provided clear criteria to help us make a decision and ensured we weren't just looking at whether one system was visually more attractive than the other or which one had more bells and whistles. We wanted to stick to that AHIMA criteria when we were selecting our system.
When we compared both of the products, the other EMR had fields where you were expected to enter in your own text and we were worried that we wouldn't be able to data mine with these fields. AmkaiCharts didn't have this issue. Flow was another big thing for us. AmkaiCharts had a better flow — how the data was going to work its way through the center. Also, we felt the AmkaiCharts system was more user-friendly and intuitive.
Q: How did you prepare to make the switch to AmkaiCharts?
Cassie Seiler: Starting early was huge for us, as was having one person in the very beginning that learned AmkaiCharts in and out. That was me. I worked with the AmkaiSolutions team a great deal. The other thing was, while they offered to develop our tables and help us build what we needed for the system, we felt that handling as much of this as possible in-house helped us to better learn the system. I wouldn't suggest doing that any other way!
It also helped that we made sure all the tables, dictionaries, and everything else was well-built before our go-live. The majority was completed 3-4 months in advance to ensure ample training opportunities for our team.
After populating the entire system, I went through every specialty, every possibility and every patient flow and figured out exactly what we wanted documented for the facility. I was essentially troubleshooting the system, working all of the ins-and-outs so that anything our staff would encounter, I encountered first. I worked through the learning curve so I could later help our team avoid any unnecessary frustration.
Q: How did you prepare your staff for the switch?
CS: In the very beginning, it was about communication. We would give updates at all of our staff meetings and through email about where we were with the system, what we were doing and what we were working on to ensure they were hearing it way before we went live and it wasn't thrown at them at the last minute.
RC: Cassie and Mark Bingaman, HSC's IT applications specialist, set up a computer lab and held a number of training sessions. She provided "print screens" (images of the system at work) that showed what needed to happen so the staff would have them in front of them while walking through the system on the computer. She also spent a tremendous amount of time having open lab time so if people had already gone through a training session and didn't feel comfortable with something, they could come in and train more. It was time consuming for her, but I think it was one of the reasons that our launch went off so well.
CS: We also spent a significant amount of time selecting the carts and computers that we were going to use, and every cart had a reference book on it that included images of each screen and showed exactly what had to be documented and how to document it.
Q: What was the system go-live experience like for you?
CS: It went very well. We set up a super user group and I spent extra time with that group to work through the common problems that people experienced. We all wore yellow shirts so we could be easily identified; everyone knew exactly who we were. We had helpers in every single area at all times to help the staff work through problems.
It was also helpful that we rolled the system out by specialty area. On the first day, we went live with our GI cases and all of our GI doctors. On the second day we did GI and added pain. On the third day we did GI, pain and then added the operating rooms.
Since we're such a busy facility, and AmkaiSolutions knew how busy we were, they provided some really tremendous on-site help during our rollout. One of the really neat things they did was if we did come across an error message or some other issue during go-live, the AmkaiSolutions team would go in and immediately fix it themselves. For our staff, that was really helpful; if there was an issue, it was solved really quickly.
Q: HSC went live with AmkaiCharts in June 2012. What is your impression of the system?
CS: AmkaiCharts is wonderful. It's efficient. It's everything we hoped it would be. I use it every day, and it's very easy to work in, especially once you learn how to move through the system. It's extremely user-friendly and has proven to be all that we were hoping it would be.
RC: One thing in particular that we really like for patient satisfaction is having the ability to put a monitor out in the lobby that provides a patient tracker. Before we had that, family members would have to go up to the front desk and ask if they could get an update on their family member or friend. Now, they can just watch as the patient goes through the perioperative process, which has helped satisfaction scores and decrease family members anxiety. There's also another more detailed tracker that we use in the back for our clinical team. As managers, we use that tracker to quickly see if there's a delay or if someone is running behind. As far as your ASC's operation goes, I think that helps you keep on top of everything.
Q: What has been your experience with AmkaiSolutions customer service?
CS: The customer service is great; they've always been extremely helpful. It's always very easy to get a hold of someone when we need assistance.
Q: Why is this important?
CS: It's mandatory because we're so busy, as are most ASCs, and the demands on us are only going to get increasingly higher with healthcare reform. You need your IT vendors to be very responsive so you don't have any down time and you can keep taking care of your patients and customers. We want the best and we demand the best. AmkaiSolutions did a really good job to make sure they met and continue to meet our needs.