Dr. McQuade-Jones Finds the Right EHR for Her Clinic
Bambi McQuade-Jones is a doctorally-prepared nurse practitioner who established a community health center ten years ago in rural Lebanon, Indiana. Boone County Community Clinic is a family practice that primarily cares for underserved and underinsured patients, many of whom are women. Several years ago, the clinic implemented an electronic health record (EHR) system, but the clinic’s providers were dissatisfied with its functionality. Dr. McQuade-Jones took the initiative to select and implement a new EHR system that better met the needs of the clinic.
Meaningful Use Guides EHR Selection
The clinic’s first EHR system offered few benefits over paper charts. Though it computerized patient records, the EHR system did not offer any practice management, reporting, or quality improvement tools. After working with the EHR system for a year, the Centers for Medicare & Medicaid released meaningful use Stage 1. Upon learning about the goals of meaningful use, Dr. McQuade-Jones knew she wanted an EHR system that would allow her to track patient outcomes, safety measures, and health care quality. The clinic worked with the Purdue Regional Extension Center (REC) to identify a local EHR vendor that would help them meet meaningful use.
Transitioning to a New EHR System
Boone County Community Clinic encountered two major challenges when implementing the new EHR system.
- Importing data: Only half of the clinic’s 2,000 patient files were easily imported. The clinic had to manually import the remaining 1,000 files, which was time consuming and labor intensive. During the data migration, the clinic had to use the two EHR systems simultaneously. To ease the transition, the clinic purposefully decreased patient volume during the implementation period with the awareness that proper implementation and training would streamline workflows and improve health care quality.
- Transitioning to a more advanced EHR system: The new EHR system had more functionality than the original system, so staff members had to be trained to use new features such as the patient problem list. To assist with the transition and mitigate any staffing challenges, the clinic hired licensed practical nurses to help capture information in the EHR and provide care planning support. Anticipating that hiring and training new staff might contribute to a period of decreased revenue, Dr. McQuade-Jones secured outside funding through grants and donations prior to the transition to the new EHR system.
The EHR System Supports Patient Priorities
Equipped with the tools to provide high quality care, the clinic conducted a patient survey to identify their patients’ major health challenges. Patients named obesity, smoking cessation, and depression as their top issues. In response, the clinic won a grant to develop the Health Education, Resources, and Services (H.E.R.S.) for Her program, a comprehensive maternal and child health program. To support the program, Dr. McQuade-Jones has been using the reporting capabilities of the new EHR system to track patient-specific goals. Early evidence indicates are losing weight and reporting reductions in depression. So far, the 400 women in the program have lost a total of 1,500 pounds.