St. John’s Medical Center is counting down the days until Oct. 22, when the biggest, most expensive nonconstruction project in the last two decades goes live.
The new electronic health records system, contracted through Cerner, will cost the hospital $20 million over the next 10 years. It revamps the hospital’s IT infrastructure, from patient check-in to bill pay.
Every hospital must have some form of electronic health records system to be reimbursed for Medicare and Medicaid patients by the federal government. Like the two old systems — Relay Health Portal and eClinicalWorks Portal — Cerner meets all the federal requirements necessary for St. John’s to receive the highest possible level of reimbursement.
“The biggest reason we needed to do this was the care coordination of our patients, because we had a different system in our clinics than we had in our hospital,” said Lance Spranger, the hospital’s chief information officer. “Now we’re going to have a much more efficient way to provide care and communication for our staff. So whether you come into our clinics, whether you come into our emergency department, whether you’re a long-term care patient in our Living Center, then you’re on the same medical health record.”
Unifying the system
Cerner is all encompassing, hospital administrators said.
“This thing runs everything we do,” said John Kren, chief financial officer. “It does everything from ordering, surgery, radiology, labs — it’s all the IT infrastructure behind all of that. It’s behind what you see when you’re sitting in your bed at the hospital to when you get the bill, all of our accounting, our financials. Everything we do IT from the core perspective, that’s what this system is.”
The current system of two portals meant that on the patient side there could be two sets of information on things like allergies, medications and surgical history, depending on the location.
“Now that’s all in one,” Kren said. “This will roll everything up to be one single database, and all the information will be the same. This will just make it more seamless for all of our patients.”
Hiccups in the changeover
The switch itself, however, won’t be perfectly seamless. That’s because none of the existing data can be transferred over to the new system.
“We do not have the ability to migrate old data, or legacy data, into the new Cerner portal,” Spranger said.
Old records will still exist in the past portals, Spranger said, or patients can contact the hospital to ask for their full medical record to be delivered to them electronically. Patients will still be able to securely message physicians and schedule appointments through the new portal.
“The reason why it’s tough is the way the database is set up in the old portals versus the new, the old information just won’t line up appropriately,” Kren said. “So even if it came over, it would still be jumbled. It would be more confusing and more painful if we tried to move it, if we even could, than just starting fresh and looking forward.”
This will affect patients, who need to reregister and potentially check two portals for their past and future health records. Spranger said physicians “have all that access at their fingertips still and will until the end of time.”
Patients can go to the hospital’s website Oct. 22 if they’d like to register immediately or wait until their first visit after that date to do so in person. Reregistration might include questions like insurance verification and inputting some duplicate information to make sure the most accurate data lives in the new system.
Past information will live at TetonHospital.org/myhealth.
The new portal has a higher level of security, because data will be saved remotely in a Tier 5 data center. Historically, data has been stored on-site.
“We get attempts every single day,” Spranger said. “But we haven’t had any incidents or breaches up until this point.”
A Tier 5 data center, Kren said, is top of the line with security that protects against everything from tornadoes to hackers.
“Cerner is cloud-hosted, so none of the data resides here in Jackson,” Spranger said. “It’s in Kansas City. They have backup facilities as well, so our data is mirrored and backed up. We just can’t provide something like that here. So moving to this really increases our security and really gives us more comfort that our health records are protected. They’re in the business of data centers. We’re in the business of taking care of patients.”
16 months, 100s of hours
The process began with a six-month evaluation process by a 35-member advisory committee — many of whom were physicians.
“I think that’s really helped us a lot to make sure that this had their input and their support to make sure we’re doing the best things for the patients that we serve,” Spranger said.
St. John’s selected Cerner in August 2017.
Testing and training of staff started in December. The hospital has put on over 330 training sessions to ensure staff are prepared.
“It’s required engagement of hundreds of people and a lot of intensive engagement,” said Karen Connelly, the hospital’s chief communications officer.
For the first two weeks following the launch, 65 Cerner staff members will be on-site to handle any hiccups.
The hospital’s contract with Cerner is for 10 years, but Spranger expects the system to last at least 15 years.
“We sure hope so,” he said. “We don’t want to do this again.”
Adding to the longevity of the system is capacity for more features to be added in years to come. It has the ability to start attaching technology from wearables and do things like feed in data from iPhones in real time. It also has the capacity to add on independent providers who want to share patient records but remain separate financially.