Interviewees:

Shannon Maio (CSD)  |  Senior Director, Client Success

Kris Knight  |  Vice President, Clinical Documentation

Tammy Stratton  |  HIM Director

EHRs are a valuable tool for healthcare organizations, but when considering adoption and achieving the desired benefits, the failure rate can reach as high as 50%. This results in financial loss, compliance issues, medical errors, disrupted patient care, and frustration for patients and staff. EHR implementation is not solely determined by the technology itself but also by the organizational culture, workflow integration, training, and user adoption.

Tammy Stratton, HIM Director for Savista at Pikeville Medical Center (PMC), a 347-bed level II trauma center in Pikeville, KY, fully understood the far-reaching implications of a poor implementation, and when her facility decided to transition to Epic, she vowed to lead her department through a successful conversion. Savista and PMC have been HIM Strategic Sourcing partners since 2010, and Tammy has been the Savista HIM Director for more than 13 years but has a history with PMC going back to 1980. Needless to say, she was dedicated to seeing PMC and her department succeed. A year after Epic went live, she reflects on how they were successful:

"It was absolutely a team effort", she explains. "Epic assigns training that must be completed and an assessment that must be passed before you can work in the system." She spoke about how her department trained and learned as a team, working together to prepare for the assessment. "While training, we would discover issues, learn from them, and head off problems we saw coming. We escalated issues early, and if a new shortcut or tip was discovered, we shared the knowledge with the rest of the team."

"Weekly meetings allowed us to obtain status updates and document problems to have Epic fix while they were still present." She says they still come across some minor bugs, but they work quickly to get them fixed.

When asked about the efficiencies Epic has provided to the department, she said that every inpatient needs a history and physical (H&P) within 24 hours. This used to be a manual process, requiring them to visit each floor and look at paper charts to see if there was one on them. Now they simply run a report, scan it, and release the information.

Simple Visit Coding (SVC) has also been a great asset. Any claim without procedure codes (labs, x-rays, series visits) goes through SVC with a 95% first pass rate for both hospital and physician claims. "We were able to move $19 million in claims in one day—it would’ve normally taken 45 days. It greatly accelerates cash when used effectively."

Epic normally recommends 18–24 months to implement their EMR; however, PMC went live after 12 months, and the HIM/coding department was the top performing implementation at PMC, with Tammy being recognized at PMC’s town hall for leading the charge.

Tammy’s advice to others going through a similar implementation: "Analyze your processes, policies, and procedures today before your conversion and ensure it’s what you want and follows best practice. Those should all feed into Epic. You need to have administration behind you to support the transition and involve all necessary stakeholders. For us, coding and charge integrity needed to be at the table. Know your queues and make sure you have people to work them every day.”