Article originally published on Digital Health Insights.
Despite the fact that nearly every hospital in the United States has an electronic health record (EHR) in place, the market for these systems is anything but stagnant. Vendors are continually releasing new and improved technology, and many organizations are still searching for just the right partnerships that will help them achieve their clinical and financial goals. As a result, EHR replacements are still relatively common, especially among organizations that have been living with multiple systems, sometimes from rival vendors, across their inpatient and outpatient facilities.
Cuero Regional Hospital was one of them. Located midway between San Antonio and Houston, the 49-bed rural hospital has a portfolio of services more commonly found in big city settings, including a dedicated OB-GYN unit, a certified stoke center, a variety of telehealth services, and even a wellness center and a med spa.
“Sometimes people think that rural health is just not that busy or exciting because we work in smaller communities, but it’s really the opposite,” said CIO Ismelda Garza. “We have fewer resources, proportionally, so we have to wear a lot more hats and be capable of dealing with a lot of surprises.”
To better prepare the facility for whatever comes its way, leaders made the decision to move toward a single, unified platform that offers a more integrated workflow alongside the latest patient experience functionalities and AI-driven tools.
MEDITECH products were already in use at Cuero, so it made sense to the executive team to implement the company’s newest platform, Expanse, in all of its physician offices as well as the main hospital.
“It’s a big decision to do an EHR rip-and-replace,” said Garza. “And it’s not as easy as flipping a switch and instantly converting to your new system. There’s a very challenging transition period to think about, and that’s where you can run into issues if you don’t plan very carefully and develop a culture for your staff that is motivating and supportive during what can be a very difficult time.”
Putting people first during a time of technical transition
Replacing an EHR is notoriously challenging and requires intensive planning and collaboration across the entire enterprise while keeping all services running smoothly for patients and staff.
“During this time, you have to maintain your legacy systems to the same standards you’ve always done while taking on the massive task of implementing and optimizing a brand new system,” Garza explained. “That means everyone is doing at least two jobs, if not more, and that can be a recipe for burnout if it’s not handled appropriately.”
Too many organizations get into trouble by neglecting this “people piece,” she continued. “As a CIO, you might think that most of my job is doing hardcore technical work. But I probably spend just as much time managing people. It’s a constant cycle of checking in and asking if they’re okay, asking what they need to do their jobs better, and being a conduit to the rest of the C-suite to make sure we are collaborating across our different areas and maximizing our resources as an organization.”
Clearly communicating objectives and goals – and the resources required to achieve them – is essential for keeping everyone on the same page and maintaining the motivation to push through the tougher moments.
“We have regular standing meetings with the managers and with the C-suite, of course, but we also use secure instant messaging when we need to share some ideas quickly. In addition, we want to empower our clinical super-users from the nursing side and the physician side to get involved so they can share that knowledge and provide informed elbow support as they train and assist others.”
“We recently completed our first integrated testing where we worked through all of the scenarios from start to finish, and it was so helpful to have everyone engaged in communicating and feeling like they were being seen and heard as we tackled all these issues.”
A little laughter to get through the tough times
During any technical project, even the best laid plans can go awry sometimes, and leaders have two choices about how to respond: anger or acceptance.
“We all get a little frustrated when we experience a setback. And it can be hard, as someone in charge, to respond in a way that rallies everyone to get through it,” Garza commented. “Personally, I believe a little laughter goes a long way toward diffusing tension and clearing our heads so we can get back on track and dive into solving the problem. We’re always going to be way more successful when we can keep people feeling like a team that’s pulling together instead of playing the blame game or punishing people for not meeting unrealistic expectations.”
Positive teambuilding with a humorous twist is core to Garza’s leadership ethos. For example, Cuero is a city known for its trees, she explained, which is why her team has used the imagery of “expanding our branches” as part of the branding for the project.
So, when the IT team started calling itself “Ismelda’s Tree Service” and even planned to have t-shirts made with the slogan on them, she thought it was hilarious.
“It’s just a fact of life that we’re going to have a few bad days,” she said. “It’s so important to come out stronger on the other side instead of tearing ourselves apart. If we didn’t have that level of trust and confidence in one another, we might not be as successful as we are.”
Maintaining momentum and perspective during an EHR replacement that never truly ends
Cuero will go live with MEDITECH Expanse in August, which will be a milestone achievement. Garza is looking forward to what the platform will bring to her organization, including single-sign-on, electronic signature capture, and enhanced mobile functionality.
But she’s well aware that going live doesn’t mean the project is over.
“EHR optimization work is never finished,” she said. “There’s always something more we can do to take advantage of our tools and enhance the clinical and patient experience. Even after we flip that switch, we’re not going to stop communicating with our users, gathering feedback, and adding more and more to our capabilities.”
“We’re so fortunate to have very smart people with different skill sets, backgrounds, and beliefs. We’ve been able to leverage all those strengths to come together around a common goal, which is exciting and energizing.”
Garza advises that CIOs and other executive leaders devote enough time to getting to know their teams and understanding what keeps them motivated, which is a crucial strategy for avoiding burnout and retaining key team members during a time when organizations can’t afford to lose qualified staff.
“Treat your people like a priority and they will treat you the same way,” she concluded. “Your projects are going to be way more successful when your team sees that you’re just as serious about their wellbeing as you are about your business objectives. If you can maintain a sense of perspective and a sense of humor, you’re going to be a much more capable leader when it comes to getting things done.”
