A 276-bed, state funded “safety net” hospital with over 70 percent Medicare/Medicaid payer mixing the middle of the Pacific Ocean does not exactly scream “perfect environment” to have a fully adopted and integrated electronic health record system (EHR).
“But we asked the question, ‘Why not us?’” said Money Atwal, who was originally hired in 2007 as the Chief Information Officer for the East Hawaii Region of the Hawaii Health Systems Corporation and became the Chief Financial Officer later that same year.
Atwal, who was previously at a much larger facility Queens Medical Center on Oahu, began the seemingly insurmountable challenge of being the first hospital to establish an EHR in Hawaii’s state hospital system. He was equipped with the backing of the East Hawaii Regional Board and a modest budget of $5 million.
Assembling the Team
Hiring an army of EMR consultants was not in the budget. Out of the 1,100 employees at Hilo Medical Center (HMC), Atwal had to find exceptionally skilled, courageous and optimistic EHR champions to form the Health Connect team. Since the internal team did not have any prior EHR project management or implementation experience, he supplemented the Health Connect team with just a few external resources.
“Not having a sizeable budget for outside consultants actually worked in our favor,” said Atwal. “We utilized our in-house Information System personnel and selected highly skilled nurses and department managers who were the most knowledgeable about their units’ and departments’ operations. This was the foundation of our Health Connect team. They were challenged to build a system that was user-friendly and provided a benefit to patient care and fiscal management.”
“We had to choose champions who believed in the project and could envision that the overhaul of the hospital would lead to better patient outcomes for the community and healthier finances for the hospital,” added Atwal. “Many members of our core team had never used an electronic medical record, let alone build a system before. I knew I was asking a lot of my team, but I trusted them to complete this project.”
By the fall of 2009, the Health Connect team was assembled and the MEDITECH 6.0x system was selected for its integrated clinical & financial applications with a total low cost of ownership. In May 2010, Hilo Medical Center held a traditional Hawaiian blessing to officially activate the system.
The limited budget also forced Atwal and the team to prioritize goals within the project.