Category: Continuum of Care
July 25 2016
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Banner Health has seen tremendous growth over the past 10 years. With 29 hospitals spanning seven states, over 200 clinics and rapid growth of the Banner Health Network, it has expanded its ability to care for patients across the continuum.

In an interview with EHR Intelligence, Dr. William Holland, VP & CMIO at Banner Health, spoke about Banner’s recent implementation of Cerner’s electronic health record (EHR) system in its ambulatory facilities, crediting its success to great engagement with Banner Medical Group physicians and operations, as well as a clear focus on leveraging technology to drive clinical improvement. This strategy, coupled with a new type of relationship with Cerner, drove both organizations to new levels of success.

Here are a few additional insights from Dr. Holland:

Banner Health has worked with Cerner for over 20 years, and we are continuing to strengthen this relationship with our most recent implementation of Cerner PowerChart Ambulatory across the medical group. Banner’s mission is, “we exist to make a difference in people’s lives through excellent patient care,” a philosophy that influences our approach to clinical improvement through standardization. Over our history, we have evolved our approach to clinical standardization in our inpatient facilities and, through our implementation of Cerner Ambulatory, are extending this into our clinics.

Over the past 15 years, Banner transitioned from an acute hospital system to a consumer-focused population health company. We also became one of the first Pioneer ACOs and started taking on risk of populations we serve. We worked to get high quality outcomes at reasonable costs and drove a high-quality consumer experience. About six years ago, we aggressively increased our ambulatory footprint, now with around 3 million visits a year. Our goal with the ambulatory EHR implementation was to create the same level of clinical standardization that we had established in the acute setting.

Our governance group was crucial in identifying the best information technology (IT) to help us achieve our vision. CLINIC (Clinical Informatics Integration Council) serves as the place for IT and Informatics leadership to work directly with clinical, operational and financial leaders to develop the clinical IT strategies to drive our clinical improvement efforts forward. The goals from that leadership team were to drive a successful Cerner Ambulatory implementation across the broad system, identify key strategies for success and drive engagement with our physicians and their teams.

One challenge we faced in the ambulatory space was having multiple EHR platforms. We didn’t have an integrated clinical record between inpatient and outpatient spaces, which made it difficult to deliver the same experience for our patients wherever they may come to seek care. In January 2015, we signed an alignment agreement with Cerner to help us accelerate our clinical IT integration efforts. Cerner associates joined our alignment office on-site at Banner to understand our culture, needs and where we wanted to go strategically prior to implementation.

Banner’s employed medical group had seen tremendous growth over the preceding few years, from a few hundred providers to well over 1,300. We knew we wanted a supplier like Cerner working side by side with our team. Leaders like Jennifer Lyon and Integration Architects like Stephen Spence, both Cerner associates, played a crucial role in bringing our teams together and driving our project to success. They are examples of the large number of Cerner associates who partnered with our IT team to build out the ambulatory EHR system, solved critical challenges, and augmented our internal training and support resources. We really felt that the Cerner associates were as invested in our success as we were, which drove a joint accountability for success of the project.

There was a lot of engagement between our physicians and Cerner’s adoption coaches and change management associates, working together to develop comprehensive implementation and change management plans. We wanted to make sure providers didn’t feel like we were doing this to them, but instead that they were highly involved in driving the change. We surveyed people initially, during the implementation and afterward to understand how aware they were, what their desire level was for the change, did they need more knowledge and was there need for reinforcement.

Following implementation, we used scorecards in the clinics each week to evaluate how the staff thought they were doing. Backend tools, like LightsOn and Cerner Advance, were also used to measure the efficiency of orders and documentation, benchmarking them against other clients across the Cerner network.

Cerner’s guidance was an important contributor to our success in preparation and execution of the new systems for our ambulatory clinics. We will continue to work with them to optimize workflows and make sure we are providing the best care for our patients.