Lora Bentley spoke with Paul Hensler, CEO at Kern Medical Center, about the California county hospital's move to electronic medical records.
Bentley: What has the process of moving to electronic records been like for KMC?
Hensler: The original challenge was simply the cost of commercial systems. We thought it would probably be a $40 million to $50 million total cost to implement a commercial system, and that wasn't anything we would have the funds to do. We eventually started looking at VistA and then Open Vista and found that was affordable for us.
Bentley: Were you familiar with VistA at all?
Hensler: I had been a little bit familiar with it. I was previously at an academic center where our faculty and residents went to both our hospital and the VA hospital. It seemed no matter how much money we were dumping in the system, they always liked VistA better. But when a couple of the doctors here said, "Can't we just use VistA?" I was very concerned about doing that. We don't have a really robust IT department. But then we ran into Medsphere, which has taken the VistA system, put it on a more contemporary platform (Open Vista) and is working with us on a consultant basis to install it.
"We've been wiring and ... have just gone through the selection of a variety of handheld devices, which actually has been the most difficult and controversial part of it."
Bentley: How's it going?
Hensler: We signed contracts in November, and we expect to go live the first week of the coming November, so we're about six months in.
It's been going amazingly smoothly. We've been wiring and also configuring a wireless network to prepare for it, and have just gone through the selection of a variety of handheld devices, which actually has been the most difficult and controversial part of it.
Hensley: Of course, everyone originally thinks they want an iPad, but as you start looking at it, that really doesn't make a lot of sense. You have to get realistic about what kind of devices to use.
Hensler: So the medical staff and the clinical folks have been very engaged with Medsphere in writing their rules and putting their protocols together. Fortunately, everybody's accepting it as, "We have a powerful new tool. Let's not just pave the cow path. Let's use the power of this new tool to consider doing things differently."
Bentley: What was the selection process like?
Hensler: In our case as a county hospital, we would have had to do an RFP process to select a commercial system. In fact, we had already taken an RFP to the board to find a consultant to help us write the RFP for a commercial system. The systems are just so complex that unless you do an RFP correctly in technical terms, you're not quite sure what you have. We thought it would be at least a two- to three-year project, even if we had the funds.
Medsphere was the only vendor we could find that offered consulting services on installing an entire Open Vista system-from inpatient to outpatient clinics and possibly to some of our partner clinics in the community. Because of that we just needed to do a sole source justification rather than an RFP.
In county terms, going from a first meeting in August to a contract in November and being up and running a year later is kind of lightning speed. And obviously, hitting the first phase of meaningful use is very important to us. We have a high portion of MediCal patients, and the formula for the ARRA funds rewards you if you have a lot of indigent, MediCal and Medicare patients. That will more than pay for the system.
Bentley: And you're confident you'll satisfy the meaningful use requirements in time?
Hensler: We don't see anything that should be a problem. We were pretty much prepared to meet all of the meaningful use criteria, so now that we can pick and choose a little, it should be a lot easier for us.