Practice Insights - Glacial Ridge Health System

REACH’s menu of technical assistance services helps clinics and hospitals with EHRs achieve meaningful use

Glacial Ridge Health System is well positioned to attest to meaningful use in 2012. It’s been working on using its electronic health record (EHR) system to enhance care delivery for over four years. Its inpatient EHR is slated to be certified by the end of the year and its ambulatory product should be certified next year.

It has a 12 person HIT Squad which is the EHR governing body, including administration and physicians, that makes health information technology policy decisions. Its clinical steering committee, made up of EHR super users and department managers, implements the policies and workflow changes.

Heidi Engle, CIO for Glacial Ridge, realizes that they are fortunate to have strong internal IS support. “Most places do not have an onsite IT person at all. If they have one, they are missing a clinical information support person, who is key to knowing how the software works from an end user perspective.”

The system consists of a 19-bed Critical Access, trauma hospital in Glenwood, Minnesota within Pope County, with clinics in Brooten and Glenwood.

Glacial Ridge was in the process of reviewing its business associate agreements, looking to see what changes were needed as a result of expansion of HIPPA (Health Insurance Portability and Accountability Act) privacy and security regulations under the HITECH Act, when they received a call from REACH offering its services.

They decided to work with REACH on specific topics that would augment what they were doing in hopes of improving patient care. From REACH’s menu of services, Glacial Ridge was interested in assistance with HIPPA, clinical decision support, and health information exchange. 

“We’ve been at this for four years and we did not want to miss any of the pieces,” said Engle.

HIPPA defines business associates as entities that use or have access to protected health information when providing services on behalf of health plans, health care providers, and health care clearinghouses. Glacial Ridge knew it didn’t have the most up-to-date language from the final rule in its business associate agreement. Engle was glad to have REACH review its agreements. 

“REACH staff was very, very helpful in reviewing the business associate agreements and making suggestions for several changes,” said Engle.

Next REACH staff will be going onsite to conduct an onsite assessment of the organization’s clinical decision support.

Throughout its work in implementing and optimizing its EHR, the number one obstacle Glacial Ridge has faced has been managing changes in workflows. By comparison, getting in and using the software has been easy. Two and a half years ago, they sat down with each provider team and asked “What does your workflow look like?  How can we take what you already have and fit it into the electronic world and improve the care of your patients at the same time?”

“We needed to process map our paper world and think about how that goes into the electronic world,” said Engle. “We found that we can’t do a cookie cutter approach. Some physicians and nurse practitioners enter their own information; others complete the documentation using a team approach.”

Glacial Ridge requires that physicians and nurse practitioners along with their nurses have the history page up to date within 24 hours of seeing a patient. While their CMIO loves electronic charting, they have two to three physicians who still dictate notes using their dictation system. That information is going into the electronic record, but it’s not discreet data—data from which you can create reports and complete coding. Glacial Ridge is working with their EHR vendor who will be able to take that text and pick out terms to convert into usable data.  

Glacial Ridge is focused on making its EHR a success and improving patient care at the same time. They constantly communicate with staff about its EHR progress. Excerpts from its monthly newsletter:

She enjoys having access to Patient Care Guidelines as well as all the historical patient information. It is easy to access and easy to sort to look for specific tests and trends.

One of Jenna’s favorite features is the Drug-Drug and Drug-Allergy checking that is accessible through E-Prescribe.

She also explains that the use of E-prescribe gives our providers the ability to track medications, as well as the drug to drug interactions. Thanks for your dedication and positive attitude.