One hospital's new approach to clinical documentation
Phoenix Children's Hospital faced a daunting though not unique challenge: implementing a single EMR across multiple clinics and more than 70 subspecialties. Administrators understood that physician acceptance was critical to the project's success, so providing doctors with an easy-to-use clinical documentation tool was a top priority.
In 2012, after an extensive search, PCH selected Allscripts Sunrise Ambulatory Care.
"We liked the open .NET framework and it used the same database as the hospital," said David Higginson, senior vice president and chief information officer for PCH. "The doctors liked the inpatient side, so we decided to add outpatient as well."
Despite the appeal of the Allscripts solution, however, PCH leaders felt the Allscripts clinical documentation tools were dated.
"It would have required us to build hundreds and hundreds of templates," Higginson told Healthcare IT News.
"We had decided not to use the clinical documentation tools within the Allscripts product and had only a year to get the system in," said Higginson. "We saw Quippe as a documentation tool that could not only give us very structured data but would also be very quick and appealing to the user."
Higginson also recognized that, because of the open Allscripts platform and its ability to run Microsoft tools, integrating Quippe would be fairly easy and allow PCH to "jump start" the template building process.
"With Quippe we can type in the disease state and it builds 85 percent of the template," said Higginson. "The templates almost build themselves."
With help from Allscripts, PCH successfully embedded Quippe into the Sunrise Ambulatory platform.
"We added features to pull data real time from Allscripts and added macros to build shortcuts," said Higginson. "We had one programmer working on it part time for nine months."
In November, 2014, PCH went live at its general pediatrics clinic and quickly gain physician acceptance.
"Within three weeks they were seeing 30 percent more patients than they ever did before and were leaving at 5 p.m.," he said.
In addition to streamlining clinical documentation, Quippe also simplified the charge entry process.
"Both the documentation and charge functions are tightly integrated into Quippe, so the doctors don't know it's Quippe and not Allscripts," said Higginson. "Before they had to go to a separate system for charge capture. Now it is all put into Quippe and the charge information is automatically fed into Allscripts."
PCH continues to find new benefits as it takes additional clinics live. "Before Quippe orthopedic notes had been fully dictated," he said. "Now the physicians use voice recognition and no dictation. That's a big savings."
Higginson also reports that chart notes are now forwarded to referring physicians on a more timely basis.
"Because there is no dictation, our community physicians now have notes from our doctors the same day," he said. "It used to take two to three days."
Higginson believes that the most significant benefit of Quippe is that physicians are now able to see more patients.
"In some specialties we have a two to three month wait for an appointment," said Higginson. "We've been able to cut out unnecessary minutes during the outpatient visit and are able to see more patients a day because of Quippe.
"At the end of the day," he said, "the number one benefit is that we are able to support the physicians in their work so that more children are being cared for."