VCU: A Clinician-Powered Approach to EMRs

Virginia is a nationally recognized leader in health IT, and the Virginia Commonwealth University (VCU) Medical Center’s adoption of HIT is an impressive example of the state’s innovation in transforming the way health care is delivered (1). The Office of Clinical Transformation (OCT), led by Dr. Alistair Erskine, was set up as a dynamic council in charge of implementing electronic medical records (EMRs) at the VCU Medical Center. For a 780-bed hospital with outpatient clinics, this is no easy task (2).

The successes so far with VCU’s EMR adoption can be mostly attributed to the unique structure of the OCT and the high level of communication within it. The OCT is made up of 5 councils: Documentation, Orders and Caresets, Rules and Alerts, Data Retrieval and Interface, and Communication. Each council is led by an MD informaticist, Nurse informaticist, Clinical Transformation Specialist, Analyst, and Training Team Specialist, and is staffed by specific people from the hospital who can give input on the process and work flow as it pertains to that council. The leaders of each of the 5 councils make up the OCT council, which provides feedback to each of the councils and also discusses integration points between the councils. In the future, the OCT also hopes to involve patients to promote family-centered healthcare, as well as to involve residents and medical students.

The VCU Medical Center will soon be at a level 6 on the HIMSS EMR criteria, and Dr. Sean McKenna, MD Informaticist for the Documentation Council, has some key insights into the success of their EMR adoption so far. He believes that it is extremely helpful to have a hospital administration that embraces the core concepts of the EMR and that provides a positive environment for EMR adoption. Also, organizing a project of this magnitude is a daunting task on an organizational level, and Dr. McKenna suggests making good use of the hospital’s project management team to help design and effectively execute goals.

The most unique aspect of the OCT strategy is putting clinicians in HIT leadership roles. It may be hard to be decisive in this new territory of HIT, but input from the individuals using these tools in the hospital is significantly beneficial to the success of an EMR adoption. These clinicians feel the pulse of the hospital, and they know what will work and not work. Physicians and nurses have invaluable insights and this source of input should not be underestimated. A final piece of advice from Dr. McKenna is not to get caught up in “paralysis by analysis,” have the ability and confidence as an informed council to make decisions and move on.

By: Hannah Rose

(1) Pegram, Tristen. Virginia Names Health IT Advisor. Published: 9/15/08. Accessed: 2/13/09. http://www.governor.virginia.gov/MediaRelations/NewsReleases/viewRelease.cfm?id=778

(2) Lepley, Pamela D. State’s only Critical Care Hospital Dedicated at VCU Medical Center. Published: 10/8/08. Accessed: 2/13/09. http://www.news.vcu.edu/news.aspx?v=detail&nid=2651

Originally written for the HIMSS Digital Office eNewsletter:

http://www.himss.org/digital_office/DigitalOffice.asp?date=20090224