What Does It Take to Implement an Expanse EHR? Ask Golden Valley Memorial Hospital’s Dr. William Dailey

Golden Valley Memorial Hospital CMIO Dr. William Dailey discusses how things are going after their recent Expanse go-LIVE, and explains what every healthcare executive should know before flipping the IT switch.

To document the success of Golden Valley Memorial Hospital’s Expanse implementation, CMIO Dr. William Dailey recently live-tweeted the organization’s EHR go-live. In this Q&A, we discuss how things are going, and what every healthcare executive should know before flipping the IT switch.

Q.: First of all, what made leaders at Golden Valley Memorial decide to move to Expanse? 

With our current outpatient platform sunsetting in 2019, we had to set an ambitious timeline for ourselves to implement a unified EMR/HCIS across all settings. That was a strategic priority for us. We had grown tired of workarounds with several different systems, and wanted better options for sepsis, antibiotic stewardship, analytics, quality, etc.

One thing to remember about Golden Valley is that we’re more complex than our size would suggest. We encompass multi-specialty clinics, rural health, non-rural health, multiple surgical specialties, oncology, home health and hospice. And so we faced the added challenge of getting all of those disciplines on the same system. We wanted our patients to be the center of everything, and that requires everyone to use the same EHR.

The goal for us in choosing MEDITECH was to achieve the usability and integration we wanted, while still maintaining our autonomy and keeping external levels of governance to a minimum.

Q.: What kind of preparation did your organization undertake, in order to make sure the implementation went smoothly?

There is no simple answer to that, but a big part of it was setting up our entire process to collect stakeholder input, at every step. Each “tribe” made decisions and designed and built their specific area, adding their knowledge into the system all along the way. This required lots of inter-tribal negotiation and an understanding of how each area interacted with the other.

Ultimately, everyone works through their turf issues, little by little, as they realize just how complex this business of healthcare informatics really is. Some of the new workflows may not seem important at first, but their value becomes really apparent at go-LIVE.

Q.: What kind of feedback have you received from your clinicians about Expanse?

Overall, the feedback from clinicians has been overwhelmingly positive. They see day-to-day improvements as their muscle memory improves with a new interface. And it helps that the Expanse user interface is a quick, smooth, and efficient one.

I like to say, “nobody ever learned to ride a bike without skinning some knees.” We may have some skinned knees but we are still smiling, pedaling, and working towards better healthcare every day.

Q.: What advice would you give to other executives planning an EHR implementation?

First of all, don’t skimp anywhere, and especially not on consulting or storage. Cutting corners will eat you alive. That said, I truly believe there is not a better EMR at any price than Expanse.

Also, you should involve everyone. Transfer your internal expert knowledge into the system and gain more knowledge from MEDITECH; they have been great partners for us. You’ll want to train many super-users — including some for the live environment to set preferences and to verify permissions. And be sure to allow two months for integrated and parallel testing. You cannot test too much.

Finally, always stay positive - both for your staff and for the future ahead. Know that whatever bumps in the road you encounter, will all be worth it in the end.

Read more about Golden Valley’s Expanse implementation in Healthcare IT Today.

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