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TEKsystems’ Technology Deployment practice managed CHI efforts to refresh its outdated equipment. The refresh would ensure electronic medical records (EMRs) could run properly on the client’s machines and further demonstrate meaningful use of technology.
CHI is a faith-based system with operations across 19 states. The nonprofit health organization has more than 100 facilities, including over 70 hospitals, 40 long-term care, assisted and residential living facilities, two community health services organizations and home health agencies. Each year, CHI provides hundreds of millons of dollars in charity care and community benefits, including services for the poor, free clinics, education and research. As the nation’s second-largest Catholic healthcare system, CHI reported approximately 1.7 million acute inpatient days, over 370,000 acute admissions, 6.2 million physician visits and nearly 790,000 home-based visits in 2012 alone. TEKsystems has been a trusted partner of CHI since 2008.
Enacted as part of the American Recovery and Reinvestment Act of 2009—commonly referred to as the Stimulus—the Health Information Technology for Economic and Clinical Health (HITECH) Act was a significant milestone for U.S. healthcare reform. HITECH was designed to promote the adoption and meaningful use of health information technology among healthcare service providers in order to improve the quality, safety and efficiency of America’s healthcare system. The U.S. government has offered financial incentives and reimbursements to providers that move away from paper recordkeeping, adapt and upgrade their technologies, and are able to demonstrate meaningful use. In fact, of the $30 billion in stimulus funds initially scheduled for investing in health information technology (HIT) in 2009, the government allocated $19.2 billion to hospitals and physicians that are “meaningful users” of electronic health record (EHR) systems1.
While eligible providers have been incentivized to make the transition, those that do not adopt EHR by 2015 will be subject to financial penalties. To adhere to government mandates as well as capitalize on reimbursements rewards for compliance, hospitals across the U.S. are making strides to modernize their IT infrastructures and applications.
1 “Leveraging the American Recovery and Reinvestment Act: Critical Success Factors to Maximize ARRA HITECH Incentives,” http://www.himss.org/content/files/solutions_arra_whitepaper.pdf, July 2009.
Hewlett-Packard PC and laptop hardware, Windows XP, Windows 7
With the enactment of the HITECH Act, the entire healthcare industry must evaluate its existing technologies and take necessary measures to comply with EHR adoption standards within the timeframe slated by the U.S. government.
For CHI, this means a significant overhaul of all equipment older than 2008—or an estimated 13,000 PCs across approximately 70 U.S. locations. In addressing this massive transformation, CHI rolled out a system-wide initiative, OneCare, a $1.5 billion investment to upgrade all patient records across the country and fully transition to an EHR environment. The outcome of this initiative will be beneficial to patients, medical professionals and CHI as a whole.
While the OneCare initiative would be highly beneficial for the client, its medical community and patient communities, transforming CHI’s network of hospitals to an EHR system proved to be challenging. CHI’s internal IT support team was working towards the upgrade as part of its day-to-day operations. Yet, the team was not producing at a high enough level to keep up with OneCare’s aggressive timeline or handle additional work. Additionally, CHI did not have the experience or knowledge to assess and plan for actual costs of the upgrades or what the optimal process for a project of this scale and geographic spread would look like. It was difficult for CHI to budget finances and human resources and as a result, projects were under or over budgeted with no end in sight for EHR completion. This not only threatened CHI’s chances for achieving meaningful use and obtaining government financial incentives but also ran the risk of accruing penalty fees for failed compliance audits.
CHI sought a partner who understood the healthcare industry and what an EHR implementation of this scale would require. Given the geographic scope of CHI’s facilities, they needed support in developing a standardized refresh process that could be repeated and adapted within each market. Lastly, under CHI’s business model, existing hospitals—with established processes and procedures in place—were acquired as opposed to built from the ground up. The client also needed a partner who could provide on-the-ground advisory assistance in mitigating any potential internal resistance to the upgrades at a local facility level.
CHI needed a solution to help quickly and effectively upgrade outdated hardware within its market-based organization (MBO) environments as a part of its OneCare initiative and in support of its EHR implementation. TEKsystems’ proposed solution involved isolating the targeted hardware that required upgrading, preparing the facilities for this refresh effort and developing a repeatable and systematic process for handling the upgrades that can be transferrable across facilities. This standardized upgrade process would ensure careful management of the project as a whole, allowing CHI to anticipate its scope, plan for the budget and measure outcomes.
Utilizing a seamless project management strategy, TEKsystems would manage this initiative across four time zones and countless people including CHI leadership, CHI employees and medical professionals and TEKsystems consultants. Leveraging our National Logistics Office (NLO), TEKsystems’ approach would allow teams to be scaled in multiple markets across the country. And every resource deployed would have the knowledge needed to perform complex, repeatable processes at every site. TEKsystems would maintain responsibility for determining how many resources would be needed and what skills would be required where; we would also be responsible for the selection, retention and onboarding of the optimal talent for conducting the upgrades.
TEKsystems proposed to listen to the client and assess what was currently working and what was not. With our industry knowledge of best practices, we would determine how CHI could launch a standardized process for facilitating the upgrades and develop and execute an EHR implementation plan. Our solution would be transferrable and repeatable across facilities. Prior to executing the plan, TEKsystems would meet in-person at local facilities to understand reactions to it and address concerns or any negative backlash from the medical community.
TEKsystems had built credibility with CHI through our historically proven capabilities including our expertise in finding, retaining and onboarding the right resources based on individual client needs. Our past performance in resourcing, our geographic coverage and our success in MBO markets also impressed the client. In addition, given that our best practices were backed by a National Project Management Office (PMO), the client rested assured that the quality of day-to-day support would not be compromised. All of these reasons guided CHI’s decision to select TEKsystems for its EHR implementation.
By effectively managing resources and driving completion of our EHR implementation efforts, TEKsystems has successfully isolated and remediated the required devices up to CHI’s expectations. We completed this within a timeframe that was shorter than initially defined. In doing so, CHI’s internal IT staff can dedicate its attention to client and end-user support while TEKsystems can continue to identify and remediate target machines.
To start, TEKsystems assessed the locations and scope of upgrades to be handled at the various locations. We sourced, screened, recruited and onboarded a team of consultants who understood our EHR implementation plan and could apply it at the various client sites. We worked to dispel the worries and objections received from on-the-ground staff at CHI hospitals, who were often skeptical about the technical changes associated with the EHR implementation. To win over local leadership and gain buy-in on our delivery approach, TEKsystems had a formal kick-off at CHI’s Des Moines facility.
We then took an inventory of all devices and created an identification convention based on name, location, model, make and specific application counts. We renamed all devices across the client’s network. This is a best practice that CHI did not have previously in place; it will ensure future upgrades and management/timing of those upgrades can be handled with ease. TEKsystems’ team remediated any hardware issues that could otherwise hinder or delay the upgrades. We then upgraded approximately 8,000 computers across all of CHI’s priority sites for the OneCare initiative.
To manage this program, TEKsystems tracked a number of metrics including: the volume of PCs deployed to date and by location; the volume of device upgrades completed by specific dates; the total time to task by machine (e.g., location, department, profile); and budget and competition rates by quarter.
As a result of our success with this program, TEKsystems has also been commissioned by CHI to continue guiding and supporting the organization moving forward towards full EHR implementation. Additionally, with our renaming effort, the client will be able to maintain compliance with government mandates well into the future, as CHI is now aligned for hardware upgrades on a three- to four-year cycle, in terms of licensing agreements.
Through careful coordination and collaboration, TEKsystems’ Delivery Manager played a critical role in leading the entire TEKsystems team to the successful completion of this program. He also developed strong working relationships with not only the client’s project sponsor but also with field and local managers. The engagement manager effectively handled client expectations and established himself as a trusted, credible voice that legitimized TEKsystems’ role in this project, bringing domain knowledge and hospital EHR implementation experience to the table.
We embraced the client as a partner, not just a client. Leveraging internal stakeholders to collect consultative advice, TEKsystems made a point to meet face-to-face with the various area managers to discuss and understand their opinions regarding the execution of this initiative. Insights from these individual conversations were integrated with TEKsystems’ industry knowledge and best practices and ultimately guided our solution. This hands-on approach enabled us to better communicate and articulate our solution within the organization.
With TEKsystems’ in-depth industry knowledge and relevant experience in the healthcare space, we were able to deliver best practices that the client was not expecting but benefited from. For example, in taking inventory of all equipment, we developed a standard naming convention and renamed the client’s assets. By doing this, CHI can now easily distinguish between old and new equipment and track which specific units are due for an upgrade. This is a long-term value added to the scope of the project and will allow CHI to realize ongoing cost savings.