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Ohio providers explore "collaborative" EHR

April 28, 2010
by Dennis Grantham, Senior Editor
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Agencies work together to cut costs, share implementation knowledge, and build clout

Some 40 behavioral health and human services leaders converged April 21 at the Northeastern Ohio Universities’ College of Medicine (NEOUCOM) near Ravenna, Ohio, to consider participating in a statewide “collaborative” electronic health record (EHR) system. Proponents say that collaborative members can expect to “go live” in about six months at a considerably lower cost in time, equipment, and risk than with other EHR approaches.

At the meeting, the founding members of the Ohio EHR Collaborative—Coleman Professional Services of Kent, Ohio, and the Center of Vocational Alternatives (COVA) of Columbus, Ohio—invited agencies to join a state-wide collaborative that uses the latest version of Qualifacts’ CareLogic EHR. This package is offered via the Internet and used on a subscription basis, an approach that Qualifacts says reduces the need for in-agency IT management and technical support.

At present, the collaborative aims to gain six new partners and bring them through the EHR implementation process throughout the rest of 2010. If successful, collaborative partners will realize lower per-agency costs for software implementation, lower per-user subscription costs, and greater market and vendor clout due to increased numbers.

Coleman CEO Nelson Burns, whose organization first implemented an EHR seven years ago, made the case clear, saying, “Coleman has a better chance of improving our technology position working with partners rather than working alone,” adding that “teaming up with a collaborative group of behavioral health organizations would make us ‘a voice at the table’ in impacting the future of EMRs.” He also offered to share his experience, and that of his IT team, with new collaborative partners so that they would not have to develop their own, separate IT resources to complete the implementation process.

After noting that he didn’t want the collaborative to “become a bureaucracy,” Burns suggested that the collaborative would ask partners to be involved in a three-pronged effort, involving working groups that would address executive, financial/technical, and clinical improvements and issues over the life of the collaborative. These groups would identify and propose strategies for coordinating with federal and state requirements, suggest continuous improvement of EHR features and efficiencies, and work toward enhancing clinical, compliance, and data-mining capabilities over time.

COVA CEO Judy Braun, MSW, said her organization joined the collaborative in 2009 because COVA’s proprietary client information was outdated and insufficient to meet the needs of the agency’s rapidly changing business. For COVA, the benefits of working in a collaborative with Coleman were obvious on many levels, says Braun. “We know Coleman and feel that there are like cultures. We need to obtain this technology at a low cost and know that we have access to IT expertise, to a clinical team that has used a previous version of the same software. We’ll be able to convert our billing, client information, and health records over at one time, and we’ll gain the infrastructure that we need to grow.”

Braun notes that issues continue to arise as COVA’s implementation proceeds. The first big hurdle involved the idea of moving from an in-house system to a SaaS (software-as-a-service) model. “We had some struggles—there was some internal resistance as people wondered ‘What about my job?’ and ‘What about my system?’ Another issue was ‘Who can access the data?’ and ‘What if there’s a breach?’ But, the truth is, we found data security to be far greater with a professional system.”

Another challenge was how to ensure compatibility of COVA’s accounting system—Blackbaud—and its payroll system with the new EHR. Braun says that she felt that membership in the collaborative, backed by Coleman’s relationship with Qualifacts, helped to ensure a rapid response to COVA’s unique data-conversion challenges. And, by hiring experienced Coleman staff as consultants to the COVA implementation—an arrangement offered “at cost” through the collaborative—Braun said that COVA’s small IT staff, just 1.5 people, were able to continue their normal duties during the implementation process.

Already, the capabilities of the new system are paying off in many ways, says Braun, explaining that the data collection and retrieval capabilities of the EHR system provides the “specialized outcomes reporting” expected by many funders, along with “richer data needed for research projects” and grant proposals. COVA’s director of marketing—and EHR project manager—Robin Hepler says that the system has also enabled the agency to forecast and manage staff productivity, budget its work to match with changing funding sources, target and win new business, and simplify compliance.


Over time, the collaborative partners believe that they will save on per-user subscription costs, while eliminating costs for user support, hardware, data backup, security, and disaster recovery through the use of the an internet-based package.

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