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Can launching an EHR be a group activity?

July 14, 2011
by Nick Zubko, Associate Editor
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Five agencies in Maine join forces to implement one new system that works for them all

Implementing a new electronic health record (EHR) system can be complicated. That’s why five behavioral health organizations in Maine decided a few years back to join forces and embark on the journey together. “This group of organizations had strong connections with one other,” noted Lynn Duby, CEO of Crisis and Counseling Centers (Augusta, Maine), one of the agencies involved.

“Now, everyone is very enthusiastic about the adventure we’re on.”

At this week’s joint conference of State Associations of Addiction Services (SAAS) and the quality improvement organization NIATx, representatives from the five-agency “collaborative” shared their experience. Combined, the agencies consist of more than 1,300 staff members and serve nearly 12,000 clients annually with mental health, substance abuse, developmental disabilities, and brain injuries.

According to Duby, a couple of the organizations had implemented EHR in the past and not done it very well, while she said the results at Crisis and Counseling Centers likely made them “the poster child for how to do everything wrong in implementing an EHR.”

“We ended up with a [system] that was fairly expensive, enormously complex, and our staff hated it,” Duby recalled. “We decided that we needed to do it differently [this time] and we needed to involve staff more than we had originally.”

For another member of the collaborative, Opportunity Housing, Inc. (OHI) in Bangor, Maine, increased accountability, decreased funding, as well as “labor-intensive” paper-based recordkeeping systems, were the key factors that “really spurred” the organization to get involved in the joint implementation. “We couldn’t monitor people’s quality of work without going through large amounts of the paperwork,” said Margaret Longsworth, OHI’s director of clinical services. “It just wasn’t an efficient way of doing business.”

Previously, OHI had invited a number of vendors to make presentations to the organization. But having learned from past experiences, Longsworth recognized that OHI didn’t have the “necessary expertise to make an informed decision.”

“The other organizations involved in this collaborative are our competitors,” she explained. “Yet, we have been able to come together and trust each other enough to go through this process. This collaborative not only provides a mechanism to harness expertise, but also to make it fiscally possible.”

A letter of intent was drafted in August 2008 and a request for information (RFI) was soon sent out to prospective vendors. Over the next year a number of responses had come in, and by late 2009 the group selected finalists to make presentations. After careful analysis, they chose to partner with ClaimTrak Systems, Inc., and signed a contract in January 2010.

“Now the real work has begun, in terms of analyzing workflows and standardizing data,” said Duby. “While these are things you need to do to implement an EHR in any scenario, for us, what’s intriguing is that we’re doing it with five organizations as though we are one.”

In addition, since the EHR will be implemented collaboratively between the agencies, each will avoid a common scenario in which “you end up with several different EHRs, because they are all customized the way each group wants,” Longsworth pointed out.

The arrangement is structured to enable other organizations to enter the collaborative and adopt the EHR for what she called “a very reasonable” amount of money. Across the five agencies, 42 services have been developed thus far, enabling new members to step right into the new EHR—and to be sure that any documents they need have already been developed.

“That will be an amazing thing,” added Longsworth. “I can’t wait until we get to that point in this project.”

Currently, the agencies are testing the new system and plans are to go live in the fall.