Upstate Orthopedics

Situation

Upstate Orthopedics Ambulatory Surgery Center (UOASC) provides high-quality orthopedics and pain management care in its East Syracuse, N.Y., facility. Opened in 2009 and located in a state-of-the-art specialty center for comprehensive orthopedic care, the organization strives to deliver the most efficient, cost-effective services. The ASC was an early adopter of electronic clinical documentation, migrating from paper records to an electronic records system in 2014. Now, its new, cloud-based solution overcomes some of the challenges the center had with its first system, including:

• Hardware needed to achieve adequate system response times and performance
• Time-consuming update and upgrade processes
• Managing a large database
• Physician documentation compliance
  
  

“When we adopted this technology, the speed at which the software performed was acceptable for our needs, but we always wished it would go faster,” said Jon Van Valkenburg, CASC, executive director of UOASC. “We were able to develop effective processes and workflows but believed a higher speed would further enhance our productivity.”

Software updates and upgrades necessitated on-site support, Van Valkenburg provided. “We needed to coordinate with the vendor, making sure our servers were rebooted and had the latest updates installed before the overnight update commenced. Following the update, I came in early and updated the client software on all our workstations. It wasn’t a difficult process, but another process to complete nonetheless.”

After a few years of heavy use of the technology, the ASC was also facing a significant decision. “Since we were hosting the system internally, we were starting to push the limits for the size of the database and physical infrastructure. If we wanted to continue using the technology, it would require an additional infrastructure investment.”

Solution

To address these and other issues, UOASC switched its EMR to SIS Charts™, a cloud-based electronic clinical documentation solution from Surgical Information Systems (SIS). Van Valkenburg said he initially had some reservations about investing in a cloud-based system. “There’s the accessibility aspect and understanding how that would work as well as how it would impact our performance. I also had some concerns about security.”

These concerns were alleviated once he learned about SIS Charts and had an opportunity to view it. SIS Charts provides ASCs with a configurable, secure solution that automates charting processes and allows for faster access to clinical information. It also reduces the total cost of ownership and maintenance costs compared to non-cloud clinical documentation solutions.

Van Valkenburg pointed specifically to two components as having a significant impact on efficiency: SIS Charts Physician Mobile, a mobile electronic medical record that provides physicians with schedule updates and anywhere, anytime ability to view and complete documentation, and SIS Charts Tracker, patient tracking boards in preop, OR, recovery, and the waiting room that update as a byproduct of clinical documentation.

“We wanted a system that would improve our performance and help streamline our workflows,” said Van Valkenburg.

The improved performance addressed some of the more significant challenges associated with the non-cloud technology. “This enhanced functionality allowed us to become more efficient and improve our workflows by reducing the amount of time required to wait for something to load or progress.”

By moving to a cloud-based solution, infrastructure limitations and updates are no longer concerns for the ASC. “Since we don’t host the software, there’s no need to support an internal database. When it’s time for an update, there’s nothing for us to do: no installation and no planning. When we come in, the new version is there and ready for use.”

Results

UOASC went live with SIS Charts in April 2018. The transition couldn’t have been simpler, said Van Valkenburg. “We waited until the week before we went live to introduce the new system to the staff because we felt it was going to be an easy switch [to SIS Charts]. We didn’t even need to bring any SIS staff on site. Our superusers received end-user training remotely and they trained the rest of our staff. We switched over to SIS Charts and haven’t looked back.”

A significant improvement has been achieved in the ASC’s medical record documentation compliance. “Getting our surgeons to complete their orders, progress notes, and medication reconciliation was something we struggled with when using the old solution. SIS Charts has made it easier for them do what they need to and for us to monitor their compliance."

SIS Charts Physician Mobile helps UOASC maintain its high rate of compliance. “It helps physicians prepare for surgery by giving them convenient access to their current schedule, case details, and attachments,” said Van Valkenburg. “They can also sign off on orders, medication reconciliation, and op notes using whichever device they choose.”

SIS Charts Tracker has delivered organization-wide benefits, said Van Valkenburg. “It has significantly reduced the frequency of family members and friends asking our front desk staff for updates on patient status because they can visually see their loved one’s progress through the surgical event. We especially like that the boards are updated automatically as a byproduct of the clinical documentation already taking place. This is both a satisfier for patients and families and a time saver for staff. With fewer distractions, staff productivity has increased as well.”

All of this has been made possible without any sacrifice in security. “Before we adopted SIS Charts, SIS worked with us to ensure our ASC and physicians’ offices had the right amount of accessibility while minimizing any risk of jeopardizing HIPAA compliance. We get the numerous benefits of a cloud-based system and still have peace of mind.”