What’s Old is New Again: Custom Development and Integration in a Post-EHR World
The Tegria Blog Jun 18, 2021
Caring for patients with medically complex conditions for weeks, sometimes months, requires more than compassion and skill. It takes a cutting-edge technology platform to support precise communication, imaging, monitoring, and care coordination. Just ask the physicians and staff of Chicago-based RML Specialty Hospital.
After serving the organization for over two decades, RML’s legacy electronic health record (EHR) system was ready for an overhaul. To help highly skilled care teams treat life-threatening conditions, RML needed a modern, nimble EHR capable of supporting advanced applications and strategic growth.
“Our onsite MEDITECH Client Server system had been in place since 1998,” says RML CFO Thomas Pater. “It was becoming a legacy system that was not state-of-the-art, not web-based, not the most user-friendly for clinicians. And we knew that trying to take legacy software and make it state-of-the-art was like putting money into a sinkhole.”
Cloud-based compassionate care
By 2019, the organization was ready to level up. Way up—to the cloud, in fact. After a thorough discovery and RFP phase, RML partnered with a multifaceted Tegria team to build a cloud-based technology platform and implement the latest MEDITECH Expanse EHR.
Finding a partner to take RML’s EHR project from the infrastructure build through implementation, training, and long-term hosting was key, says Todd Prellberg, RML’s Director of Information Services. “Early on, we looked at onsite solutions as well as hosted, and decided that hosting onsite was not feasible for us. With 10 IS team members in our department, we’re a small group. And the server requirements of MEDITECH were beyond what we could stand up.”
With expertise in hosting, implementation, and healthcare, Tegria understood the needs of RML’s providers and staff. “There aren’t many long-term acute care hospitals like RML in the country, and their workflows are uniquely challenging,” says Tegria’s Sean Harnett, who led RML’s technology and hosting implementation.
A multi-stage hosting and implementation project like RML’s requires a strong partnership, says Chad Skidmore, Tegria’s VP of Hosting and Infrastructure. “This was a true partner relationship, not a vendor relationship. We approached this as our problem to solve together.”
Getting to go-live
Championing a lengthy IT project that touches every hospital department and care team brings its share of challenges. Communication is an under-recognized source of struggle during IT implementations, and achieving buy-in from physician and leadership teams can be slow. “It was a bumpy road to get everyone in the organization on board, but we kept pounding the pavement,” says Prellberg.
One problem that could have delayed the entire project was an issue with RML’s legacy picture archiving and communications system (PACS). “There were some unexpected challenges with interfaces that occurred, like an issue between our legacy PACS and the Chrome browser that prevented our doctors from sharing imaging through MEDITECH,” says Pater. “It was almost a deal-breaker; we wanted a new PACS and so did our radiology team.”
Tegria advised against installing a new imaging system during an EHR overhaul. “To this day, I’m very grateful that Tegria stood their ground,” says Pater. “They figured out how to utilize a Chrome extension that allowed us to use our existing PACS. That was a key issue that Tegria helped us solve. “
Along with troublesome technology interfaces, RML’s leaders had to help front-line caregivers adapt to change. For physicians and staff, adjusting to updated workflows and tools took time. “Tegria handled all of that, up to and after our go-live,” says Pater. “They kept physician leadership in the loop every step of the way, whether it was the design of the system or the educational part, tailoring the education to their needs.”
From go-live to growth
On August 1, 2022, RML achieved their goal of launching on-schedule, a feat that required “laser focus” from RML’s management team. “We learned from MEDITECH that 65 percent of their clients do not go-live on their planned go-live date,” says Pater. “From our board, all the way down, we were connected on this project. We understood that this had to be the number one priority.”
With a cloud-hosted EHR in place, RML can keep its momentum going. From here, the organization plans to prioritize interoperability and advancements in patient care. “They’re now at the cutting edge in terms with what they’re doing at the point of care with technology,” says Tegria project manager Michael Bartman. “We’re excited about what we can help them achieve.”
Ensuring a smooth, successful go-live starts with hiring the right consultant, notes Pater. “I’m extremely pleased—Tegria exceeded my high expectations. We know we made the right decision to go with Tegria, and look forward to a long relationship.”
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