Colorado centers combine tech know-how

Implementing a new electronic health record (EHR) system is a daunting task for any behavioral health group. It touches every aspect of an agency’s work, and the transition from paper records or from a previous technology solution has to be as seamless as possible to avoid disrupting the clinical practice.

The transition can be even more difficult for small and rural organizations, which have few information technology resources and staff to devote to an EHR project. But as provider organizations in Colorado have discovered, there is strength in numbers.

Tightly knit

Over a year ago, nine provider groups in the Centennial State that are implementing the same EHR and practice management platforms decided to form a statewide users group that would meet on a quarterly basis. One of the goals of creating a statewide user group was to hold quarterly in-person meetings and share the cost of training from a software vendor or consultant.

Will Walser, vice president of information systems and chief information officer at Jefferson Center for Mental Health, which has 20 locations in Jefferson, Gilpin and Clear Creek counties, says that although his organization is one of the largest in the state, it was not one of the first in the state to implement the Netsmart EHR the group is using, and so his staff has benefited from participation in the group.

“I have always been a big proponent of training,” Walser says, “and I see this as an inexpensive way to stretch my training dollars, and the social networking also is good for my staff. We can’t continually try to reinvent the wheel. It doesn’t matter the size of the organization. Everybody has good ideas of ways to do things better.”

The community mental health agencies also decided to form four subgroups to meet online on a weekly, biweekly or monthly basis. The first subgroup to form focused broadly on the technology of EHR implementation, including integration with other applications.

“The tech group was born out of an idea that a subset of the larger user group could get together on a weekly basis to review what agencies are doing,” says Liz Faris, director of electronic health records at Northeast Behavioral Health in Greeley, Colo., which provides shared services for two community mental health agencies in Northeast Colorado: SummitStone Health Partners in Larimer County and North Range Behavioral Health in Weld County. “There are tools available within the application that we could all be exploring and sharing,” she adds.

For instance, if one center creates a report, the other agencies might use the template. Community mental health centers have limited resources, so such collaborative efforts help create efficiencies.

Usually the online sessions involve presentations by representatives of the larger health providers that are typically further along in their implementations. Stephen LeClair, a data architect for Mental Health Center of Denver, was the engineer responsible for customizing and integrating the medical record system into other applications at the center, which is one of the largest providers in the state, with approximately 850 employees, 14 residences and seven primary locations. He sees participating in the tech subgroup as a way to help other providers in Colorado.

The tech group started out by meeting on a weekly basis online for several months, but now is reducing that frequency to monthly. “That is partly because several folks are in the short strokes of their implementation cycle now, so they don’t have time to learn,” LeClair says.

As a meeting leader, LeClair says, sometimes it can be a challenge to determine what to discuss for a given week that would help the participants.

“They don’t know what they don’t know, so it can be tough to get answers from them about what to work on,” he says. “I mostly cover things I thought were cool. We have a really good evaluation and management form, so I spent a few sessions on that form. We have a rules engine we have invested in, and we have had another center create a rules engine with our structures. Things like that are challenging on the tech side but really useful.”

And the meetings are interactive, not just a lecture. In the first 10 minutes he may ask participants how things are going for them. If someone says they are having a particular problem, LeClair can set aside the planned topic and focus on the more urgent need then or talk outside the regular meeting for one-off strategies. Usually if one organization is focused on a concern, the others would want to know about it, too, he says.

Although his IT organization might be more sophisticated than some of the other providers participating, LeClair still learns from others in the group.

“I am proud of what we have done here, but there is a lot of creativity going on in Jefferson County, our closest neighbor,” he says.

Specific topics

Jill Johnson, who most recently was the EHR manager for Centennial Mental Health Center in Sterling, Colo., says the Colorado group started with the tech subgroup because that was the highest need, and then added a practice management subgroup focused on billing issues followed by a clinical workstation group and finally one focused on state reporting requirements specific to Colorado.

Faris, who has been leading the state reporting subgroup, says people who work in information technology gravitate toward the technology or clinical workstation groups, while billing staff attend the practice management sessions.

“Our chief financial officers are interested, but not attending, weekly calls,” she says. “It depends on where their area of responsibility lies and how deep of a dive they need to do to understand the software and create change.”

If other states try to emulate what Colorado has done, they should be prepared for the variety of information providers find most useful based on where they are in the implementation process. Faris says questions change from set up concerns to troubleshooting.

“Every time I come together with other users, I definitely feel valued and also I am able to garner some great tips, tricks and new functionality that we haven’t explored yet,” she says.

When there are enough people in a state or region using the same system, users just need to have leaders and a collaborative approach to get it going, Walser says.

“Fortunately, here in Colorado we have had that,” he says. “We know each other and work with each other in statewide workgroups because we have always had common goals.”

David Raths is a freelance writer based in Pennsylvania.