JOHN DAY — By the time you read this, Blue Mountain Hospital will have a new electronic record system in place.

The hospital has been keeping patient clinical and financial records in electronic form for many years, but hospital officials say the new system represents a major upgrade.

Making the switch, however, is a major undertaking, requiring months of preparation and training — all of which was set to come to a head at midnight on Monday, Sept. 11, when the new system was scheduled to go live.

Maisie Taylor, the hospital’s director of quality and information technology project manager, has been overseeing the conversion. In an interview last week, she said she had no concerns about the changeover to the new system.

“We’re ready,” Taylor said. “We’ve been ready — it’s been a long project. Not that there won’t be hiccups that come up, things we didn’t foresee. But we’re prepared.”

The system

The new electronic health record (EHR) system, called CommunityWorks, is made by Cerner, a subsidiary of Texas-based Oracle Health. It’s specifically designed for small, rural medical centers like Blue Mountain, a 25-bed critical access hospital.

Based in the cloud, the system will store and manage a full range of records for the hospital and its affiliated physician group, the Strawberry Wilderness Community Clinic.

The types of records in the system will include everything from notes on doctor visits to lab test orders and results, X-rays and other medical images, charts for emergency room and acute care patients, and full patient medical histories. It will also house appointment scheduling information, billing data and patient discharge notes, as well as keeping track of medical supplies, drugs and other inventory.

“It’s all built in,” Taylor said.

That all-in-one capability is one of the things that made Cerner CommunityWorks attractive to hospital leaders after they started shopping for a new electronic health records system more than two years ago.

“The main feature that stood out to us is we can have the hospital and the clinic on one (system),” Taylor said. “We actually have two electronic systems now, one on the hospital and one on the clinic side.”

The new system did not come cheap. In addition to $1.5 million in upfront costs, there will be ongoing fees of $40,000-$45,000 a month. While that’s more than the hospital was paying for the legacy systems Cerner is replacing, the ongoing cost includes automatic updates and upgrades of operating systems and data platforms, analytics across the entire enterprise and full support services.

Prepping for the switch

In addition to Taylor, the team in charge of putting the new Cerner CommunityWorks EHR system in place and ensuring a smooth transition from the old systems includes Chris Wall, the hospital’s director of information technology; Shannon Gardner, clinical informaticist; and Kristen Adams, nurse informaticist.

Preliminary work on the project began last November, Taylor said.

Once the groundwork for the system was laid, staff training began this spring, using a “train the trainer” approach. Key people in each department of the hospital and clinic were the first to learn the new system, then they trained their staff.

That’s been going on since March, Taylor said. The effort has ramped up in recent weeks, with conference rooms converted into training facilities with rows of computer terminals.

“It’s everyone who uses the EHR,” Taylor said. “Anyone who’s clinical or billing has had training on it, and our (patient) registration staff, too.”

While the staff has been schooled in all the ins and outs of the new system, they weren’t working with actual patient information. That remained compartmentalized in the old systems to protect patient privacy.

“They’re training in a sandbox environment, so it’s all fake information,” Taylor said.

Now, after all those months of training, Taylor said the whole hospital staff is ready to transition to Cerner.

“There could be some challenges the first two weeks as we get used to the system, especially checking in patients, getting everybody’s information into the system,” she said, but after that she expects fairly smooth sailing.

“Cerner is sending 15 to 20 people next week,” she added, “so we’ll have that support from Cerner as well as we work through those issues.”

She’s also been encouraged by the positive attitude she’s seen from hospital and clinic staff throughout the process.

“Everyone here has been working so hard — everybody,” Taylor said. “It’s been amazing to see everyone working together. Everyone’s excited. It’ll be good.”

Benefits for patients

Taylor said the new system will make things easier for staff throughout the hospital and clinic. With all the records stored in a single system, there will be less duplication of effort and much better access to information.

Cerner will also reduce hassles and wait times for getting patient information from other health care providers in the region such as St. Charles Medical Center in Bend, which treats a lot of patients referred by Blue Mountain Hospital — even though St. Charles uses a different EHR system.

“It’s more interoperable with other systems,” Taylor said. “We used to have to get records faxed over from Bend.”

And ultimately, she added, it will also make things easier for patients as information is migrated from two separate EHR systems to one.

“We’re doing it all with them in mind,” she said. “This will help us give even better patient care.”

To illustrate the point, she gave a before-and-after example.

“Say a patient went to the clinic and had labs ordered, then they walked over to the lab (at Blue Mountain Hospital) and those lab orders would not have crossed over yet,” Taylor said. “Also, once you have your labs done, there would be delays getting the results back to the provider because they were on a different system.”

Not anymore. After the conversion, Taylor said, those lab orders and test results will be available immediately to both clinic and hospital personnel “because we’re all on one system.”

While officials at Blue Mountain Hospital and Strawberry Wilderness Community Clinic say their new unified electronic health records system will be a dramatic improvement, they also caution that patients may experience delays during the first two weeks or so while staff get used to the new EHR system and migrate information from the two old systems it’s replacing.

Bring ID: Staff will need to verify patient information as it goes into the new system. Patients are asked to bring their insurance cards, proof of identification and emergency contact info to appointments at the hospital and the clinic.

Extended check-in times: It may take longer to check in for appointments during the transition period. Patients should arrive at least 15 minutes early.

Longer waits: Patients may have to wait longer to be seen by a health care provider.

Appointment scheduling: It may take longer than usual to get an appointment with a provider while the new EHR system is being put into place.

Only temporary: Hospital and clinic officials say all of these delays should go away after the new EHR system has been up and running for a few weeks.