Case Study

ChallengesWhen Linda Reed, RN, MBA, became the chief information officer in 2004, she quickly identified gaps in Atlantic Health’sclinical application infrastructure.

“We needed to significantly expandour clinical offering to support thehigher level of care our patientsexpect and to enable us to remaincompetitive,” notes Reed. “Andwhile our patient safety record wasgood, we wanted to do more.”

Objectives included creating an integrated EHR for every patient,with patient information accessibleto authorized caregivers anytime,anywhere. The organization also wanted to standardize clinical processes, provide caregiverswith clinical decision support, andbetter measure and enhance patient outcomes.

Atlantic Health created its firstapplication-based strategic plan,with medication and patient safetyimprovement topping the list.

“Our No. 1 goal is patient safety,”says Trish O’Keefe, RN, chief nursingofficer, Morristown Memorial. “We focused on performance and process improvement to improvequality, reduce the potential foradverse drug events, and enhancepatient care.”

Atlantic HealthCreates a Fully Integrated Electronic Health Record with Advanced Technologies

Atlantic Health is the largesthealth system in northern NewJersey and a leading provider ofstroke, cancer and cardiac care.Throughout its 100-year history,Atlantic Health has been amongthe first to offer groundbreakingtechnologies, such as CyberKnife –a robotic radiosurgery system fornonoperative cancers – and theMerci Retrieval SystemTM to removeblood clots from stroke patients.Innovation is a differentiator and helps attract patients fromthe surrounding area and New York City.

However, Atlantic Health had focused for years on an IT infrastructure that mostly supported its admission, discharge, transfer (ADT) andfinancial processes, and differentsolutions were in place from hospital to hospital. To meet itsenterprisewide mission to deliverhigh-quality, safe and affordablehealthcare, Atlantic Health partnered with McKesson toimplement a broad range of systems, including an electronichealth record (EHR) solution. With the new systems in place,Atlantic Health has not only connected and standardized care across its system, but also improved patient safety,reduced costs and enhanced its revenue stream.

Atlantic Health is a leading

provider of stroke, cancer and

cardiac care. Its flagship hospital,

Morristown Memorial, is

MagnetTM-designated for

excellence in nursing services

and houses New Jersey’s only

regional trauma center.

Overlook Hospital is home

to the pioneering Atlantic

Neuroscience Institute,

New Jersey’s first comprehensive

stroke center. In addition to a

children’s hospital, cardiovascular

center and cancer center, the

health system includes a host

of support services and

residency programs.

error-prone transcription practices — saving nurses valuable time now spent caring for patients

CPOE also has improved access topatient clinical data and decisionsupport tools — one of AtlanticHealth’s key goals. Order sets are inplace and evidence-based clinicalprotocols are being developed topromote best practices, expediteorder entry and enable clinicians tomore easily follow safe medicationpractices, including weight-baseddosing formulas for pediatricpatients. Care at the bedside is safer and better. McKesson’s nursing documentation system with automated triggers helps nursesmeet regulatory requirements for assessing pain, fall risk, skinbreakdown and more. Nurses also use a point-of-care system to electronically scan bar-codedwristbands and medications, helpingto ensure “five rights” checkingbefore patients receive medications.

“McKesson’s medication administration solution hasimproved our care environment,”says O’Keefe. “Every inpatient unithas embraced it, and nurses feel it has made a marked change in their practice. Our patients welcomed it, too. It’s tangible evidence of our commitment to safety.”

In addition, O’Keefe credits technology such as Horizon BusinessInsightTM, which provides real-timeperformance improvement analyticsand feedback, with playing a key role in Morristown Memorialachieving MagnetTM designation.

AnswersFor more than 15 years, AtlanticHealth and McKesson have enjoyeda unique relationship. The healthsystem has been a McKesson beta partner and an early adopterof multiple McKesson products. It has helped design, build, test and implement key business andfinancial solutions.

So when it launched its aggressiveclinical and medication safety initiative, Atlantic Health turned to McKesson for a powerful solutionset including Horizon Clinicals®

and capabilities from McKessonAutomation for nursing documentation, computerizedprovider order entry (CPOE), medication administration, clinicalalerts, pharmacy robotics, and more.Although the full technology rolloutwon’t be complete for another two years, positive changes arealready apparent.

For example, the integration ofHorizon Expert OrdersTM, McKesson’sCPOE solution, with the pharmacyhas reduced medication processingtime. The CPOE system helps physicians follow best practices when selecting therapies and doses, while the pharmacy systemsupports pharmacists’ ability to provide appropriate medicationtherapies for patients. Clinical alertsproactively notify physicians ofpatients whose clinical conditionchanges. A pharmacy order imaging system has acceleratedretrieval of scanned physician ordersand improved prioritization of STAT orders. And, pharmacy systemintegration with the electronic medication administration record has eliminated repetitive and

At a Glance

Organization

Atlantic HealthMorristown, N.J.

– Health system with eight majorfacilities including MorristownMemorial Hospital, OverlookHospital and Goryeb Children’sHospital

– 1,197 licensed beds

– 63,000 inpatient visits

– 148,000 emergency visits

– 580,000 outpatient visits

Solution Spotlight

– Horizon Admin-RxTM

– Horizon Business InsightTM

– Horizon Clinicals®

– Horizon Expert OrdersTM

– Horizon Meds ManagerTM

– HorizonWP® Physician Portal

– Pathways ContractManagementTM

– PatientCompassTM

– Practice Partner®

– RelayHealth® secure online communication service

– ROBOT-RX®

– STARTM Patient Accounting

Using data provided in the system’sexecutive dashboards, managers can continuously monitor wherethey stand or need to improve.

To connect with its physician community, cut costs and ultimatelycreate EHRs shared across both theinpatient and outpatient settings,Atlantic Health deployed PracticePartner®, McKesson’s ambulatoryEHR, and the financial and clinicalinteractive services of RelayHealth®. To date 500 physicians have signedon to RelayHealth.

“We offer RelayHealth to physiciansas a tool to enhance patient care,”says Reed. “Some are skeptical atfirst, but when they see how it cantransform their office, improvepatient communication and reducecosts by moving everything online,they welcome it.”

Patients love RelayHealth becausethey can communicate with theirphysicians at their convenience,receive lab results and referralsonline, and renew medications easily. Ten thousand patients arenow registered users. The programhas been a key consumer marketingeffort as well, with a section of the company’s Web site featuringRelayHealth access.

Reed believes RelayHealth is theperfect catalyst to create anywhere,anytime information access for bothpatients and physicians. “Eventually,everyone will have a personal portalwith e-bank, e-shop and e-healthcomponents. We want to be a doton that portal.”

Atlantic Health has experiencedfinancial improvements as well.

With solutions such as patientaccounting, contract managementand RelayHealth’s Web-basedaccount management service that enables online transactions, the health system works more efficiently and improves revenuecycle management.

Future plans include implementation of HorizonEnterprise Revenue ManagementTM,which will streamline workflowwhile enabling informed decisionmaking, automated necessity checking and coordination of care.“We expect the system to help us automate many of the manualfinancial processes that currentlyexist,” explains Nancy Kaminski,director of patient financial services.“We’ll also have a single databasetied with Horizon Clinicals®, whichwill tighten the revenue cycle so we collect every dollar we’re entitled to collect.”

The patient experience will beenhanced with Web-based registration, e-statements andonline account management.

Atlantic Health also maintainsprovider and facility informationthrough McKesson’s call centerapplication. Call center representatives can seamlesslyresearch information for prospective patients, including medical specialty, education, office location, board certification,hospital affiliation and insuranceplans. In keeping with Safe Harborlaws, a random listing of providers is rotated after referral activity. A Web solution offers patients aclass and screening registration service, with detailed information

At a Glance

Critical Issues

– Lack of systemwide applicationinfrastructure

– Patient safety

– Lack of connectivity and communication across the care continuum

– Caregiver satisfaction

– Inability to measure and affect outcomes

– Inability to track patient interestin services

Results

– Reduced medication error rate to less than 1% (CPOE live units)

– Achieved 95% medicationadministration scan rate

– Reduced medication processingtime by 40%

– Connected 500 physicians on the RelayHealth network

– Provided 10,000 patients financial and clinical interactiveservices through Atlantic Health’svirtual information exchangepowered by RelayHealth

– Decreased days in A/R to 39

– Enhanced ability to track marketing outreach and monitor physician search trends

McKesson Provider Technologies

5995 Windward ParkwayAlpharetta, GA 30005

http://www.mckesson.com

on programs such as hospitalservices, health screenings, andhealth education seminars. Detailed reports enable hospitalmanagement to assess and improve demand for services.

Future plans also include deployingan enterprise visibility system toimprove day-to-day hospital efficiency and manage patientthroughput. Using large, electronic“whiteboards,” the system will display data from clinical, ADT, environmental services, transporterand other systems against the hospital’s floor plan, enabling caregivers and managers to respondmore quickly and adjust as needed.

ResultsImplementation of McKesson technologies has helped AtlanticHealth become more competitive,improve medication safety througha closed-loop process, reduce costsand enhance revenue efficiencies —all while streamlining the patientexperience and increasing safetyacross the continuum of care.Results include:

– For each patient care unit live on bar-code scanning, nearly 95%of medications are now scannedbefore administration to patients

– In areas where CPOE is live, the medication error rate is less than 1% per month.Residents use the technology to enter 90% of their orders

– The combination of CPOE, anenterprise pharmacy system andautomated central dispensinghave reduced medication processing time during peakusage by an average of 40%

– More than 60% of AtlanticHealth’s physicians use McKesson’sphysician portal, a Web gatewaythat provides secure access toimportant inpatient and outpatient data from across the health system

– Physicians say CPOE helps thementer orders more efficiently 80% of the time

– 500 physicians and 10,000patients are connected for clinical and financial interactivitythrough Atlantic Health’s virtualinformation exchange poweredby RelayHealth

– Days in accounts receivable (A/R)have been reduced to 39

“From everyone’s perspective, ourlong relationship with McKesson hasbeen terrific,” Reed says. “There’sopen communication, a willingnessto hear what’s of concern, and weboth work hard to drive thatchange together. It’s a partnershipall about improving patient care.”

Copyright © 2009 McKesson Corporation and/or one of its subsidiaries. All rights reserved. Horizon Clinicals,HorizonWP, Practice Partner, RelayHealth and ROBOT-RX are registered trademarks of McKesson InformationSolutions LLC. Horizon Admin-Rx, Horizon Business Insight, Horizon Expert Orders, Horizon Meds Manager,Pathways Contract Management, Patient Compass and STAR are trademarks of McKesson Information Solutions LLC. All other product or company names mentioned may be trademarks, service marks or registered trademarks of their respective companies. PRT387-04/09

“From everyone’s perspective,

our long relationship

with McKesson has been

terrific … It’s a partnership

all about improving

patient care.”

Linda Reed, RN, MBA

Vice President/

Chief Information Officer

Atlantic Health