C Electronic MR

Switching to a New Hospital
Information System
Going Paperless…
John Haven
College of Veterinary Medicine
University of Florida
A New HIS is an Opportunity to
Re-Engineer Workflows
• Temptation is to do what we do now, in the
new system… Lost opportunity to improve
• Must adapt to the software – not the other
way around… billions of dollars has been
spend by industry and academia fighting
the internal work flows of PeopleSoft,
SAP, etc.
Faculty vs. the Software
The Core of the Software
Won’t Change
Can turn modules on and off
Can control security
Can change colors
Vendor can not maintain code integrity
with drastically varying workflows
Why is a Paperless Record So Hard?
• VTH’s have “unique” needs for student
• VTH’s have referral documents
• VTH’s have in house lab interpretation and
radiographic interpretation
• VTH’s have high level pharmacies
• Faculty Comfort Level
Comfort Level
• Some faculty have no interest in learning
new software
• Some faculty like to view hand written
materials vs. view on a computer screen
• Some faculty are used to having students
write brain dumps vs. clear concise
professional notes
Keys to Success
• High ratio of computers to users – can be
expensive but doomed to fail without
• HL7 interfaces between equipment to automate
the transfer of data
• Templates for work ups, operational reports, and
• Charge Code Groups to speed invoicing
• High ratio of technicians to DVMs per service
• Server Cluster to protect data
More Keys to Success
Point of Sale/Activity signature capability
Scanners for written documents
Printers for samples
Printers for client documents/discharges
Picking A Vendor
Financial strength as a going concern
Large Help Desk
Large Development Staff
Willing to go to the next level – HL7,
DICOM, etc…
• Use of platform in practice
Commercial HIS Track Revenue
• In general they do not have a GL package
– don’t have payroll or AP expenses
• Need a GL
• Need a mechanism to pull Expenses and
Revenue together to have
unified/complete financial statements
The UF Effort
• Approximately a year from start to go live
• Testing period yes – run in parallel – no
• Core development group from across the
• Document current workflows
• Document future workflows
• Training before go live for all
UF Experience
• First customer to require the HL7
interfaces for labs, radiology and
pharmacy – not all were ready at go live,
but went forward
• Difficult to maintain high level of energy on
the project and do day jobs
• Difficult to maintain faculty involvement in
the project
More UF Issues to Consider
• Maintain team for future enhancements
• Need a dedicated project leader for the
whole time
• UF lost its IT manager early in the project
• Project management and continuous
follow up is key!!!