During the next five years, MaineHealth plans to have all its member hospitals hooked into a shared medical record. The vision of “One Patient, One Record” is to allow patients and their healthcare providers to have access to their medical records at any MaineHealth site.

But developing a paperless system isn’t easy, even with the assistance of a company such as Epic, Inc.

Waldo County General Hospital is getting in on the ground floor of developing this new system. Included in the first phase of the project are Maine Medical Center in Portland and Waldo County General Hospital, which are scheduled to put the new system into operation in September 2012.

But first there is a great deal of work to be done, with many WCGH employees involved. Included in that number are Waldo County’s Manager of Nursing Education and Informatics, Donna Larrabee, RN, MSN, and accounting specialist Linda Stover, who have studied hard

to become Epic-certified.

Donna Larrabee RN

Donna will be working on a team of five to make sure any order that a provider wants to issue is available in the system—and that’s thousands system-wide. The orders will also have to be standardized as much as possible among the hospitals that belong to MaineHealth.

For example, that means when someone checks into the emergency room at any MaineHealth hospital, the provider will be meeting the same quality standards, ordering the same lab work and diet, giving the patient the same medications, and sending all the information on to the next provider, as his counterpart at another MaineHealth facility who is caring for a similar patient.

Donna says it’s remarkable how many of the processes are already the same but there are some differences in the medications that are ordered. Advisory groups will be created to decide which processes can be standardized and which differences need to continue to exist.

Donna says this will be good on many levels and will make sure there are no gaps in individual treatments. “The system will give all the options that need to be there. It’s on paper now but we need to mesh it with the electronics,” she says.

Of the five individuals on Donna’s team, four are nurses and one is an information systems expert.

It will be a lot of work but Donna is excited about it. “It’s like learning a new language at the level I’m learning it. It’s an exciting opportunity to be branching into something new,” she explains.

The assignment will also necessitate Donna working in Portland at least three days a week. And with a husband and two teenagers at home, she needed their support. They agreed, she should go for it. Accepting the position also meant giving up her nurse educator position, which she has done.

She said the electronic medication administration record process that Waldo County put in place in June 2010 sparked her interest in getting involved in the project and should also make it easier for the nursing staff to get comfortable with the new process.

“As a nurse I’m very excited. I think the nurses and physicians will be pleased overall. It will help with the work flow, once they get through the learning curve,” she said, adding that each employee will receive 16 to 24 hours of formal training on the new system.

To get Epic certified, Donna made three trips to the Epic Center outside Madison, Wisconsin where she had three days of intensive classes each time and she also had to pass a written test and complete two projects. The trip went well but the second was more difficult. Luckily, on the bus rides to and from the center, she heard others talking about how overwhelmed they felt, too. She said she just kept telling herself, “I’m not dumb. I can do it.” By the third class, she could see how all three fit together.

Donna says this new system, which is being called “SHR” and pronounced share is going to change the way medicine is practiced but she says, “I think doctors will be very pleased with it. It’s different but well worth it.”

Linda Stover

Linda Stover is on the hospital billing team. That team will be coordinating billing for inpatients and outpatients in order to streamline the billing and collection processes, reduce payer denials and minimize accounts receivable throughout the Maine Health system. Reporting tools will also be built into the system to help management track financial performance. Instead of receiving a number of bills from different departments, a patient receives one.

Linda says when she was asked to join the team of seven who will work on the billing program, “It sounded good. It was a chance to start from the ground floor and see this through to fruition. It will give me a real sense of accomplishment.” She also had to go through an extensive training in Wisconsin and testing processes to become Epic certified. This certification must be maintained for all new versions and applications.

In her 13 years at Waldo County General Hospital, Linda says she has had exposure to many different areas, which have helped her understand the revenue cycle of the hospital. She has supported and trained users of many systems within the hospital, Home Health and Practice Management. Linda has been working on the new system fulltime since November and has made a five-year commitment to the project.

“We will go live in September 2012. Within this time frame, the MaineHealth facilities will come together through many sessions in Portland agreeing on processes that will work for one system.” Building the system starts the process, followed by testing, user training and finally implementation to go live. Linda says the model system she saw in Wisconsin “works so well and the paper goes away. I can go online as a patient and send an email to my doctor or check my bill.”

Linda, who also will be required to spend several days a week in Portland for the next year, is thrilled to be a coordinator on the Hospital Billing Application Team. “Every Epic module within the hospital sends information to the Resolute Hospital Billing application, it gives you the chance to work in those different modules and see the information come together. This opportunity forced me out of my comfort zone onto what feels like a limb at times but I realize I am very well supported. This isn’t a limb but a new avenue for all involved with MaineHealth. Working on this Epic project, where every day there is a WOW!,” is great,” says Linda.