Now that North Valley Hospital is live with its SDS HealthPort® electronic document management system (EDMS) in the emergency department (ED), the entire team-from physicians to health information staff-has enjoyed some substantial wins. Like every project, the wins are peppered with lessons learned, which we will certainly use in our next steps, same-day surgery and inpatient records. For now, it's time to stop and enjoy our success in the ED!

Dear Diary,
Donald Trump lectures about it. Anthony Robbins produces CDs about it. Michael J. Fox even starred in a cheesy 80s movie about it. What am I talking about? Success, of course. And now, the North Valley Hospital team is living it. Watch out, Donald, we're right behind you!

We just went live with our EDMS in the ED, which averages 8,000 visits per year. Our hospital is located in a dream-come-true vacation environment, complete with Glacier National Park , Whitefish Lake and other natural wonders. For nearly everyone, our area is relaxing and fun. For the skier who breaks her arm or the hiker who sprains his ankle, however, it can be stressful. North Valley Hospital wants to treat and help those people in the best manner possible, and that's why being live on HealthPort EDMS in our ED is such a success. Here are four specific "wins" we're particularly proud to claim.

Win #1: The Timeframe
Two weeks after we began scanning records, the HealthPort EDMS system went live and was fully adopted in the ED. Looking back, it was like standing on top of the Old Faithful Geyser at Yellowstone in hopes of keeping the water below ground level. We were a little overwhelmed and probably needed more time. In the end, though, we made it, and we stayed within our Phase 1 timeframe.

Win #2: Promptness and Customer Service
The skier I mentioned is ready to head home and needs her ED record. Our service to her, as well as our process internally, is now remarkable. In less than 5 minutes, she has her records and is out the door. In the old days, the ED record traveled down many paths before landing in its final home, the HIM department. As a result, it took several staff people and much more time to locate it.

Win #3: Efficiency and Resources
Our department is small, so it isn't staffed 24 hours a day. In the evening, a nurse house coordinator looks up any requested records. In the paper world, that meant a trip to our office, where the coordinator would unlock the file room, locate the chart and return it later. While our house coordinators became pretty skilled at finding records, a misplaced chart meant calling a staff member at home. Now a physical visit to our office isn't necessary.

Our house coordinators log into HealthPort EDMS, pull up the record they need, and are done. Our performance improvement coordinator enjoys the same benefit. She and our staff used to have a juggling act. We'd struggle to get just the right amount of records pulled for her to review, without having them out longer than necessary. Now she pulls what she needs online. The ED manager summed it up when she recently told me, "Wow, I don't even think I've had to come into your department in months!"

Win #4: Physician Adoption
Our ED physicians are beginning to look up information from the HealthPort EDMS system rather then relying on nurses or staff. We've limited printing records from the system to encourage physicians to review records online vs. in hard copy, and it seems to be working! The physicians' quick adoption has eliminated phone calls, confusion and wasted time for everyone-plus, they're able to retrieve patient information precisely when they need it.

Lessons Learned
We're still working through the optimal process for scanning and coding ED records. As a rule, yesterday's ED records are scanned today. The tricky part is whether to code or scan first. The turnaround time from patient treatment to coding needs to be brief for billing purposes, but what process is the best and most efficient workflow? We do not currently ask the ED to scan records themselves for quality control purposes, but it's under consideration. It would certainly hasten the process.

Next, we learned that physician training needs to be sound bytes when they need it, not lengthy overviews in training rooms. We make ourselves present and available in the ED, saying, "Do you have a minute? Can I show you how to do this?" We also send e-mail reminders with quick tips. We learned that informal, on-the-spot training really works for the physician audience.

As you know, we set up Phase 1 to include ED, same-day surgery and inpatient records, with the goal of completing the phase in 4 to 6 months. Will we do it? Stay tuned, Dear Diary. It's an ambitious goal, but we're flying high due to our ED success!

Traci Waugh is director of health information and compliance at North Valley Hospital, Whitefish, MT, and a client of SDS.