St. Anthony's health system operates two behavioral health hospitals in Wichita and Olathe, Kansas. It focuses on adults older than 50, particularly those with mental health challenges such as dementia delusional disorders and generalized anxiety disorders.

It provides both inpatient and outpatient services, with a multidisciplinary team of nurses, psychiatrists, social workers and group therapists. 

St. Anthony's is operated by Axiom Healthcare Services and works closely with the 12 other Axiom facilities for seniors in Kansas and Colorado.

THE PROBLEM

"Like a lot of behavioral health providers, we're still using paper records," said DeShaun Linson, RN, regional director of nursing at St. Anthony's. "It definitely slows down our staff and forces them to spend hours filling in their patients' charts."

When the health system started looking for an EHR, it initially went with one from vendor ADSC. But the EHR was designed for a clinic setting, rather than an inpatient hospital setting.

"As a freestanding psychiatric facility, there are regulatory measures we are required to meet, and none of the EHR systems we looked at were designed to meet those needs," Linson said. "They weren't flexible either. Using their software was like trying to fit a square peg in a round hole.

"Ideally, an EHR system should improve your care coordination and make you more efficient," she continued. "But if it's not designed for your needs, it will only slow you down and frustrate your staff. We wanted a solution that we could customize to our workflows."

St. Anthony's also wanted an EHR that could be integrated with telehealth.

"For freestanding psychiatric hospitals and other specialized providers, you want to be careful to make sure the EHR vendor will actually take the time to understand your needs and work with you to customize the system to fit your workflow."

DeShaun Linson, RN, St. Anthony's

"A lot of our patients are extra vulnerable to COVID-19, so we've ramped up our telehealth use during the pandemic," she explained. "So far, it's been a success. There's a large rural population around us, so telehealth enables us to treat patients that would otherwise have to drive a long way to our hospitals.

"We plan to continue using telehealth after the pandemic is over, but we wanted the system integrated with our EHR, so we didn't need to use two separate technologies at the same time."

PROPOSAL

For its EHR, St. Anthony's staff were drawn to vendor Azalea Health because it did not shy away from working with smaller, more specialized hospitals.

"They were willing to collaborate with us as a partner, understand our challenges and innovate with us to solve them," Linson said. "They would also help us customize the configuration of our EHR system to comply with the regulations for freestanding psychiatric hospitals."

Azalea's EHR platform is cloud-based, which enabled St. Anthony's to implement the software remotely. This was important because the health system wanted to limit any potential COVID-19 exposure to its elderly and high-risk patients. The cloud-based system also was valuable, because it meant that St. Anthony's did not need to dedicate any of its limited IT resources to manage the system on its premises.

"We also liked that Azalea's EHR came integrated with telehealth," Linson noted. "After our experience with the pandemic to date, we were ready to make telehealth a permanent part of our practice. With Azalea's platform, our clinicians would be able to access the telehealth interface directly from their EHR, and patients could access it through the patient portal mobile app."

The EHR platform also had revenue cycle management capabilities built in, making it easy to optimize revenue and bill patients directly from appointments, she added.

MEETING THE CHALLENGE

"We started implementing the EHR at the end of last year and will have the system fully operational by August 1," she said. "For now, we'll be using it for inpatient care, but we'll later expand its use to ambulatory care and practice management. Azalea helped us build the system so it will service any future hospitals that we add to the portfolio, which currently includes both St. Anthony's hospitals."

The simple design and configurability of Azalea's EHR is allowing St. Anthony's to streamline the experience for its clinicians, she added.

"We were able to create our own custom templates or choose from a library of existing templates," she explained. "That appealed to us, because we could design the system to fit our workflows. Our staff wouldn't have to waste time learning how to navigate the system if they helped design it."

The new EHR will also save staff time when members fill in their patients' charts. Coming from paper records, this is going to transform care management, Linson said. Providers of different specialties will be able to collaborate in the same patient chart at the same time, which makes it easier to coordinate care across disciplines.

"The Azalea team has been really hands-on from the start to make the EHR work for our needs," she noted. "The training and implementation has gone smoothly so far, and our staff is looking forward to having the system fully up and running."

RESULTS

The EHR will not be fully operational until August, but Linson said she's already noted a change in employee satisfaction.

"Our nurses spend hours filling in their paper charts, so everybody is excited to move to an electronic system that will make things easier," she said. "This new EHR will remove a lot of the administrative burden on our staff and allow our team to spend more time with patients.

"That matters a lot at psychiatric hospitals for seniors. Most of our patients have trouble with their memory or cognition, so that human connection is really important to their care."

ADVICE FOR OTHERS

"A lot of EHRs sell themselves as a one-stop shop to meet all your needs," Linson observed. "Most of the time that isn't true. For freestanding psychiatric hospitals and other specialized providers, you want to be careful to make sure the EHR vendor will actually take the time to understand your needs and work with you to customize the system to fit your workflow."

Providers always want to stay at the cutting edge of care, she concluded, but if one rushes to install an EHR that is not built with one's needs in mind, it will slow things down and make the job harder.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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