One of the main purposes of a community site is sharing meaningful information about the community topic. It's instructive to include what works (best practices) and what doesn't work (lessons learned). Springfield Clinic in Illinois went live with its EHR in June 2006, and it demonstrates what's working with EHRs.

Springfield Clinic has 300 providers in multiple specialties across 20 facilities. It handles nearly 900,000 patient records.

Here's what Springfield Clinic did right:

They created an oversight committee to determine their automation needs and evaluate potential EHR products. Administrative and clinical staff comprised the committee, although it would be good to know how the committee members were selected and whether everyone on staff had a say. It apparently did a great job of selecting the right EHR vendor for its needs.

They did a mini-bang implementation, meaning they did one facility at a time but included the entire facility and not by specialty. This seems the cleanest way to go about it, especially with 20 sites and multiple specialties. They chose a smaller site for the pilot implementation, which is manageable, especially if there are any glitches. More importantly, they chose a site that was home to one of the physician champions for the project, which means positive energy flowing through the implementation process for the clinic's initial implementation.

They created a team that specifically looked at workflow issues to ensure that productivity wasn't compromised. They included nurses and an IT staff to marry both clinical and technical issues. They customized the software so that individual clinicians' work patterns weren't disrupted, which helps ensure continuity of use - not to mention creating trust and good will in the clinic's decision making and its EHR system.

The staff underwent an intensive training program and had to pass a proficiency test. While some may wince at having to take this on, it's one way of getting that training upfront at the same time for everybody and ensuring that people aren't just sitting through the training without fully grasping how to use the system.

The team also acted as trouble-shooters, fine-tuning the EHR system before moving on to the next facility. After all problems were resolved, Springfield Clinic went on a rolling implementation every two weeks.

The bonus of having partnered with its EHR vendor, Allscripts, is that when the clinic decided to forge ahead with other automation process initiatives to deliver more convenience to its patients, it was able to work with its vendor to create a self-service patient kiosk.

Springfield Clinic demonstrated savings in reduced human resources (to the tune of $3 million annually) and transcription costs, as well as gained real estate from repurposing its former paper chart storage areas. The clinic netted $4.5 million in its first year, which is astounding, and expects a $35 million ROI over the next five years.

What would be great to know is more details on provider satisfaction and full use of the system. Even more important is the quality of clinical care, and patient satisfaction since the EHR was implemented.

What's amazing to me is the reported return to pre-EHR patient load levels for all providers within two weeks. You don't get that kind of result without having gone through all the well-executed steps that they had put into place.

Springfield Clinic had a vision back in 2005 and being an early adopter, it looks like the clinic is well on its way to qualifying for the federal incentive funds. They ought to take their success story on the road and be a model for other similar healthcare organizations.