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An Arizona system turns a nine-month IT implementation into a 9.5-week sprint.

It was the realization of any information technology manager's worst nightmare: The vendor that provided Sun Health Corp., now part of Banner Health, with its electronic health record/repository system had served the three-hospital organization with a 30-day notice of termination. Ostensibly the vendor was terminating the contract because of the huge volume of documents being scanned by Sun Health at the vendor's cost. But Barbara Knight, then Sun Health's director of health information management, says the move was a negotiating ploy, with the vendor anticipating that Sun Health would renegotiate its contract. With only 30 days before the organization would be forced to revert to paper-based medical records, Knight decided to take the termination as an opportunity to look for a new vendor.

Sun Health's HIM departments had been scanning medical records for remote coding for more than five years using an application service provider (ASP) model product. Knight says she had already casually been looking at what else was out there, and in a short amount of time she says she chose MedPlus' Chartmaxx health information management/medical record solution. "I told them that in order to complete the contract, they would have to implement their product within a maximum of 90 days from contract signing, which they had not done before. This is normally a nine- to 12-month implementation cycle, and the soonest they had ever done it was somewhere around seven months," she says.

The vendor eventually did agree to her terms, however, and MedPlus and Sun Health agreed to break the project scope into two phases. Phase one would be a basic or "vanilla" rapid system implementation to allow Sun Health to become operational with scanning again. It included hardware and software install, chart completion workflow automation and registration, and extensive staff training.

During phase two, the system would be further refined to meet Sun Health's operational needs by customizing the chart completion workflow, reviewing and revising the system tables based on formal training sessions, and specifying and developing the additional priority interfaces. At the end of the 9.5-week period, Sun Health had a centralized legal medical record with automated chart completion and electronic release of information with remote coding capability for the entire 782-bed system.

How were they able to complete a nine-month project in nine weeks? Knight says it was a combination of serendipity and upper-management buy-in. The serendipitous part was that Mason, OH-based MedPlus just happened to have an account representative who lived near Sun Health's operations in Phoenix, AZ. "We were able to do 50 demos in a week. We practically lived together," says Knight.

As for management, they had already seen how well the former system worked under Knight and her team, and they gave her the last word in choosing the new vendor. "It helped immensely not having to go to a steering committee with every last decision. In fact, we didn't even have a steering committee meeting until we were already live, because everything happened so fast," she says.

It's been two years since the new system was implemented, and since then Sun Health Corp. has been acquired by Banner Health and Knight has moved on to become director of health information and privacy officer for West Valley Hospital in Goodyear, AZ. Nevertheless, she says the rapid implementation "was the greatest thing I've done in my 28 years in health information. I wish I could go back and do it all over again."

Kathryn Mackenzie

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