It's Never Too Late: Selecting the Right EMR System for a Transdisciplinary Team


Migrating your organization to a new system is a big undertaking. Once you complete a migration, the expectation is to relax and reap the benefits. But what if your decision ends up being the wrong one? Do you forge ahead, or do you start all over?

At On With Life, we found ourselves on the wrong path, and starting over was the only option that made sense.

On With Life is an inpatient and outpatient neuro rehab organization specializing in caring for persons with brain injuries, strokes and other neurological conditions. Since the beginning, we've believed in one mission: persons served first—always. On With Life is the only freestanding rehabilitation program in the world outside of a hospital to be accredited by CARF as a Comprehensive Integrated Inpatient Rehabilitation program in brain injury and stroke for both children and adults, and we take this very seriously. 

We have more than 75 clinical team members, all of whom are involved in various stages and touchpoints during an individual's recovery process. But the size and scope of our work were becoming overwhelming, especially with an outdated EMR system.

Our Unique Setup Needed a Robust Solution

Thanks to our uniquely designed rehab structure, our EMR system was inefficient. We didn't have a way to retrieve data quickly nor track outcomes effectively. We did what we could to share information, but that usually involved stopping each other in hallways for informal conversations or other "shadow systems," such as making notes and saving them on an individual computer, then emailing that to others as requested. Not only was this frustratingly complicated for care providers, but it posed some safety concerns around protected health information (PHI).

I came to On With Life in 2017 as the Director of Nutrition Services. Over time, I noticed these nagging problems that involved all of our departments. We had plenty of data and feedback, but the way we captured it in our systems wasn't serving us well. I kept asking myself, "Do we think we're doing a good job, or do we know we're doing a good job?"

In 2019, it was clear that our aging EMR system was on its last legs. We needed to move to something more modern, with better messaging and communication features. The executive team decided on a new solution, and I switched roles to EMR Coordinator to handle the migration. Everyone was giddy at the thought of having better technology, but it soon became quite clear this newer system would be just as clunky and problematic as the first one. Then we were scrambling with the decision to double down on our new yet inefficient system or to make a better choice for the company, our staff, and our persons served. 

Properly caring for persons served and their families requires making data-driven decisions from referral to discharge.

Amidst this conversation, the pandemic threw us all for a loop. Our team could no longer gather in conference rooms to discuss patient information in a safe and professional environment. We were limited in our ability to access files on individual computers. We couldn't fall back on our old crutches anymore. If we were going to care for persons served and their families properly, we would need to make data-driven decisions from referral to discharge, and for that, we needed a more effective EMR system.

Tip #1: Don't Be Afraid to Reverse Course

Despite the frustration of having to start over, it's always best to turn the ship around before the situation moves from bad to worse. In our case, we weren't sure of our other options or how other platforms would fit into our organization. To avoid making the same mistake again, we started with our non-negotiable needs.

The biggest of these non-negotiables involved solutions that improved our medication errors. We can talk about communication and efficiency all day, but it becomes a safety issue once you have med errors. Our med errors were way too high, and we needed an electronic system that provided greater accuracy and collaborative support.

Another non-negotiable was the ability to create our own assessments. Neuro rehab needs to be highly collaborative, and we wanted to share assessments and information across our transdisciplinary team. We also wanted to change these assessments easily as the situation required.

One of our colleagues, an MDS nurse, took charge and started asking other organizations and nurses about their needs and recommendations. By far, the most frequently mentioned and highly recognized platform was PointClickCare. Aside from its intuitive interface and excellent word-of-mouth reputation, the platform's robust solution sets provided everything we needed and more. Cautiously this time, we began the implementation process.

Tip #2: Make the Most of Your Implementation Team

I couldn't have been more impressed throughout our deployment. PointClickCare assigned us an implementation team that was invaluable during our tight turnaround. They've been there, done that—and even if they hadn't, they were happy to answer our questions and willing to show us how PointClickCare could solve problems specific to our circumstances. Taking full advantage of their implementation team was one of the best things we did to ensure our new migration got off to a great start. 

Taking full advantage of the implementation team is the best thing you can do to ensure a migration gets off to a great start.

Training looked a lot different than anyone expected because of the pandemic. Their team provided a host of virtual 1:1 sessions to ensure we understood the software. They were careful to ask sincere and actionable questions, including how we wanted to set things up, what our needs might look like, and the types of training we wanted. This team, coupled with PointClickCare's SmartZone e-Learning option, allowed us to provide training at scale.

Thanks to their dedication, On With Life hit the ground running.

Tip #3: Make the Most of Features to Get the Best Results

Life has been so much better with PointClickCare. We rely heavily on several features, including Cliniconex and the Skin & Wound module. Cliniconex Automated Care Messaging allows us to communicate to persons served and their families at scale, notifying them of anything from social events to changing COVID-19 regulations. Skin & Wound was particularly beneficial to a team like ours. Many of our persons served have reduced mobility leading to an increased risk of getting blisters, sores, or pressure ulcers. Team members can easily see the last time a wound was assessed, and they can also take pictures that live within PointClickCare—a big deal when it comes to PHI. Skin & Wound ensures everything is in the right place, everyone can see it, and we can track and monitor progress. 

Perhaps the most valuable solution has been Integrated Medication Management, PointClickCare's pharmacy integration. This allows us to scan medications and save them within the platform. It improved communication with the pharmacy and helped with efficiency, too. When a team member administers medication, the image pops up, which they can consult to confirm everything is correct. We've seen a 79% reduction in medication errors since moving to PointClickCare, which has had a considerable impact on patient outcomes, and it's also given us peace of mind that we're keeping everyone safe.

We continue to increase our number of referrals, and we've started to use PointClickCare's CRM for all referral documentation. Not only does that make the assessment process more collaborative, but we can determine a payment source upfront, which means there are no surprises for the person served further into the process, and we can better predict revenue. By centralizing our documentation, we can provide "Lead Ratings" of Green (strong referral), Yellow (intermediate referral), or Red (weak referral). 

This method prioritizes various persons served and streamlines our process as the number of referrals we receive grows. Additionally, we've seen a sizable reduction in time from referrals to admittance decisions. While this dramatically increases our overall revenue, it also helps our persons served. The faster we can get persons served into beds, the sooner we can begin their healing process.

On With Life has recently started to use Document Manager to keep track of signed consent forms and admit paperwork. Apart from all these features, we also use PointClickCare for billing. We continue to look for integrations that will prevent the duplication of work and reduce costs, ultimately streamlining our work and outcomes. One of these is PointClickCare's Secure Messaging module, potentially increasing our efficiency and communication even further.

PointClickCare is increasingly becoming a one-stop-shop for us and a powerful tool for our medical providers.

Tip #4: Improve the Experience for Persons Served and Staff

When deciding on any software, make the user experience top of mind. How will these changes impact the experience for persons served and staff? How will their daily lives improve?

When deciding on any software, make the user experience top of mind.

PointClickCare has improved the care experience on all sides of the equation at On With Life. We have amazing nurses, CNAs, therapists, and other staff, so we want them to spend their time doing what they do best. Their value is in patient interactions, not digging for information or performing extra administrative work. PointClickCare has increased our efficiency, a trickle-down effect that touches everyone. We can make the most of everyone's skills and help everyone get on the same page, even when we are not on the same work schedule or shifts.

Our staff is much more comfortable and confident that the information is correct and easily accessible at a glance, helping to integrate them into the company faster than ever. Traveling nurses and other agency staff can quickly get up to speed and are far less likely to flounder at the start.

Within a couple of years, PointClickCare has become the single source of truth at On With Life. Everyone on our transdisciplinary teams knows they can find accurate and up-to-date information at the touch of a button. Not only does this give them enormous peace of mind, but it also improves our business outcomes and patient care as a result. Thanks to PointClickCare, we’re helping our persons served move on with their lives.

Trust me—It's never too late to select the right solution, and we're living proof.