Case Study: ProVation® MD Software Enhances Image and Information Access at Alegent Health

Business Profile: Alegent Health

Alegent Health is the largest not-for-profit, faith-based health care system in Nebraska and southwestern Iowa with nine acute care hospitals, more than 100 sites of service, over 1,300 physicians on its medical staff and 9,000 employees. Founded by Catholic Health Initiatives and Immanuel Health Systems more than a hundred years ago, the health system provides services across the continuum of care, from women's and children's services, primary care, wellness counseling, and senior care to cardiovascular services, orthopedics, oncology, physical rehabilitation, home care and behavioral health.

Alegent Health has achieved high marks for patient satisfaction and quality, is a leading innovator in health care and continues to be among the nation's "Most Wired" hospitals and health systems.

Project Goal

Alegent Health has a vision of delivering world class quality care to its patients. As part of that strategic plan, the health system is in the middle of a $315 million renovation expansion plan at five of its metro hospitals. The construction project, dubbed "Generation Patient" is designed to streamline access to information and improve patient care.

Choosing a Solution

Alegent Health’s IT group, with the help of surgical operations directors, looked at several possible solutions including software from ProVation® Medical, part of Wolters Kluwer Health. ProVation® MD software replaces dictation and transcription, allowing clinicians to quickly and completely document medical procedures at the point of care. "One of the largest physician groups we work with uses ProVation®, and it’s rare to see the kind of enthusiasm they’ve expressed for the system," says Broz.

"We looked closely at both the system and the company," he continues. "We liked the software infrastructure and interface, but we were also impressed with the company. Management and representatives from ProVation® are very invested in the product and have gone out of their way to involve physicians in its development. They’re experienced and efficient, and their interactions are extremely well organized. With all we’ve got going on, that was very important to us.

"The other software we looked at just didn’t measure up, either on the product side or the company side, so we were leaning very strongly toward ProVation®," he said. "The final factor for us was the fact that the software was available in a range of medical specialties. Once we purchased the system for Gastroenterology, we knew that adding medical specialties to the platform would essentially be a 'plug-in' process with significant economies of scale."

Phased Implementation

Alegent installed the system at six sites over a period of five months. "The sites were fighting for the chance to go first, which I see as a vote of confidence in ProVation®," says Broz. "We sent folks designated as 'power-users' to Minneapolis for training a few weeks prior to going live. They came back ready to act as ongoing resources to their groups after the initial ProVation® on-site training.

"The build and go-live timelines were met and the rollout was extremely smooth," Broz continues. "Users told us they were pleasantly surprised at how easily they could adapt to it. The system had to be configured to our operation, modified for the scopes we were using and our travel cart workflow, but it was a well-managed, streamlined implementation.

"The system has had very little impact on our IT resources. The ProVation® project management and technical implementation support was very good, and the system has required very little oversight. Aside from a few custom report requests that are handled by my team, we rarely hear from users."

Integrating Systems

The ProVation® system fit easily with Alegent Health's legacy systems, helping to streamline workflow and data access for GI operations across the board. Alegent Health's Siemens Soarian Electronic Medical Record (EMR) acts as an information hub, making information from ProVation® MD available across multiple facilities and systems. Scheduling is sent real-time whenever an appointment or appointment modification is entered in Soarian, making it readily available to nurses and practitioners.

"There was nothing that we threw at ProVation® that they couldn't handle," says Broz. "One example was the creative way images are transferred to our Siemens Soarian EMR. We wanted data from ProVation® made available throughout our entire system through Soarian. The problem was that HL7, the standard communication protocol, can communicate text but doesn't support image transfer. ProVation® solves that problem by sending a reference pointer as part of the HL7 results message. The reference pointer enables the Soarian system to navigate automatically to a PDF file that contains images and anatomical diagrams. The PDF file is acquired and stored in Soarian, where physicians can then use Soarian to pull and view the information."

Immediate Results

ProVation® MD has had significant impact on Alegent Health's operations at all levels. During GI procedures, the system's series of cascading menus streamlines data input by anticipating the clinician's likely next move and adapting to each new piece of information as the procedure progresses. It automatically maps medical content to CPT and ICD codes, which are regularly updated to ensure fully compliant coding. The system makes real-time information available to GI doctors, to referring physicians and to billing and medical records. It even allows one-click customization of patient instructions and follow-ups.

"We know it simplifies documentation for clinicians at the point of care and eliminates the hassles of dictation and transcription," says Broz. "We also know it will be more accurate and capture codes that could otherwise be missed for billing. And it certainly will have financial ramifications, not just by allowing us to bill for procedures that might otherwise be overlooked, but by eliminating administrative rework and delayed payments that result from incorrect or incomplete documentation."

He continues: "We definitely expect the system to improve patient care by giving referring physicians electronic access to more complete information without the delays of our old system. It's also better for the patients, who now have immediate access to specific, personalized information and instructions."

Long-Term Goals

"Our ongoing strategy is to look at everything related to information from a systems perspective," says Broz. "We want to consolidate wherever possible. We want patients to be able to move easily among our facilities. We want departments to be able to share information, and we want information to flow smoothly all the way from appointment scheduling to outcomes research. ProVation® MD helps with all of that."

"In the future," he continues, "we hope to implement the ProVation® system in pulmonary and pain management. We may use it in urology and, possibly, orthopedics. Whatever we decide, we know it will go smoothly. ProVation® is one of the best organizations I've ever worked with. Their products and processes are excellent and the people who work there are extremely knowledgeable."