Case Study: ProVation® MultiCaregiver Wins Over Kona Surgery Center Clinicians While Overcoming Unique Geographic Challenges

Customer Profile

Kona Surgery Center, a partnership between Hawaii Health Systems Corp., Hawaii Pacific Health and several West Hawaii physicians, is a two-suite multi-specialty surgery center focused on gastroenterology, podiatry, general surgery, plastic surgery, orthopedics, dental surgery and ophthalmology. Located in the Kona District on the Big Island of Hawaii in the State of Hawaii, Kona Surgery Center opened in January 2010.

The Challenge

While Kona faced several challenges that are common among new surgery centers, its location on the Big Island added a unique layer of complexity to initial planning and design. Specifically, the high cost of commercial real estate and construction meant that every possible inch of space needed to be dedicated to revenue-generating activities.

"There was no room for anything that was not clinically related, so a room dedicated to storing medical records wasn't going to work," said Chris McMenemy, Vice President for Administration, Ortmann Healthcare Consultants, which oversaw the design, construction and launch of Kona Surgery Center. "In fact, when the design was done, there was actually no storage space at all", said McMenemy. "That really helped push them toward finding some sort of electronic solution."

In addition to eliminating paper records, the electronic solution ultimately selected would also have to work well in multiple specialties, with an emphasis on gastroenterology (GI). Kona offers surgical services for five specialties; however, GI is by far its largest practice area, making up approximately 60% of the caseload. Thus, the solution would need to work well for GI but still address the needs of the other specialists who practice at the center.

Finally, it needed to drive compliant documentation. However, the solution also had to provide enough flexibility to accommodate individual charting patterns and workflows.

After its clinicians participated in demonstrations with several solutions, Kona selected ProVation® MD software for procedure documentation and coding, and ProVation® MultiCaregiver electronic health record and patient charting solution.

Focus on Implementation & Training

Equal in importance to overcoming Kona's physical challenges while addressing the needs of a multi-specialty physician base was the ease with which the ProVation Medical software could be implemented and clinicians and staff members trained on its use.

ProVation MD software allows physicians to efficiently document procedures at the point of care. It then produces complete, coding-ready and image-enhanced documentation that results in greater efficiency and clinician satisfaction.
ProVation MultiCaregiver, specifically designed for ASCs, offers robust electronic documentation and document imaging for all elements of the patient encounter, and interfaces with vitals monitors, information systems and ProVation MD.

To ensure the software was properly implemented and any technical issues were resolved when construction was complete, a ProVation Medical project manager was onsite, working directly with Kona staff and a local IT vendor to ensure data lines were properly located and suitable hardware installed. An interface between the software and a local pathology lab was also built.

"That was important because they wanted to keep things local and it eliminated any double-entry to record results," said McMenemy.

ProVation Medical technical support was also available around-the-clock to support the local vendor throughout the implementation. This included weekly and biweekly calls with our project manager to ensure the implementation was proceeding smoothly and within the necessary timeframe.

Physicians were trained within three months to use both ProVation MD and ProVation MultiCaregiver, including two weeks of hands-on training with a ProVation Medical employee. Two Kona nurses were also trained as super-users to provide further education and support post-implementation.

"Our ProVation Medical trainer was onsite for first cases, to ensure they could capture GI pictures immediately," said Jane C. Dierenfield, RN, BSN, CPAN, CAPA, Staff Nurse. They also set up training for physicians, who came in around appointments throughout the week. "By following this strategy, the system was set up and physicians were fully trained by the time they did their first cases", said Dierenfield. "There was never any need for dictation. They were able to go straight into ProVation MD for documentation."

Nurses were then trained within six months to use ProVation MultiCaregiver to document pre-call, pre-procedure, procedure, post-procedure and follow-up calls. They also utilize the software to electronically complete and sign all required point of care documentation.

Realizing the Benefits

Software from ProVation Medical has enabled Kona Surgery Center to streamline patient workflow and drive compliant coding of physician documentation for faster reimbursement. It has also eliminated the costs associated with off-site chart storage.

Among the features most embraced by Kona clinicians is the ability to customize pre-built medical content, as well as the software's ability to interface with vital sign monitors and other information systems.

"Physicians like the menu-driven way that ProVation MD works, especially being able to create their own preferences - that ability to customize and not have to deal with something that doesn't quite work," said Dierenfield. "That ease of use is very important."

Physician offices are linked to ProVation Medical software for post-procedure care information, which allows physicians to document procedures quickly and completely, allowing for rapid production of coder-ready and image-enhanced documentation, plus ancillary reports with instructions.

In fact, the speed and ease with which reports can be produced and disseminated to Kona's coding and billing department, as well as to any referring physicians and the patients themselves, has resulted in a high level of satisfaction among key Kona stakeholders.

"Both ProVation MD and ProVation MultiCaregiver software offer reporting capabilities that support quality initiatives, benchmarking and other reporting statutes," said Dierenfield. "This innovation and technology for Kona, as the furthest point south in the U.S., is tremendous."