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cancelled on the day of surgery, just 12% of first cases started on time
and surgeons used only 47% of allocated block times. "Obviously, not
good numbers," he says.
Four years later, when Dr. Foglia measured the impact of using the
EMR system on operational, financial and quality performance meas-
ures, the turnaround was staggering: Case volume jumped by 35% and
surgical revenue increased by 53%.
The numbers, while impressive, were only part of the story. "You
can put processes in place, but you also have to change the culture,"
says Dr. Foglia. "The only people who like change are babies with wet
diapers."
Patience pays off
Surgical facilities typically lose efficiency during the initial months of
EMR implementation, says Dr. Foglia. First case on-time starts at
UTSMC dropped from 30% to 22% after the EMR was launched, but
eventually rebounded and steadily increased to the current mark of
80%.
Brace yourself for inevitable pushback from staff and surgeons
who'll pine for pen and paper. This is such a nuisance, they'll say
when the electronic system goes live. But wait for the aha moment to
hit months later, says Dr. Foglia. That's when the useful data starts
pouring in, the numbers you couldn't get before. For example,
UTSMC can now track the room turnovers of specific OR teams with
the aim of limiting the unproductive time that Dr. Foglia says eats up
an hour or 2 of a surgical day.
Alana Booth, RN, CASC, was trapped in the old school of thought of
preferring pen to mouse. She's the administrator of PCET Surgery
Center in Knoxville, Tenn., which has been equipped with EMRs since
opening in January 2013. Working with the technology from the jump
was an advantage for Ms. Booth's staff, many of whom came from a
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