Hattiesburg Clinic’s EHR efforts put patients, doctors first

Hattiesburg Clinic’s journey to optimize their EHR use in ways that improved patient care and led to efficiencies for physicians started back in 2017.

In the years since, leaders at the physician-owned and -governed Mississippi health system have embraced a wide range of possibilities available through Epic to provide more detailed records for patients and doctors alike. As a result, Hattiesburg Clinic has been awarded Epic Gold Stars Level 10 for four years in a row, making it one of only four health systems among all customers to earn the designation.

Earning the designation “requires an organization’s commitment to ongoing training, system optimization, and a culture of innovation. The award recognizes health care organizations that actively embrace and implement Epic’s latest advancements, leading to increased efficiency, reduced administrative burdens and ultimately, better patient care,” according to a release from Epic.

The real journey began when administrators took a deeper dive into the data behind the Gold Stars designation, and found a great deal of useful information, noted Betty Dickerson, chief information officer for Hattiesburg Clinic, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

“We brought on a skilled project manager solely to oversee this effort, and we started working really hard to meet all of the marks,” Dickerson said. “Today, we’ve earned 93% of the available stars,” such as quality and safety, physician productivity and joy to use, nurse productivity, and patient engagement and self-help, among others. The score is based on the overall adoption percentage of more than 700 Gold Stars items.

Among the first Epic tools used by Hattiesburg Clinic was a physician-facing application that allows doctors to track trends seen in their patients’ records. A simple click opens datasets that physicians previously could not access as quickly. Pre-charting was also instituted, enabling physicians to better prepare for patient visits.

“For physician productivity, we’re at the 98th percentile,” which is based on 95 features that help doctors move more efficiently through their system workflows, Dickerson said. “Nursing productivity is at 100% and patient experience is at 99%.”

Here is how Hattiesburg Clinic has embraced the EHR and found ways to reduce documentation for physicians to improve well-being.

Hattiesburg Clinic tested a self-service check-in kiosk for patients arriving at their locations for care. They found almost immediately that patients preferred the new check-in method, and it freed up administrative staff to address other needs that required a human touch.

These locations also found that they could share records seamlessly with the Care Everywhere system.

“Patients who travel to many other health care systems around here—from University of Mississippi to Singing River—we can easily exchange records with them through Care Everywhere,” said Jeremy Screws, MD, a pediatric gastroenterologist and lead physician informaticist at Hattiesburg Clinic. “We can provide better care across the board when we can find the electronic records, resulting in less repeated labs and imaging.” 

Dr. Screws, Dickerson and other Hattiesburg Clinic administrators quickly understood that all the Epic tools would not help anyone without proper training and support. Clinical analysts with backgrounds in Epic were brought in to educate and support physicians and other health professionals as they adopted the new tools. They also helped with Epic troubleshooting.

“They usually have a mix of clinical and technical background, and they’re assigned to each location as the face of the Epic department,” said Dickerson. “They’re available for questions and support.”

Additionally, Hattiesburg Clinic set up an EHR steering committee, tip sheets, e-learning and training sessions. They also offered an open-door policy for physicians to share what they found helpful, or detrimental, to their work.

“We hold what we call ‘happy hours’ where physicians have time away from clinic to ask questions, and we can show new technology that we’d like to roll out,” Dickerson said.

Dr. Screws noted that a close relationship between physicians and the IT team helps bridge technological gaps and has been enormously helpful.

Hattiesburg Clinic also embraced ambient scribe technology to lessen the challenge of keeping up with clinic notes from patient visits. They started off with a test group of 35 physicians. In just one month, physicians reported saving up to 60% of time working outside of clinic hours, thanks to the technology. This contributes to physician productivity, which is part of the Gold Stars.

“It’s been a big year for us using this technology,” Dr. Screws said. “It’s been a great experience.”

Physicians and other health professionals can opt in to use the ambient scribe service. The physician specialties using scribe technology include primary care, pediatrics, family practice, internal medicine, plastic surgery, otolaryngology, vascular surgery, and adult and pediatric gastroenterology.

“The physicians get to make that choice,” Dr. Screws said. “And physicians get to weigh in on the different vendors we seek out for these services. Autonomy is an important factor in our efforts to reduce burnout.”

Assessing whether adding technology makes a difference ultimately comes down to the patients. Are the new tools helping physicians improve health, and how?

Giving doctors the ability to see and track patient trends easily through Epic tools helped physicians to get ahead of chronic health issues. For example, hypertension-control rates of patients at Hattiesburg Clinic went from an average of 54% to 70% in about three years. This is part of the Gold Stars.

“We made sure there’s easy access to the electronic records, and that the metrics and scoreboards for patients are easy to analyze as well,” Dr. Screws said. “They’ll show green, yellow, red for different health trends and it’s shown to directly help with patient care. We’ve also seen improvements in diabetes and depression rates since we began using these tools.”

Hattiesburg Clinic plans to add to their stack of collaborations, trainings and available records resources. And they’ll need to do so to maintain their Gold Stars status. Epic keeps qualifying health systems on their toes each year by changing the requirements periodically.

“When enough people achieve a benchmark, they'll just take it off the list and they’ll put something else on there,” Dickerson said. “But we’ve kept up with them so far.”