MURRAY – After years of planning and nearly 18 months of training, Murray-Calloway County Hospital (MCCH) launched a new consolidated electronic health record (EHR) system from Oracle Health, retiring the patchwork of platforms it used to store patients’ medical records for decades.
With a price tag expected to reach, and possibly exceed, $15 million, only the Regional Cancer Center comes close to rivaling the project in terms of capital investment, but given the fact that it impacts practically every department organization-wide, the scope and scale of the Oracle project are far beyond any of MCCH’s previous endeavors.
“I’ve told my folks to spend whatever it takes to make people comfortable.” MCCH CEO Jerry Penner told The Sentinel in 2024. “So, I basically gave them a blank check. We knew it was going to be in that ($15 million) ballpark. From the start, we never even put a budget marker on it. We knew we were going to have to spend whatever it took to get this thing done right. Thank goodness we only have to do it once.”
“You can’t touch it; you can’t feel it; you can’t see it, but you know it’s working behind the scenes. Isn’t that crazy?” he added.
The need to consolidate the three electronic records systems used throughout the organization – T-Systems in the emergency department, Athenahealth in the outpatient clinics and Meditech on the inpatient floors – has been a consideration in the board of trustees’ strategic planning for several years.
Discussions increased throughout 2022, and in early 2023, representatives from Cerner and Meditech traveled to Murray to give week-long demonstrations of their respective products. Ultimately, MCCH selected the CommunityWorks platform by Cerner, which was purchased by Oracle and subsequently rebranded as Oracle Health.
Originally, the plan was to go live with the new system in September 2024, but as the date approached, the call was made to delay the launch until this year.
Despite preparing for months upon months, some tasks could not be performed until hours before the switch. At noon on Sunday, hospital staff arrived set up patient profiles on the new system, with primary focus on transferring the records of approximately 60 admitted patients from Meditech to Oracle. Administrative staff closed out the old profiles and created the new ones, while nursing staff manually entered medication lists and orders.
New patient wristbands and Care Aware devices, which are handheld devices, like cell phones, that nurses can use for charting as well as to scan wristbands and medication, were distributed to nursing stations throughout the hospital at 6:30 p.m.
“That is a clear step in the process,” Michael Lucey said with a laugh on Sunday evening. “But there’s a lot of steps, and they all happen in sequence and concurrently.”
Lucey is the president of the Massachusetts-based consulting firm Community Hospital Advisors. MCCH contracted the company in early 2023 to guide them through the process. Penner praised Lucey’s vast experience helping community hospitals transition to new EHR systems, adding, “From the first inception, when we started all this, he’s been invaluable to us.”
In addition to Lucey’s team of roughly 15, more than 60 Oracle staff are on-site this week to help the clinical staff acclimate to the new system. MCCH also has an internal team of “super users,” who received specialized training to serve as local support staff over the coming weeks. For the first few days, support staff will be present 24 hours a day.
There are two reasons why it is necessary to have so many support staff here for the first week, Lucey explained. One is that the Oracle system has several specialized components that require expertise in specific areas, such as pharmacy, radiology and laboratory, which is further broken down into three parts.
“If there is a critical problem that happens, we have to have the people here,” he said. “I have to figure out: is it workflow, or is it technical, or is it contributing from both? Well, if I don’t have workflow people and technical people in the room – and the technical people might be from four different contributing areas, you have to have them all here.
“The other reason there’s so many is that, for these first four or five days, there’s an issue of volume over complexity. There’s just a lot of people who started using this system an hour ago; and if they have user issues or (other) issues, we have to have somebody right there beside them.”
On Monday, Lucey said that the switchover Sunday night went very well. He explained that, from this point, there are three types of challenges – technical, training and workflow. Technical challenges concern the system itself and whether it is performing as expected. Training challenges largely come down to the sheer volume of information people have had to learn.
“When I’m learning a lot of new things, I’m not going to learn them all. That’s the second thing,” Lucey explained. “And the third is work-flow challenges. … When I’m training someone, and I’m looking at the system, and I’m realizing, ‘So, if your supply cabinet is all the way down at the other end of the hall, having the scanner here is not a good idea.’
“Sometimes it’s a combination of that workflow recognition and a technical change that has to be made, and they interact with each other. Those are the kinds of things that you’re not actually going to recognize until you’re using the system.”
Lucey anticipated that the first few days will involve addressing mainly technical and training challenges. By Thursday, he said, workflow challenges will “rise to the top,” noting that, while some of workflow issues will require a technical change to the system, others may simply require a change in habits.
“You want to get to that place relatively quick,” Lucey said, “because if we’re resolving those things in the next three or four weeks, you keep people from reinforcing the ‘workaround.’”
To ease the transition, MCCH has deliberately throttled the number of procedures being performed and patients being seen in clinics this week, Penner advised. He acknowledged that some people may be frustrated by the limited number of available appointments but advised that it is only temporary.
“We wanted to make sure that we didn’t overwhelm the staff with bunches and bunches and bunches patients – a normal day – because it’s not going to be a normal day or a normal week,” he said. “Number one is patient safety. It’s not about trying to do something fast; it’s doing it right.”
Learn more about MCCH’s new patient portal here.
