MCH’s Cerner implementation showing progress

Medical Center Health System President and CEO Rick Napper laid it all out on the line Tuesday for the Ector County Hospital District board of directors in regard to the implementation of the new electronic medical record system.

Napper called the implementation of Cerner, or MCH1, one of the biggest issues the organization is currently facing.

“There was an attempt to find an ideal system,” Napper said, going back to when the health system had to choose a new computer system after being advised their current system would be discontinued and how they had to meet federal government requirements. “That is not a possibility. There is no ideal electronic medical system.”

Napper said he has worked at hospitals who have worked with Cerner, as well as other computer systems including Epic and MEDITECH, and all of them have had the same problems.

“You as a board of trustees and the leadership of this facility and the medical staff, no matter how frustrated we are with Cerner, you made the right decision and you went forward with Cerner and decided it was time that we transition to a new world,” he said.

Some key issues Napper identified Tuesday was system stabilization, handling of the revenue cycle, workarounds that cause errors and reporting issues.

“Then, and probably the biggest issue that typically happens, is training. Inadequately training your staff or inadequately training your medical staff is a huge challenge and we are no different than any other organization that says, ‘we got this.’ And typically it is several months down the road before you realize, you did not do that well enough for your staff. And I stand before you admitting that we did not do that well enough,” Napper said.

The third party vendor, Cerner, was blaming physicians, nurses and administration — pretty much everyone except themselves — for not properly implementing the system correctly, but Napper said Cerner had to take some of the responsibility, as well.

Now that they’ve begun to work together and coordinate resources though, Napper said there’s been significant progress. A better transfer of knowledge with the IT team is taking place, MCHS has agreed to contract with Xtend to help manage revenue cycle until employees can get better trained, Cerner consultants were brought in at no cost to the hospital to fulfill their contract and meetings are occurring three times a week between executive staff and Cerner to continue improving the implementation.

“I have a one-on-one phone call with the Cerner executives once a week now for them to give me a review and an update and their progress as to how they are going to fix the problems,” Napper said.

“I have told Cerner that I did not want to stand in a circle and point to the right and everybody blame the person to their right, we needed to look to the center of the circle, put the patient there and we all needed to achieve the implementation of Cerner.”

The hospital is financially on track as far as budgeting for the system goes, as well, and there is a possibility they may even come in under budget.

A budget of about $55 million was approved for the Cerner system and up to this point, about $34.7 million of that has been spent. Napper said they anticipate the total cost will be about $47 million and they expect a savings of about $7 million.

“If we are in need of spending some of that $7 million to collect the net revenue that is out there, we may use some of that money to assist with that,” he told the board.

Napper also reported on success benchmarks MCH has seen compared to the health systems nationwide, showing that they are ahead in the overall adoption of the new system compared to the national average and are also ahead of success benchmarks in electronic documentation, as well as other areas.

Other updates Napper presented to the board included an organizational chart update, showing changes made on the administrative and executive teams, a Cejka Executive Search Agreement to fill the vacant Chief Medical Officer position after former CMO John O’Hearn resigned.

Napper also discussed the Texas Hospital Association Annual Conference, what he learned from it and what concerns he now has as a result of it.


The ECHD board also approved the following items:

>> Finance committee report, including the financial report for three months ended Dec. 31, 2017.

>> Joint Conference committee report.

>> Executive committee report, including an agreement with Xtend for revenue cycle services.