Webinar Recap: Optimizing Oracle® Cerner’s EHR with Innovative SaaS Solutions

Are your hospital’s staff sighing at their keyboards? Clinicians, nursing teams, and administrators may be limited by technology that doesn’t address their most important tasks.

That’s because even the most vaunted EHR platforms, like Oracle Health Cerner, largely stick to recordkeeping.

On their own, EHRs aren’t designed to provide robust specialized features outside of patient data management. However, new tools can help EHRs do so much more.

Addressing these EHR gaps was the focus of Understanding New Technologies for Oracle® Health’s Cerner-based Surgical Teams, a continuing education panel co-presented by LiveData and OR Manager.

The webinar was led by Mike Foster (an independent health IT consultant who has implemented LiveData in for-profit hospitals) and Matt Churchill (formerly a clinician and currently a LiveData executive). Mike and Matt explored how “SaaS” - Software as a Service solutions - give EHRs new surgery support capabilities.

Add-On Modules Amplify the EHR’s Capabilities

For Oracle Cerner EHRs to better aid clinical operations, the first step is to reconsider the EHR’s role.

Matt recommends thinking about how to turn EHRs from a system of record into a “system of engagement” that actively facilitates workflows.

“What we mean by [the] distinction is that a system of record is … a repository for patient information,” Matt said. Conversely, “a system of engagement is the layering of certain SaaS applications, bidirectionally integrated to the EHR, to help close those communication and workflow gaps that may exist in a given hospital's environment.”

“We know that the EHR is definitely designed as an enterprise system and is not necessarily focused specifically on every hospital department, and their specific requirements,” Matt said. With Cerner, surgeons “don't necessarily have visibility into the surgery schedule … and that creates some blind spots for them to figure out how to best optimize the use of OR time.“

In Matt’s experience, those improvements to specific functions - like “things that perioperative clinical leaders and stakeholders need to better run the operations of the surgery department” - are where SaaS-based solutions can drive more functionality from an EHR.

For example, tools like LiveData can provide real-time information to OR teams about the progress of cases. This removes the manual effort, or 40-minute delay, that surgical nursing stations traditionally face when seeking updates from operating rooms.

SaaS Modules and Safety

EHR add-on modules are generally deployed via SaaS (Software as a Service). SaaS is a method of software delivery on the cloud, like Google Drive or Netflix, that minimizes the constant challenges of installing, updating, and licensing tools.

Healthcare centers, Mike said, previously “used a heavy lift with on-premises, physical servers, network connections, a lot of local maintenance, and installing on local machines.”

Now, widespread SaaS adoption has sped up innovation in healthcare. “Really it's as easy as pushing an icon out to the workstations that you need and easily being able to access that software,” Mike said, “taking that lift off of your local IT”.

By living in the cloud, SaaS applications prevent most tech breakdowns on local machines from disrupting their functionality. Solutions providers handle the work of keeping their programs up-to-date, shifting health IT teams out of a reactive stance.

“Moving to SaaS was one of the biggest security positives that [our hospital] saw,” Mike said. “We don't have to have a physical server on site … or keep up on the OS updates … running to every machine to do an update because of a security patch,” Mike added.

Good SaaS tools can work on paper and in practice. Responding to a question about adding LiveData to a Cerner Surginet system, Mike said that “the integration was pretty flawless.”

Transforming Surgery Workflows with SaaS

SaaS applications allow EHRs to provide more targeted help to specialists. While clinicians can benefit from specialized tools, some implementations also address the top-to-bottom needs of entire departments.

In surgical settings, “SaaS applications better connect hospitals to their providers, driving improved service offerings … by improving the communication and streamlining the workflow, from the surgeons' practices to different hospital staff that help operate that surgery department - like surgical schedulers, for instance,” Matt said.

“Certainly [SaaS tools] can help to unlock hidden scheduling opportunities merely by putting the schedule into the surgeon's office. [Surgery practices] can see their own block time and any potential open time that a given hospital has in their operating rooms and thereby increase access to surgery for patients and help make it easier for surgeons too,” Matt said.

Another benefit of SaaS platforms is how they tend to fit the custom needs of different facilities.

“We spend a lot of time walking through, ‘how do you want to use the software?’” Matt added, “and ’what timestamps do you want to use? What do your checklists look like? What are your preop milestones? How many operating rooms do you want to put into LiveData PeriOp Planner?’ I think more of the time than it takes to integrate. And to be clear, we're getting data out of Cerner in real time, which means every minute, as well as putting data back into Cerner Surginet, where it belongs, in real time.”

An audience member subsequently asked about pushback from surgeons, who can be reluctant to engage with new tools. Mike reported that, in fact, his hospital’s LiveData SaaS deployment “caught on due to surgeons asking and could not be deployed fast enough.” 

Surgeons, Mike added, “wanted open workflow, offices wanted access … scheduling and communication improvements were felt quickly in the hospital, eliminating the legacy burden of faxes,” Mike said. “Exactly what the hospital had in mind.”

SaaS Tools Deliver Both ROI and Workforce Improvements

Hospital leadership told the speakers they saw dramatic impact from SaaS tools that support their EHR too. While tools like PeriOp Planner create more surgery capacity, the real-time reporting in tools like PeriOp Manager Analytics made SaaS benefits clear.

The feedback Matt received was that “PeriOp Planner is a volume growth driver. Day-of-surgery tracking boards are the engine that gets the ‘bad minutes’ out of the day to create the capacity to serve the new volume being brought in by PeriOp Planner.”

Nor are surgeons the only clinicians to benefit from SaaS tools. These enhancements to existing EHRs also improve the work environment for associated staff like anesthesiologists and nurses.

Beyond immediate returns, Matt said, “healthcare is in a short-staffed environment. And so the last thing that you all want to do as surgery stakeholders is bring more volume [without managing schedules], further pushing your staff to do more cases and potentially have to stay late and miss dinners and things like that with the family.” 

“So the hard dollar payback,” Matt concluded, is about “seven to eight times for anybody who decides to implement this solution. But it's really more than that … the applications work together, to get you where you want to go, without taxing your staff.”

Best Practices for Finding a Good Vendor

Mike also gave his thoughts on mutually beneficial hospital-vendor relationships. The most important thing? Communication.

Whether online or otherwise, “I could always get LiveData on the phone if there was an issue with workflow, or there were questions or communication differences … sure enough, the team would show up a day or two later and they would be there for a week if necessary.”

What distinguishes a good relationship is a company that takes time to build relationships with facility staff like clinicians and IT. Hospitals should look for “not just a vendor, but a real partner that integrates within your system.”