Out With the Old: Comprehensive Nursing Systems' Transition

Comprehensive Nursing Services is unique in many ways, which makes its journey from paper to electronic an interesting one. While on paper, clinicians would scratch out notes and struggled to keep track of paper documentation, which meant health information often was not updated in a timely manner, and the potential for alteration of medical records was possible. While the agency was still providing excellent care, coordination was a challenge because it relied solely on paper. However, all of this will soon change after the agency’s recent partnership with Netsmart.  After a surveyor with the Joint Commission called Comprehensive Nursing Services the “last walking dinosaur,” they knew it was time for a change.

“We were facing so many obstacles that wouldn’t exist if we had a robust electronic health record (EHR) platform,” Owner and Administrator Linda Arthur said. “With the Netsmart EHR, we’ll be able to update our records in real time without the hassle of shuffling through ridiculous amounts of paper.”

Comprehensive Nursing Services, Inc. is licensed as a Residential Service Agency in the state of Maryland that provides pediatric private duty home care services.  Comprehensive Home Health Services is owned by Comprehensive Nursing and is a Medicare certified specialty Home health agency specializing in maternal, newborn and pediatric care.

Comprehensive Nursing Services attempted an EHR implementation for both agencies about 10 years ago. However, the system was not meeting its needs and required an extensive data build from the nurses – taking them away from patient care. Feeling like it was given merely a skeleton to work with, Comprehensive Nursing Services used the EHR platform for a year and returned to paper documentation as a less burdensome alternative for clinicians.

“I’m a nurse,” Arthur said. “I have no idea how to code or program, and I shouldn’t have to. I’m here to provide care for people, not dissect an EHR program.”

The agency’s nurses manually send in billing documentation and time slips. If the documentation is late or delayed, then the whole billing process is held up. When a billing document is written, it is sent by mail. If there is a mistake in the documentation, an updated document goes out by mail. Comprehensive Nursing Services clinicians only hope it’s received in a timely manner, corrected and returned.

In order to keep up with current and future requirements and regulations, and, most importantly, continue to provide efficient quality care, the agency needed to upgrade from paper to a new EHR solution. It needed a technology partner who could accommodate a system with its unique needs. However, the thought of looking for a new EHR partner left the agency feeling overwhelmed, scared and apprehensive. Implementing a new EHR platform, especially when transitioning from solely paper, is a huge leap and can be stressful and challenging. A bad taste of the old EHR and all the headaches it ensued loomed at the forefront of everyone’s mind. Would this implementation be better? Would it be worth the trouble?

The agency ultimately decided to give it another go and began its pursuit for a new EHR solution. The office manager researched each company and asked them about their capabilities, knowing Comprehensive Nursing Services is a unique animal that most EHR providers couldn’t tame. Although the agency is Medicare-certified, it also serves the pediatric community: a duo not many healthcare IT companies can accommodate. After a four-to-five-month journey, Comprehensive Nursing Services found a partner with Netsmart, whom it believed could adequately meet its unique and dynamic needs … now and in the future.

After the myUnity® implementation takes place, clinicians will have the ability to write and send notes electronically. If there is an error, the system will flag it for correction prior to submission. It will be fixed nearly instantaneously. Comprehensive Nursing Services care givers will be able to focus solely on continuing to provide quality care at a productive and organized rate.

“This EHR implementation is going to change our operation for the better,” Arthur said. “We’re going to be much more efficient and organized. It’s time for us to make this transition, and most importantly, it’s time for us to get rid of all this paper.”

Comprehensive Nursing Services has more than 300 field staff plus 30 office staff; therefore, this transition into myUnity will be a feat unlike anything the organization had seen before. However, the agency finds comfort in the consistent communication and relationships formed with its Netsmart team.

“The people that we are working with at Netsmart have been absolutely awesome,” Arthur said. “If they don’t know an answer, they go find it. They’re totally willing to work with us in every aspect. Our community is unique, and these Netsmart associates are so patient to understand our needs and challenges.”

In addition, Comprehensive Nursing Services hopes the EHR implementation will equip it to face one of its biggest challenges: meeting hefty state and federal regulations, as well as The Joint Commission. It’s often difficult for the agency to comply with all the rules and regulations, especially because there is an array of forms, papers and documentation that must be turned in on deadline. When you’re using solely paper for clinical entry, documents can get lost, edited and become unclear. However, when the agency transfers to an EHR, deadlines, documentation and forms cannot easily be overlooked or lost. Everything is in one, concise location, making it simpler for clinicians and the agency to meet these standards and continue providing quality care.

As the agency continues to move forward with the Netsmart EHR implementation, staff and clinicians are eager to ease out of paper and into the future.