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Boston Children's

Boston Children’s speeds up EHR response times, reduces unplanned downtime following RHO flip

Boston Children’s Hospital providers are recording faster average transaction response times (ATRTs) after the hospital transitioned to a remote hosted option (RHO) in July 2017. Boston Children’s and Cerner worked together on the transition with the expectation that it would improve overall system performance, eliminate unplanned downtime, and enable limited client resources to work on additional strategic initiatives. 

When Boston Children’s experienced an extended downtime in March 2015, all hospital departments worked together to ensure patient care would not be impacted, even if the system was offline temporarily.

“That was an important event for us. We've been electronic for over a decade, so going back to paper for an extended period was difficult.” said Jonathan Hron, MD, pediatric hospitalist. “With our RHO transition, there was a lot of preparation required for about a 12-hour window of planned downtime. It went remarkably smoothly because everyone was prepared.”

With the transition to RHO, which allowed information technology (IT) staff to dedicate resources to other electronic health record (EHR) enhancements, simple tasks in the EHR also appear to be running smoothly for the staff at Boston Children’s, according to Hron. “I heard several people say they think things were running a little bit faster and seem to load a little bit quicker.”

From August to October 2017, ATRTs improved 45.5 percent when compared to ATRTs from April to July 2017, prior to the transition. During the same period, login average response times improved 61 percent, and transactions that took place in fewer than five seconds improved 80 percent.1 There has not been a full system unplanned downtime since the transition to RHO. 2

“With RHO, we have a system that is faster and more reliable,” said Lee Williams, RN, director, Clinical Education and Informatics. “Because of its infrastructure, RHO also introduced us to implementations related to functionality and enhancements we did not really have before.”

Unplanned downtime for any hospital can impact patient safety due to limited or delayed access to the patients’ medical records.

“One of the enhancements we made was an improved read-only version of a patient’s historical medical information,” said Williams. “If there is a period of unplanned downtime, our providers can review that record instead of having to go back and rely on paper.

“Some of the staff here have never experienced a world without technology. Having that capability within our system helps them shift their time and resources to other priorities.” 

In addition to seeing faster ATRTs, Boston Children’s also benefits from having access to upgrade resources and the ability to remain current on Cerner code with less disruption to users.

From the small period of planned downtime when the transition occurred to present, engagement from providers has been the real achievement behind Boston Children’s successful transition to RHO.

“The engagement of providers in preparing for the planned downtime in July was a great success of the RHO flip,” said Williams. “The continued engagement from our end users means a continued success for our system, meeting the needs of our providers, and our patients and their families.” 

1 All transaction data was pulled from Cerner’s Lights On Network®

2 As of January 2018

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.