In Rush’s quest to become the medical center of choice in the Chicago area, the 613-bed academic medical center adopted a new EMR system that would help streamline and automate a host of processes surrounding patient care — from admissions to bedside to discharge and all points in between. As a leading U.S. medical center, Rush’s commitment to top-quality patient care is unwavering — which requires the utmost dedication of IT resources to implement advanced technology solutions, often on an accelerated schedule.

In this case, Rush needed to make significant additions to its already complex environment to support the EMR rollout, including hundreds of new servers, wireless access points and point-of-care devices, and they had less than 15 months to get it done.

Rush’s IT department turned to CDW Healthcare for help with both its infrastructure upgrade and a PoC technology solution to introduce the EMR system across the enterprise. At the heart of this initiative is a custom-configured Ergotron medical cart built exclusively by CDW Healthcare.

The compact cart on wheels features a mounted LCD monitor display with height-adjustable Ergotron brackets; an optical mouse and keyboard tray; a Wyse thin client terminal with a preinstalled wireless PCMCIA card; a power and Ethernet cable management system neatly organized under removable panels; and a chargeable battery. Each mobile cart contains a thin client and monitor that CDW configured with software imaging capabilities to ensure that all settings are preprogrammed to deliver Rush’s new EMR application and order sets.

Using intuitive PoC technology with which physicians, nurses and other medical practitioners are comfortable helps to accelerate the adoption of healthcare IT throughout the organization, ultimately leading to better patient care and safety.

Despite tight timelines, CDW Healthcare was able to quickly configure Rush’s initial order of 304 Ergotron medical carts in only 10 weeks. The carts were staged and stored in CDW’s on-site Distribution Center, then shipped to Rush in batches of 20 to 30 as needed. This was followed by another order of 70 more carts. As of May 1, 2007, all 374 carts have been deployed and offer a comprehensive, end-to-end solution that brings the benefits of EMR to Rush’s practitioners and their patients right at the point of care.

From inpatient rooms to the emergency department (ED) to surgical suites, the cart has a prominent place in nearly every facet across the hospital. CDW Healthcare has played a critical role in helping the IT staff to conserve resources, work within space and time limitations, and realize a low total cost of ownership (TCO) on its overall investment.

When it comes to excellence in delivering patient care, Rush University Medical Center is a leader, due in part to embracing the move to become a completely digital hospital. What used to be hard copy medical records are now being made available to the clinicians at the bedside, in the exam room, the ED and even in the operating room (OR). But the process isn’t necessarily “instant”; it involves conversion to a new EMR system across the entire hospital in a three-phased approach.

This expansive EMR initiative is critical for Rush to move toward a progressive paperless environment over the next few years. Just as important as the EMR software application is the hardware technology required to leverage the full potential of digital data delivery and exchange. Rush needed the right automation solution to bring patient data directly to the point of care, where it could be accessed, viewed, updated and shared among other clinicians in virtually any setting. Not just any hardware device — but a comprehensive, end-to-end PoC solution specifically designed for Rush — in only 10 weeks’ time.

Not only was time a consideration, so was space. Rush required a mobile PoC technology device with a small footprint that could be easily transferred from room to room, yet carry the power and functionality of a full-scale EMR solution. Being a hospital, Rush also was restricted in terms of where it could store these devices without cluttering hallways or inpatient areas. The IT department did not have the floor space or capacity to stage and build the technology on-site, nor could it afford to wait months for shipment of a preconfigured solution from an overseas vendor.

“We had an aggressive agenda to go live with Phase I of our EMR deployment by May 1,” recalls Jim Kearns, Vice President, IT Operations, Rush. “Not only was our IT staff time-constrained, but we had to make a substantial amount of infrastructure upgrades to support this large scale EMR implementation. We didn’t need a technology vendor; we needed a strategic partner to make this happen…someone with the right service, attitude and flexibility to help us find the ideal solution.”

Treating patients and saving lives requires a commitment to quality and innovation, and Rush demands the same of its technology partners. That’s why this top-ranked medical center chose CDW Healthcare as its one-stop source of IT solutions to bring Rush’s new EMR system to life.

CDW Healthcare was selected as a strategic partner to support Rush’s IT infrastructure expansion and its PoC technology solution to bring EMR to the bedside. After working with the organization for more than seven years, Rush had confidence in CDW Healthcare’s ability to deliver critical thinking outside of the proverbial box.

Kearns’ IT group and CDW Healthcare’s account team (headed by Danny “Charlie” Brown) mutually arrived at the best solution to deploy the EMR software application: a custom-configured Ergotron medical cart. Brown worked closely with Erik Von Rueden, CDW Healthcare’s senior services sales specialist, to size up the capabilities of CDW’s own on-site Configuration Center for this assignment.

“Erik investigated whether we had the bandwidth and expertise to take on this project,” Brown recalls. “’Absolutely!’ we told them. Not only could CDW Healthcare help Rush procure the right technology components, but we could build and store the carts right here in CDW’s on-site warehouse until Rush needed them. Our goal was to make their cart installation as plug-and-play as possible upon receipt of delivery.

There was just one catch: Rush needed the first batch of 304 carts in just over two months!”

By the end of 10 weeks, the entire rollout of 304 carts was completed. This initial order of 304 was followed by Rush’s request for 70 more carts, which CDW easily accommodated. CDW stored the completed carts right next to its Enterprise Configuration Center in CDW’s Chicago-area warehouse and shipped them out in batches of 20 to 30, depending on Rush’s needs.

“This buy-and-hold arrangement was ideal for us, because we did not have the space to store the carts at Rush. Once the carts arrived, they were ready to plug and play, saving valuable time for our IT staff. They simply needed to perform an internal QC check, and then the carts were ready for release. This made it easy for our practitioners to begin using the new EMR application — which, in turn, helped to accelerate its adoption,” Kearns states.

From inpatient rooms to the ED to surgical suites, the Ergotron medical cart now holds a prominent place across nearly every facet of Rush. CDW Healthcare was also instrumental in helping the IT department upgrade its infrastructure, with a new storage area network (SAN), hundreds of blade servers and a replicated data environment to support the EMR application. The upgrade took about 15 months to complete prior to the May 1 “go live” milestone that kicked off Phase I of the EMR deployment.

The goal of Phase I was to transform key areas of the patient experience at Rush including admissions/discharge, pharmacy, nursing care/documentation, surgery, computerized practitioner order entry (CPOE), and billing. Part of the CPOE implementation involved the creation of over 140 evidence-based order sets used to provide greater consistency of patient treatment and care. The Ergotron cart configuration utilized CDW’s software imaging offerings to preprogram the Wyse thin clients.

Rush medical staff members use the carts right at each patient’s beside to view the LCD monitors and gain instant, accurate access to patient demographics, medical history and relevant lab results, which are saved as part of the patient’s EMR. Rush is also implementing a positive patient identification (PPID) bar code application to verify the “Five Rights” at the point of care. With the swipe of the patient’s wristband, all information can be scanned and verified before a prescription is administered or ordered.

As a result, clinicians are better equipped to improve patient safety and reduce medical errors by issuing prescriptions electronically for direct fulfillment by pharmacists. Prescribers can instantly check for adverse drug interactions and use clinical decision support tools that direct them to lower-cost alternate medications. By using standardized physicians’ orders, Rush can help to ensure adherence to care guidelines, best practices and government regulations such as HIPAA.

“Phase I marks a major step toward enabling a better patient and family experience at Rush, while also providing our clinicians the tools they need to provide outstanding care,” Kearns explains.

Expanding EMR Across the Enterprise

Phases II and III will continue to advance Rush’s EMR adoption and improve the quality of patient care by expanding EMR utilization to ambulatory and other patient care areas across the medical university.

“Throughout Phase II and Phase III, our goal is to complete the integration between critical patient applications and our EMR system. In some cases, we will be replacing outdated applications to ensure this transition is seamless and invisible to the patient and our clinicians,” Kearns says.

Throughout Phase II and beyond, the Ergotron medical carts will be “on call” in other areas of the hospital. Essentially, wherever patients are located, so, too, will be the carts — wheeling vital patient data right to the point of care. One example is integration with Rush’s Picture Archiving and Communications System (PACS). Rush’s PACS solution will ultimately feed directly into the EMR system, as will other applications such as Rush’s lab system and even critical care monitors and I.V. pumps.

A Continued Technology Partnership

What’s next for Rush? Following the incredibly successful launch of its first phase of the EMR project, the IT team, working hand in hand with the Rush clinicians, will continue the quest for Rush to provide the ultimate patient experience. Improvements that will enable patients to request order prescription refills, schedule doctor appointments and coordinate other aspects of their care electronically through Rush’s Web site are already underway.

The technology transformation is a key component of the Rush Transformation. Through new facilities and new technologies, Rush is redefining the meaning of first-rate patient and family-centered care. Rush will soon break ground on a new orthopedics ambulatory facility and not long after that, a state-of-the-art hospital facility followed by renovations of some existing clinical buildings, all on its Chicago campus. These new “state-of-the-art” facilities are being designed in a manner that puts the patient and family experience at the center of all activities at Rush. The new EMR system has been planned in close collaboration with the team planning all of Rush’s new patient care facilities and renovations.

“We’re looking at all aspects of providing the best patient care, safety and satisfaction levels in the industry. In addition to improving clinical effectiveness, Rush’s IT systems must help drive our revenue enhancement goals at the lowest total cost of ownership. We’ll again be working with our trusted partner — CDW Healthcare — to support Rush’s interconnectivity, systems and application requirements as we move toward a digital enterprise,” Kearns says.