Oroville Hospital Creates EHR Development Office to Continue Improving Its VistA Implementation

The extraordinary success of its EHR roll out and CPOE implementation has led Oroville Hospital to create a software development office to continue enhancing and customizing its open source VistA EHR

Oroville, CA, June 6, 2013—Oroville Hospital, the first hospital in the United States to self-implement an open source electronic health record (EHR) system and then to roll out a successful Computerized Physician Order Entry (CPOE) implementation, has created its own code development office. One of the key elements behind this success has been the ability of Oroville's staff to take advantage of the inherent flexibility of VistA to customize it to its needs. The office will continue the hospital's efforts to enhance the world-class VistA EHR and adapt it to its own uses.

The office is headed by Zach Gonzales, a long-time employee of the hospital, who early on saw the potential of VistA. As the hospital started its VistA implementation it was Gonzales who discovered the potential of the Enterprise Wed Developer (EWD) framework. EWD has played a major role in helping the staff improve VistA.

Gonzales' promotion is an example of Oroville's long-standing policy of recognizing local talent and encouraging it to develop their abilities, follow their passions, and take leadership. Gonzales joined the Oroville staff in 1999.  He initially had an interest in respiratory therapy, but quickly realized that his real calling was information technology. His passion for implementing and enhancing VistA came next.

Over the past several years Oroville Hospital has engaged independent VistA consultants to help them customize VistA to the needs of the hospital and extend its capabilities. By creating a development office, Oroville Hospital is both consolidating all the work that has been done to date as well as laying out the groundwork for future development work that is increasingly being done by Oroville's own staff.

In addition, Oroville has set up training facilities in the same building that houses the development office. Classes range from how to use VistA, all the way to intense workshops on VistA enhancements. The enhancement classes are being attended not only by the development staff, but also by nurses and clinicians who want to learn how to improve VistA so they can better take care of their patients.

As a result of this combination, Oroville Hospital is building a world-class team of developers that can provide VistA with all the necessary enhancements to address all needs of EHR use and CPOE in the private sector. This team played a critical role in the roll out of CPOE in Oroville Hospital.

The following are some of the specific CPOE-related development efforts:

• Admission Discharge and Transfer (ADT) Interface into VistA
• Sunquest lab system Interface
• Implemented VistA Imaging
• Adopted scheduling application developed by Indian Health Service (IHS)
• Custom configured Pharmacy System
• Developed ePrescribing module

The following are specific VistA enhancement development efforts:

• Using EWD Oroville's team developed a real-time patient-dashboard application. This breakthrough application uses data from VistA to show real time status of patients in one screen. The idea is to replace the manual white board used by the hospital to keep track of patients. The dashboard monitors orders and other patient activity.
• The Oroville team wrote a pediatric growth chart application in EWD. This effort required three developers who worked for approximately three months from inception to full roll-out in production.
• The one great challenge Oroville encountered during the CPOE rollout was the conversion of VistA's flow sheet application. It proved to be too complex to adapt for use in Oroville's CPOE effort. The Oroville staff is currently developing a flow sheet from the ground up using EWD. This new application should be completed in the next 3-4 months, at which point Oroville will be able to complete its CPOE implementation.
• To meet requirements for Meaningful Use Stage II, Oroville is integrating features of the HealtheMe patient portal/PHR with VistA and developing additional feature sets that will be included.
• Oroville is also currently developing a centralized bed control application.  This application will assist hospital staff with patient flow by improving patient movement through the system and help with the planning of potential hospitalizations. 

The development department’s is focused on enhancing VistA in areas specific to improving patient safety, patient satisfaction, provider/staff satisfaction, and the overall success of Oroville’s EHR.  For questions relating to the Oroville Hospital’s Development Department contact Zach Gonzales at zgonzales(at)orohosp(dot)com.

Stage I Meaningful Use was achieved in 2011 and 2012 for the hospital and some of the clinics. Oroville Hospital is currently working on Stage II.  So far all the development work for all the applications as well as the EHR and the CPOE implementations have been achieved for less than $7 million as outlined here, less than a quarter of the average cost of implementing a proprietary EHR in similar regional hospitals.

About Oroville Hospital

Founded in 1962, Oroville Hospital has grown from a modest community hospital supported by a small staff of dedicated doctors into a 153-bed acute care facility specializing in a broad range of inpatient and outpatient services, including multiple physician practices. Oroville Hospital is a private, non-profit corporation serving the citizens of the Oroville area and Butte County by OroHealth Corporation. With a medical staff of more than 130 physicians, Oroville Hospital prides itself on providing the highest quality medical care in a friendly and compassionate environment.

For more information, please contact:

Shanna Roelofson
Director of Marketing
Oroville Hospital
sroelofson(at)orohosp(dot)com
(530) 532-8044
http://www.OrovilleHospital.com