Surviving a Costly Conversion to Enterprise and Back

Madison Memorial Hospital returns to EV™ after enterprise EHR struggles


After converting their emergency department (ED) nurses to an enterprise-wide electronic health record product, Idaho nonprofit Madison Memorial Hospital began to notice significant financial, operational and clinical problems.

Prior to the switch, Madison had used T-System paper templates in their ED and later upgraded to T-System's emergency department information system, EV™. But at the urging of their hospital to use a single system across the enterprise, their nurses began documenting in a new system while the physicians remained on EV.

With the new nursing solution, critical patient care information became hard to find. Lab culture processing could take hours or days. Once submitted and recorded, there was no communication to staff that patient results were available. Any reports run for lists of the labs ordered came back empty.

Nurses also were frustrated by the many steps, layers and clicks required to negotiate data entry, and were unable to view what they had charted. Physicians wasted time checking back for chart information, and in the nurse's absence found themselves forced to search the enterprise system themselves.

Both issues hurt their ability to provide quality, timely patient care, and harmed morale for patients and clinicians. Over time, administrators noticed another matter: the ED was inexplicably losing money. When their accounts recovery team investigated, they found infusion start and stop times were not being recorded – causing a loss of $15,000 per month.

With Meaningful Use attestation deadline fast approaching, Madison Memorial knew they needed to return to EV, the T-System solution they'd trusted before the pressure to use an enterprise EHR arose. After three years of struggle, they reinstalled their nursing module, installed CPOE, and were able to complete attestation on time. With every piece of data in place and the high rate of user adoption, they received payment from CMS even more quickly than expected.


"It was frustrating to have those crucial processes not work for us and be losing money as well. I'd spent nine months working with the [enterprise] development team to get our module set up right."


– Alan Brower
   ED director at Madison Memorial

T-System & Madison Memorial Hospital

Madison Memorial Hospital

Location: Rexburg, Idaho
ED: 10,700 APV
T-System Solution: EV™ for physicians, Nurses, CPOE, Patient Tracking, Intelligence

EV Results:
  • Infusion start/stop times being recorded, $15,000 per month restored
  • High user adoption rate
  • Attestation for Meaningful Use 1
  • Faster payment from CMS
Find out more about the solutions used by Madison Memorial Hospital...
Easy, Effective, EDIS
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