Summit expansion project on track (copy)

Pictured is the northeast corner of the new Administrative Services Building located at 2200 E. Show Low Lake Road. Several departments are housed in this building including Patient Financial Services and Medical Records.

SHOW LOW — There is an exceptional amount of trust that patients place in physicians, medical facilities, labs and hospitals.

For example, when you make an appointment to see your doctor, you trust that they have all of your previous medical history on file.

If you require a procedure such an ultrasound, a CAT scan, an EKG or an MRI, you trust that the doctor’s order for that procedure will be sent in a timely manner.

When you request a prescription refill, you trust that your doctor’s office will handle it promptly.

But that’s not what has been happening for many patients of Summit Healthcare Regional Medical Center, and their affiliated physicians and clinics. On August 1, Summit Healthcare began a process to “go live” with a new, streamlined online medical records system — Sunrise Allscripts. Allscripts replaces eight different medical records systems previously used in different areas of Summit’s operations. But Summit’s roll-out of the system has not gone smoothly, and has impacted patients across many areas of service.

Different patients, similar problems

Patients that previously felt they had received good care from Summit now say things are different.

Several patients reached out to the Independent since early August, citing ongoing frustration and concern following Summit Healthcare’s rollout of Allscripts, citing problems getting doctor’s appointments in a timely manner, or emergency room visits that seemed chaotic.

They have waited weeks for procedures to be ordered. Some patients report difficulty obtaining prescriptions, especially refills. Multiple calls and trips to their doctor’s office, calls to the Patient Experience Center and attempts to escalate these issues to office managers have, at times, also failed.

“The quality of care has declined significantly,” says patient Sarah Fox of Lakeside. “Several years ago we were told that Summit medical staff and hospital were really good. We agreed. But not so much anymore.”

“There is always a wait at the various doctors (2 plus hours for a 10 minute appointment!) and we were even asked to write down 3 questions to ask the doctor, as that’s all the time that they have for each patient,” Sarah wrote in an email to the Independent.

“It’s so chaotic; it’s just chaos,” says Phil Mortello of Show Low in regards to he and his wife’s recent experiences with Summit Healthcare.

“I have been a big fan of Summit Health for the 11 years we’ve been up here,” assures Mortello. “My wife has had cancer twice and we’ve had great service.”

Mortello said that it wasn’t until Summit’s recent expansion project and the software conversion that they began to experience problems with their care. As a former information technology professional, Mortello says that his first concern was that the online “hospital portal and the Summit Healthcare doctor’s portal had records that were not consistent.” He claims that the patient’s prescription lists did not match; one had some “old, not-current prescriptions.”

More troubling, patients have also experienced problems in the emergency room.

A patient who wished to remain anonymous, on a weekend visit to the ER, reported that “... employees couldn’t access any of our records and several of our doctors have been with Summit for over two years.”

They were repeatedly told the “system was down” and the staff apologized several times.

The couple became more concerned when the doctor ordered an EKG, the test was completed during the visit but, several weeks later, no record of the procedure existed in the portal, in the ER system or with the billing department.

Summit Tour X-ray machine

A staff member takes a volunteer on a ride on the $1 million X-ray machine at Summit Healthcare Regional Medical Center’s VIP Tour held in 2018. 

“We were told we have to go back to our doctor to ask for another EKG,” says the couple. “We were also told to check back in one month to make sure the EKG didn’t get billed to our insurance.”

Most recently, Mortello’s concerns stemmed from difficulty obtaining prescriptions.

“My wife was in tears last week because she was trying to get a prescription filled,” explains Mortello. “It happened twice. The pharmacy called and said ‘we are cancelling your order because the doctor is not responding.’”

Mortello says they made multiple calls to his wife’s primary care physician who confirmed they “were having trouble” receiving requests from pharmacies and sending prescription orders to the pharmacies. The couple called Summit’s Patient Experience Center — a call center — but reported that the representatives answering the calls were unable to help and unsure of how to escalate the problem. Eventually, they went back to the outpatient center and spoke to a very helpful manager who assured them that she would contact the mail order pharmacy and then call them at home.

“She called us back and said she got it going,” says Mortello, “and we even got a notice from the pharmacy that they had the request. But that was two weeks ago on September 10 and we still don’t have the prescription,” he said.

The problem is still not resolved and the Mortellos, as of Friday, Sept. 13, were still struggling to get their medication according to a new email sent to the Independent.

The anonymous patient also reported that they have experienced similar delays obtaining a refill of their heart medication. They first requested the refill on August 18 and did not receive it until August 29 – 12 days later.

Summit Healthcare Regional Medical Center CEO Ron McArthur, Chief Compliance and Risk Management Officer David J. Murray and Chief Marketing and Development Officer Angie Fabian sat down with staff from the Independent on Wednesday, Sept. 4. The Summit team was receptive and willing to speak candidly about the problems patients have been experiencing.

Getting down to one

Allscripts is supposed to streamline operations because a complete medical record for each patient is accessible in one location. Previously, Summit used different software programs for different departments — eight in all. And they didn’t communicate with each other.

Within each of the previous systems, patients had an online medical record, explained the Summit team: When a patient sees their physician in a clinic, they have a record. When they are admitted into the hospital, they have a record. If they visit the ER, they have a another record. And, if a patient delivered a baby, they could have a fourth record in obstetrics.

Now that Allscripts has been implemented, patients will have a single record. The merging of the old records is taking place as patients move through the system.

Healthy hospitals lead to health communities

Ron McArthur

“We have been wanting to go to a single platform for online medical records for years,” says McArthur. “About two years ago, the board approved it and we have been working with the Sunrise Allscripts company to build it.”

“Allscripts is like having Microsoft Office where all of your different applications talk to each other,” explained Murray. “Before Allscripts, the hospital staff had to log into two different systems. Seventy percent of patients come through the Emergency Department so the hospital staff needed to be able to log into the same system — to be more efficient.”

“We know we’ve got some problems,” acknowledged McArthur. “This was an enterprise-wide system conversion. At the same time, we are completing the new pavilion and outpatient center which is one part of the largest construction projects in Show Low’s history.”

“We did have issues and we know we had things that didn’t work at first,” said Murray. “Going from eight systems to one, you practically have to reinvent the wheel.”

“With any conversion like this there’s going to be hiccups and we are working through them,” assured Fabian.

Summit responds with ‘Command Center,’ accountability meetings, Allscripts reps on-site

Summit intended to go live with the new software platform in May but moved the date forward twice, then settled on August 1. Summit explained that there was no way to run the old software systems parallel with Allscripts. They simply had to start using the new system — no matter what happened.

“That’s exactly what happened on August 1; we flipped the switch,” says McArthur.

“The inpatient conversion went well — very well,” says McArthur. “But we’ve had a problems with the emergency record portion of Allscripts which caused backlogs in the Emergency Department that we are working through … The emergency and the physician clinics have had bottlenecks as we’ve gone through the conversion.”

The hospital and affiliated clinics went to downtime procedures, also referred to as “paper mode” during the first week of implementation, also according to Murray.

Some of the patient complaints brought to Summit “… probably happened during down times which were most frequent in the middle of the night, (between 2 a.m. and 5 a.m.) which is when we most often schedule taking the system offline for updates.”

Patients also observed downtime procedures occuring during regular business hours in some locations. According to Summit, immediate action was taken to solve the problems and protect patient safety.

“We immediately set up a Command Center to try and figure out what was going on,” says McArthur.

“We had a Command Center for providers and staff to call when they have a question. At the beginning, we held four huddle meetings per day to address problems and discuss what is being resolved and what is being worked on,” says McArthur and Murray. “Currently, we hold two huddle meetings a day along with the conference calls.”

In the weeks since August 1, Summit says they have made steady progress.

The Quality Team also works with the Allscripts team daily to identify and fix problems as they are reported. Allscripts is able to work with Summit’s Information Technology Department to adjust and customize the software as necessary.

“We have had an Allscripts team onsite,” adds McArthur. “In addition, we meet with the CEO of Allscripts and their leadership team weekly via phone. They actually flew two people in for the (Sept. 3) meeting,” Mc Arthur explained.

“(W)e also meet every Wednesday with our physicians to see what the progress is being made, what do we need to work on, so there’s two accountability sessions every week where we look at here’s the issues, and what progress have we made in getting them solved,” McArthur added.

“We have a huddle with our Department heads every morning so that anything that is identified as an issue can be addressed right away,” assures McArthur. “This includes a fully staffed Quality Team that partners with nursing to follow critical care. In some cases, a phone call is made directly to the lab and the patient. “This level of care has not changed.”

“We have an entire team devoted to watching for and preventing medical errors,” echoed Fabian. “Patient care is our number one priority.”

“It typically takes 90 days of implementation (of a new system) to get the kinks out,” says McArthur. “We just finished a little over a month ago and we’ve still got 60 days to go. We’re trying to manage expectations and we are setting goals to get issues fixed, week by week,” he said.

Help for patients

Fabian and Murray explained how a patient’s initial visit to their provider triggers the population of data from the old online medical record system to the new patient portal, Follow My Health, and in Allscripts.

“The patient’s previous medical history is there in the background,” explains Murray. “Patients are asked to re-create their personal history in the new system at their next or first provider appointment.” This is what starts the information migration he said. “And, patients can still log into the old system and download their information.” (Patients can also call the outpatient clinics, Summit Healthcare or the Patient Experience center to get copies of their online medical records.)

In addition, roll-out of the new patient portal, Follow My Health, has been confusing for staff and patients. In response, the Independent will explore this in a future story.

For assistance with obtaining their physician clinic medical records, patients can contact Summit Outpatient Clinics at 928-537-6851.

For Summit Healthcare Regional Medical Center hospital records, patients can call 928-537-6254.

If patient wishes to speak with provider about specific concerns, prescription refills, or to make an appointment, patients are encouraged to call the Patient Experience Center at 928-537-6700.

Reach the reporter at

lsingleton@wmicentral.com

Laura Singleton is a reporter for the White Mountain Independent, covering Show Low city government, business and education.

(12) comments

fishinguy

Better have the company come out from Chicago and fix the software they sold Summit. We the patient are the ones suffering. Never cared for the portal thing at all. Glad the article is in print now. The care from employees is the same they to are frustrated with the software.


che guevara

A number of good doctors have already left Summit specifically because of these chronic issues associated with the new software . Someone in administration made a huge judgment error , and as a result many innocent people have , and still are suffering . Someone needs to be held accountable . Adding to the plethora of woes at Summit is the fact that there are far too many youngsters being thrust into positions of authority who have yet to fully mature , and who are primarily focused upon climbing the career ladder , rather than providing a professional level of patient service . All is not gold that glitters .


SummitTruth

Great article and the question remains. Why did Summit not select from either one the top two providers, Cerner or Epic? After all, how many patients are transferred to Phoenix Children's, vs. say Banner? Banner users Cerner and interoperability in the electronic health record would lead to more seamless transitions of care. Or, Summit could have chosen Epic, used by the Mayo Clinic. Certainly, if Sunrise Allscripts was the best, wouldn't Banner or Mayo have chosen them? Nice to see some objective reporting from the WMI on Summit Healthcare for a change. Someone needs to be held accountable and while you're at it, get rid of the good old boy board that governs the hospital. Real estate agents and retirees aren't what this hospital needs!


Climbing sunflower

This is about software failures. Mr CEO...my Mom needs her medication and I expect you to figure out a way all the patients that have already been through too much can at least get their medication. The least you could do is find another way. But this country is about the mighty dollar and we would rather risk someones health then find them the care they need.


P A M @ ShowLowAZ





You know this “90 days is normal” may work in a different environment, BUT it does not work in the healthcare environment. You cannot put people’s health at risk while you put band aids on the migration.







In the past 30 days:



• Lab scripts were delayed so long that doctors wrote paper scripts, and patients took them to NON-Summit labs



• Prescriptions were lost and patients had to drive to the hospital to get them.



• Prescription were sent to the wrong pharmacy.



• Patients could NOT contact their doctors via a portal message…..because the patients’ doctor list was NOT ported to the new database, and is not planned to be ported until the patient SEEs the doctor.



• Phone calls to the physician that went thru the call center took 20 minutes to be answered, and then 40+ minutes with no progress. Yeah I know there were a lot of calls. That should have been planned for.



• Oh there are many more problems with this migration. The above is just the tip of the iceberg.







Also, how do you treat a patient correctly when the providers have to go to multiple databases, because you have not migrated, nor merged the history records in ONE easy to query database? Speaking with contacts at the hospital, they insure me that the old records will be available…..then go away at some time. They cannot quote the “Sometime” period. In the past, by law you were required to retain the patient records for 7 years. Is that what is going to happen? Is that still the law? Do you even know these facts?







For the past decade I rated Summit in Show Low as maybe a 9 on a scale of 1 to 10. With this current fiasco I now rate Summit as a 3 on a scale of 1 to 10. This migration was either a) NOT planned thoroughly. b) Planned with band aids in the back end. c) Or you just said the patients will have to live with it for a while. Now there is a key word LIVE. Let’s hope you do NOT harm/kill anybody during this mess. So tell us did you take the cheapest bid to create this mess?







I have more to say, but I have to stop. My polite vocabulary is running dry. I really want to call a spade a spade, you know what you did to many (maybe a 1000+) patients and still beat on your chest thinking it was a quality move. This whole move is an embarrassment to the community. I suggest after this is completed (if ever), that you seek employment in a NON-Healthcare environment.







Now a suggestion to the patient base. Since we have to jump through a bunch of loops, maybe this is the time to switch to NON-Summit physicians. We can use Summit for the big things. Oh here is equation for you



“Patients-=Customers=$$$$$$” No patients, no $$$$$$$.







Okay I’m outta here.




littlehunk

I’m a Summit employee and have been since it was a single building called Navapache. Over the past 5-10 years I’ve seen more and more worrying trends at our hospital, but I’ll try to keep this comment focused on the issues this article discusses.







Of course Ron, David, and the marketing and PR teams are going to try making this sound like a mere speed bump and say we just need to let the shocks settle after hitting it so hard. All is not as well as they’re trying to make it seem. This isn’t the first time Summit has migrated to a new system. This isn’t the first time the people from Allscripts have done it. Hospitals switch systems all the time without all the trouble we’ve had. What isn’t mentioned here is that Allscripts was put under a dangerous amount of pressure to rush this process. They were given an unrealistic amount of time to build this system, train employees on how to use it, and implement it because the folks running Summit dropped more than one ball and let them roll a long way before scurrying to pick them up. It’s led to some serious, potentially deadly errors (ie. wrong meds being given to wrong patients). While I’m sure there has been plenty of negligence along the way, I just want to add my cents to some of the comments here.







Yes, Allscripts was chosen because it is SIGNIFICANTLY less expensive than better options like Cerner or Epic. Like many things in life, you get what you pay for. Not only was it less expensive, they were willing to let Summit bully them into drastically cutting back on their timeline. It’s like your cheap contractor said he could build your house from scratch in six months, but you demand it be done in three. There’s headache after headache and crews push themselves beyond their limits, but you barely manage to “finish” the house in three months. Would you really expect the build to be the same quality you’d get from an expert contractor who was given all the time he needed?







P A M suggested switching to non-Summit physicians. It’s a great idea, but more and more difficult to do when Summit is so bent on monopolizing healthcare on the mountain. You’ve probably noticed Summit logos going up at most of the clinics around our towns. They’ve tried to take over more, and continue to push for more. Good luck finding a physician in town who hasn’t had Summit



wiggle in to their practice. This, combined with the very worrying fact brought up by che about our doctors leaving Summit because they’re unhappy is what worries me the most.







We do have a lot of young, inexperienced people being forced into leadership roles. We also have high turnover. We also have a lot of temporary staff. We also have physicians who are here not because it’s where they want to work, but because it’s where they can work. Summit is so desperate to retain physicians that they allow them to get away with some pretty alarming behavior and practices. For example, bullying staff beneath them, refusing to come in and treat a patient on a weekend or holiday, making questionable clinical decisions because they can’t take a hit to their ego by admitting they’re wrong. Administration stands behind them because they don’t want to lose another physician.







When Summit raves about putting patients first, beware that you really come behind money and reputation in the eyes of the people running this place. The people you actually deal with, the nurses or techs or receptionists, housekeepers, cafeteria staff, they’re all great and we’re doing the best we can with a hand tied behind our backs, weights on our ankles, and whips cracking all around us. But for now you should imagine your community hospital is a shiny new race car with all the top performance parts and upgrades. It’s being driven flat-out by people who couldn’t handle a lawn mower, never check their mirrors or blind spots, and care more about their money than their fans while the pit crew tries desperately to keep the wheels from falling off.


P A M @ ShowLowAZ

I’m not sure if this is going to get posted. I appended my first post and it did not get posted. I wanted to correct a typo. It was the equation. It should have been: “Patients=Customers=$$$$$$” No patients, no $$$$$$$.







I worked many years in IT/IS as a programmer. I have experienced what “Littlehunk” describes. Unfortunately, the worker bees down in the trenches get the blunt of the grief…..from both sides. I have seen the stress that THIS migration has put on the Summit employees that interface with the patients.







When projects like this take place, upper management take the credit if………it is a big success. Now if it is a disaster, the worker bees take the blame. Patients do not care who gets the credit/blame we just want to have good healthcare. Remember they are at the Hospital/Doctors because they have a health concern.



You know, in years past, stress like this on the employees brought about Unions and strikes. Now I’m not proposing either, I just think someone has to stand up for the employees and the patients.













worker bee

Some other aspects of this that has not been brought up is that we were trained on the new system back in March and April expecting a go live of May 1. We went live on Aug 1 with no retraining before the new go live date. You forget a bunch without a refresher course on a brand new system.



Also, we went through a computer system change several years ago named Mckesson. Most likely spent 20 million dollars on the system, new hardware, training, travel, extra staff and software license. When that system was purchased staff was told that MCKESSON was going to combine the patient's medical records that were out there in the various places. NOW we are being told there are 8 places where the patient has records that need to be consolidated. Why did we buy the MckesAson system.



Last, we bought Athena just a couple years ago. Once again to make it easier to make a complete medical record. That money apparently has gone down the toilet.



And now we start over again. More overtime.


tsjackete

I had an appointment with Summit's cardiology department for 9/20, scheduled weeks ago and confirmed by text the day before the appointment. When I approached the window to check in, I was told they had no appointment for me. I showed them the confirmation on my phone. Didn't make any difference. Said I would have to re-schedule. The reason for the appointment was for follow-up on an echo cardiogram performed a couple of weeks prior. I also wanted to discuss my medications with the doctor and remind him that I had not had a blood test for months. With the meds I'm on that's critical to be sure that my potassium and other levels are OK. I was unable to accomplish any of those things. The lady at check-in was very apologetic and tried to see if there was anything she could do. After going back to check with the doctor, she told me all she could do was re-schedule. Needless to say, very frustrating and disappointing. At this point I wonder if I would be better off finding a cardiologist in Flagstaff or Phoenix. Summit runs plenty of ads saying how great their facilities and service are. Total B.S. in my opinion!


Whtmtn2004

This is not surprising. I have worked for Summit for years and they are becoming all about image/money and not about what’s best for the patients. The staff ask for equipment/supplies to perform their jobs and they are told they don’t have the money for it but yet they spent millions on new buildings and made sure to upgrade the finishes/fixtures. I’ve watched Summit change these last few years and it breaks my heart because it really was not like this years ago. (Comment edited by WMI)


(Edited by staff.)

P A M @ ShowLowAZ

So today I wanted to get a message to my PCP to refill a prescription, So, I try the portal "Message" function. I compose and send the message and it disappears. I look in the "SENT" box and it's NOT there. I ask my wife about her experience and she said in the past (maybe 4+ weeks ago) she never received a confirmation. SAY WHAT!



Okay, so I call summit. Get the operator and explain that I want to report something to IT. She has no idea of where to report it, but xfers me to someone who offers to try and get a message out for me. Only time will tell.



So what did I do. I texted the office manager to refill my prescription. Since I was changing drug stores, calling the drug store was probably NOT going to work.



And yet the saga continues.











I believe portal message function is important for communicating to the medical staff you need. I sure hope they fix it SOON!.


P A M @ ShowLowAZ

I'm back. Figured I'd post because maybe this will help (or confuse) someone else.



Yesterday I received a call back from Summit. They researched MY problem sending messages. It APPEARS that sending messages (maybe receiving them too) does NOT function until you meet with the Dr. who you are sending the message to.



So, if you want to get a new/refill RX, you have to use another path, like calling Summit Physicians @ 537-6700 (maybe) and leaving a message, going to the hospital, or having the prescription provider (drug store, mail order) contact your Dr.



It would have been really helpful it there was a banner or something that indicated that the message di not function until you met with the Dr.



I hope this at least helps those attempting to use the "Message" function on the portal.


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