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Silver Hill Psychiatric Hospital Implements OpenVista EHR to Promote Patient Safety

Top psychiatric hospital goes live with open-source health IT solution and contributes best practice treatment protocols to Healthcare Open Source Ecosystem

SAN DIEGO, Calif., AND NEW CANAAN, Conn.--Silver Hill Hospital and Medsphere Systems Corporation today announced the successful implementation of Medsphere’s OpenVista® electronic health record solution at the nationally recognized psychiatric hospital.

Silver Hill selected OpenVista—a comprehensive, open-source EHR proven to significantly improve clinical effectiveness—as an affordable and fully integrated enabler of real-time clinical information in a paperless environment. As the leading provider of open-source healthcare IT solutions, Medsphere developed OpenVista from the U.S. Department of Veterans Affairs’ VistA solution, widely credited with helping transform the VA into the nation's most efficient and clinically effective healthcare organization.

“Physicians are famous for their handwriting, so electronic order entry, which eliminates handwritten prescriptions and other orders, is intrinsic to any patient safety initiative,” said Silver Hill President and Medical Director Sigurd Ackerman, MD. “Many of our physicians know VistA from their VA training rotations, making OpenVista, essentially a derivative of the VA system, pretty popular. All they wanted to know was ‘how soon can we make this happen?’”

OpenVista now gives Silver Hill clinicians access to a host of proven applications, including three that operate in tandem to prevent medication errors—computerized physician order entry (CPOE), medication order management (pharmacy) and a bar code medication administration (BCMA) application.

“Since humans will always make mistakes,” noted Ackerman, “we implemented a triple-check safety process to eliminate the potential for a medication error.”

“Medsphere is proud to partner with an institution of Silver Hill’s caliber,” said Medsphere President and CEO Mike Doyle. “Dr. Ackerman and his superb clinical staff have demonstrated tremendous vision in choosing a health IT system that provides comprehensive clinical support and doesn’t strain financial resources.”

With lab, pharmacy, clinical documentation and billing systems already in use, Silver Hill was 80 percent paperless before implementing OpenVista, according to Ackerman, who is also a professor of clinical psychiatry at Columbia University College of Physicians & Surgeons (New York City). However, when the hospital tried to add CPOE to the mix, they found these legacy proprietary systems were basically “unlinkable,” hindering efforts to implement electronic order entry functionality. OpenVista, on the other hand, offered a clinically comprehensive EHR solution that is fully integrated—i.e., runs on a single database—and interfaces easily with other systems.

Silver Hill chose to implement all pertinent OpenVista components, including lab and pharmacy, simultaneously instead of the more common phased implementation. “We chose a ‘big bang’ go-live so our clinicians could enjoy easy, secure access to real-time patient information from day one,” explained Ackerman. “Electronic systems don’t replace good medicine but they certainly help us give patients the best care possible. We were intent on reaping the greatest safety and outcomes improvements as quickly as possible.”

OpenVista also features clinical documentation tools that promote efficiency and ensure clinical notes are properly recorded. “Our therapists are excited about the Group Notes feature,” noted Ackerman. “They can now record group therapy notes in one place, and OpenVista automatically saves these notes in each patient’s record, eliminating redundant recordkeeping and ensuring consistency.”

Silver Hill patients often require close monitoring and OpenVista enables staff to view relevant clinical data in a very accessible format. Open-source architecture gives Silver Hill the freedom to tailor OpenVista to facilitate suicide assessments, multidisciplinary treatment plans and other custom requirements. Open source also gives Silver Hill a collaborative health IT platform for achieving the same prominent leadership position it has in psychiatry. Through OpenVista, Silver Hill can share valuable clinical insight with other mental health care providers.

Last fall, for example, in anticipation of the OpenVista go-live, Silver Hill staffers shared the products they had designed via a work group on the Healthcare Open Source Ecosystem, a global community of clinicians, administrators, software developers and enthusiasts who, as with Linux or Firefox, provide a parallel development and support structure. Silver Hill’s Ecosystem treatment protocol contributions include psychosocial assessments; a suicide assessment scale, CAGE questionnaire (the name is an acronym for four standard alcoholism screening questions) and mental status assessment; nursing assessments with detailed substance and psychiatric history components; and diagnosis-specific treatment plans.

“Medsphere is different,” remarked Ackerman. “Their Ecosystem works the way medicine should work—continuous collaboration to share new technologies and best practices. We immediately started helping to develop the clinical applications and templates we need. Now we encourage other institutions, private or public, to join us as we continue to improve the mental health field.”

Open-source affordability also was a factor, added Ackerman. “We’re a small hospital with a small IT budget, and psychiatric hospitals don’t qualify for federal stimulus incentives under ARRA. Still, we were determined not to settle for second best. OpenVista software is free; Medsphere only bills for implementation, training and support; quarterly payments are spread over five years. You could say we created our own stimulus plan for improving mental health care by leveraging the VA’s historic multibillion-dollar investment in VistA.”  

The Silver Hill implementation “stands as a testament to the flexibility of open source,” added Doyle, “and OpenVista’s ability to adapt to diverse healthcare settings. We are thrilled to partner with a hospital as committed to collaborating for clinical transformation as Silver Hill.”

About Silver Hill

Founded in 1931, Silver Hill Hospital is a nationally recognized psychiatric hospital with 129 licensed beds. Located in New Canaan—a Fairfield County, Conn., suburb of New York City—the independent not-for-profit facility provides inpatient and residential Transitional Living Programs for adolescents and adults on a pastoral 45-acre campus.
Silver Hill treats patients for mood disorders, including depression and bipolar disorders; schizophrenia and other psychoses; and eating, personality and substance use disorders. The hospital brings particular expertise to the treatment of patients with dual psychiatric and substance use disorder diagnoses. A high staff-to-patient ratio, dignified home-like setting, continuum of care philosophy, and emphasis on family involvement help patients achieve rapid stabilization. Silver Hill Hospital is affiliated with the Yale University School of Medicine, Department of Psychiatry.

About Medsphere and OpenVista