The busiest moments in emergency medicine always seem to happen all at once.
Three patients arrive back-to-back, a critical patient crashes, the phone won’t stop ringing—and a doctor needs vitals no one has had the chance to take yet.
Wilvet Salem Emergency, a privately owned 24/7 emergency and critical care hospital in Salem, Oregon, knows these moments well. In just four years, the hospital has grown to 12 doctors and more than 40 support staff—and as the only reliable ER in their area, there’s always another case coming through the door. Their old system just couldn’t keep up.
When we spoke with practice manager Jess Lawrence and office manager Tia Dumas, they walked us through what triage used to look like—and why something had to change.
One Whiteboard, Too Many Steps
At the center of it all… a crowded whiteboard. Triage required the same information to be written multiple times—first by the CSR, then by the nurse—and charts moved back and forth just to capture vitals and a basic history. The team remembers how clunky the process felt.
“When a patient arrived, a CSR would check them in, write their name on the board, and hand the paper chart to a technician,” Jess explained. “The technician would record the history and triage vitals on the chart, update the whiteboard with the colored magnet, and then enter the information into Cornerstone. It was a well-loved system, but it was cumbersome and time-consuming.”
Eventually, they started looking for something better. And when they discovered Instinct EMR, something clicked.
“The more I looked into it, the more I thought, this program is magic,” Jess said.
With the decision made, it was time to set the team up for success.
Clear Roadmap, Zero Guesswork
They’d been through software transitions before—the kind where you’re handed a PDF and a login and told good luck.
“We were so stressed going into it, thinking it was going to be awful. It was just so refreshing to be like, ‘Oh, it’s just laid out beautifully for us on a roadmap,’” Jess said.
Tia explained how that roadmap became a game-changer—outlining tasks, timelines, and expectations, while indicating how long each step should take. The team found the guidance clear and structured, and when asked to rate communication and project management during onboarding, both gave it a perfect 10 out of 10.
“For being a remote onboarding process, you guys have done a remarkable job at making it feel like you’re not necessarily remote,” Jess said.
And support was always available.
“I never felt hung out to dry,” she added. “I could just reach out and I would get an answer.”
Training That Made Onboarding Click
Training combined self-guided learning, hands-on practice, and live instruction. The team used Instinct Academy to learn at their own pace and practiced in the sandbox environment (“Purractice”) to test workflows without pressure. Flyers around the hospital reminded everyone what to complete and by when.
But the turning point was the simulated patient walkthrough.
“The Patient Walkthrough was probably the best teaching tool out of everything we asked them to do,” Jess said.
It showed the team what their real workflow would look like—not just where to click. And by go-live day, they didn’t just know the software. They were completely ready to use it.
From New Software to Second Nature
Despite all the preparation, no one slept well the night before launch.
“I was like, ‘This is going to be one fire after the next,’” Jess said.
But the first days went smoothly. Instinct’s implementation team was on-site for support, and even staff who weren’t scheduled came in on their own time to learn. They picked it up fast and immediately taught others.
“I get panic phone calls quite literally daily about absolutely nothing,” Jess said. “And I did not get a single, ‘Oh my God, I don’t know what to do.’ Not a single one.”
Across different generations and comfort levels with technology, the team expected pushback. They didn’t get any.
“Our onboarding experience genuinely couldn’t have been better in any way, shape, or form,” Jess said. “Chef’s kiss. Absolute magic.”
Better Processes, Better Patient Outcomes
Once onboarding was behind them, Instinct EMR became part of everyday patient care.
“Now everything—checklists, anesthesia, surgical supplies—is tracked digitally,” Jess said. “If something isn’t done, it’s flagged in bright red. Everyone’s doing it, and patient care has improved because of it.”
The ICU also noticed a change. Patient status and outstanding tasks are visible, so when someone is swamped, the rest of the team sees it.
“A lot of the ICU nurses will just drown,” Jess said. “Now everybody can see it. They don’t have to ask, ‘What do you need help with?’”
Charge Capture That Pays Off
Instinct EMR’s automatic charge capture revealed how many billable items were being missed—especially small, easy-to-overlook treatments like tube feeding.
“There are charges that some of the nurses thought we weren’t billing for,” Jess noted. “No, we do. We should have been the whole time.”
In reality, those treatments were slipping through the cracks. Once Instinct EMR started catching those missed items, the impact was immediate:
“Our revenue went up by almost $100,000,” Jess said.
Support That Shows Up
When questions came up along the way, support was right there. The team uses Instinct Support constantly. The built-in AI assistant handles quick questions and escalates to a live human when needed.
“I can get an actual answer to anything in a 15-20-minute period of time,” Jess said. “That full circle is something I really appreciate.”
And when asked how support could improve, she laughed:
“Short of them being in the office with me, I don’t know how that would be possible.”
More Than a Software Switch
What started as a solution to a messy whiteboard became something bigger. Instinct EMR didn’t just streamline their workflow—it improved how the team communicates, collaborates, and cares for patients.
When asked what she’d tell another hospital preparing to make the switch, Jess’s advice was simple: trust the process.
And when it comes to whether she’d recommend Instinct EMR, she didn’t hesitate:
“Your patient care is going to improve, your workflow is going to improve, your communication between team members is going to improve, and your bottom line is going to improve.”
Thanks to Jess Lawrence, Tia Dumas, and the entire Wilvet Salem Emergency team for sharing your story with us!
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