EHR Implementa-on at a Community Health Center March 31, 2011
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1 EHR Implementa-on at a Community Health Center March 31, 2011 Kallanna Manjunath, MD, CPE! Chief Medical Officer! Whitney M. Young, Jr., Health Center! Albany, NY!
2 Whitney M. Young, Jr., Health Services - Albany site NCQA Level 3 PCMH - Troy site NCQA Level 3 PCMH Core programs Specialized programs Internal Medicine Developmental Pediatrics Pediatrics Family Medicine Women s Health Dental Services Psychiatry/Social Work Substance Abuse Programs Plas-c Surgery, Ophthalmology, Podiatry Pharmacy Golub Corpora3on School- Based Health Medicaid Prenatal Care Services HIV Services WIC
3 WMYHS - Organizational Aim July 2005! To implement Electronic Health Records to redesign our care delivery model to provide Safe, Effective, Patient-centered, Timely, Efficient, and Equitable health care.!!!
4 Application of Care Model for EHR Implementation Health Care Organization Strategy & Financing Community Collaboration HIXNY Delivery System Design Implementation & workflow redesign Self-Management Clinician acceptance & active participation Decision Support EHR selection Ongoing I.S. support Informed, Activated Patient Productive Interactions Safe, Effective, Patient-centered, Timely, Efficient, Equitable Care Prepared, Proactive Practice Team
5 EMR Implementation- Building Blocks!!Mobilize community resources to meet needs of the organization! IT initiatives are key part of the organizationʼs strategic goal$ Strong support from the Board of Directors, Senior Management, Clinical Chiefs, Providers, Nurses, Management Staff and Front-line staff.$ HRSA grant acquisition$ Three Health Center Collaboration$ Consultations with early adopters$ Participation in regional RHIO efforts$
6 EMR Implementation- Product Selection Steering committee! Providers! Kallanna Manjunath, MD! David Ray, MD! Barbara McLaren, MD! Rhonda Stein, MD! Myria Emeny, MD! Asha Shah, MD! Cheryl Della Sala, CNM! Tonia Stevenson, CNM$ Nursing Staff! Sue Oʼ Rourke, RN, MS! Mary Ellen Pace, RN! Sean McGary, RN! Laurie Kleitgen, LPN! Administration! James Sinkoff, CEO! Mary Connolly, VP Finance! Jaafir Khan, IT!
7 EMR Implementation Sub-Committees - Clinical - Billing / Front Office Operations - Hardware - Data migration - Finance - Employee marketing $
8 EMR Implementation- Product Selection! $Define EMR system, vendor requirements and plan for a step-wise selection process! Internal and external resources! TEPR, MS-HUG, HIMSS, California Healthcare Foundation, AAFP, PACT conference! Extensive online search for appropriate articles for distribution! IOM gold standard attributes! Internal ranking process!
9 EMR Implementation- Product Selection! $Define EMR system, vendor requirements and plan for a step-wise selection process! Use published vendor comparisons to select best potential matches! NextGen, Practice Partners, AllScripts, Cliniflow, and eclinicalworks! Obtain capabilities information from leading vendors! California Healthcare Foundation! HIMSS! Foundation for e-health initiative! Online research! Conduct effective demonstrations! Five demonstrations each in two locations!
10 TEPR Awards #1 EMR Medium to Large PracKces 2006 #1 Pediatric Specialty Category 2006 #1 e- PrescripKon Management 2005 #1 Medical Records and Document Management 2004 Top Rated PracKce Management 2004 #1 EMR 2003 TEPR Towards Electronic Pa3ent Records
11
12 EMR Implementation Staff Training! Critical to success of the project! Areas of Focus! Basic computer skills using MS Windows$ Software training on Practice Management System$ Hardware training on Tablet PCs and other peripherals$ Training on report generation, document scanning, software customization, etc.! Small group training by ecw staff$ Super users to provide on-going support to staff $ Provide additional time per patient initially$ Linkages with online user groups$
13 EMR Implementation Hardware Systems for End Users!
14 EMR Implementation Interfaces! Laboratories! SPH/Bender, LabCorp, NE health, Quest$ Pharmacies! Pharmacies linked to SureScripts, HouseCalls pharmacy$ Hospitals! AMCH, SPH, NE Health$ Specialists! Large groups with EMR$
15 EMR Implementation Reports! Grant Needs! Federal grant (UDS), URS (HIV), Addiction medicine program needs, Asthma Initiatives, others$ Quality Improvement! Internal needs, Managed care reimbursement, future grant activities$
16 EMR Implementation Security! Patient data! Access to Protected Health Information (PHI) on a need to know basis using HIPAA guidelines.$ Accurate tracking of data access and flow$ Access rights to be granted by a sub-committee of the steering committee$ Patient data will be stored on central servers rather than any peripheral terminals$ Remote Access to patient data for providers for use when they are on-call $
17 EMR Implementation Security! Hardware! Tablet PCs to be secured to a stationary object in the workstation areas$ Servers are secured using our existing practice$ Access to wireless is protected by more advanced (WEP2) protocol$ Disaster plan! Continuous data back-up using back-up servers$ Additional back-ups to disks using external backup drives$ Policy M-10 relates to electronic data protection and recovery.$
18 Anticipated Challenges! Unrealistic expectations$ Hardware and network issues$ Delays in patient flow$ Initial decrease in productivity$ Staff frustrations$ This process TAKES TIME$
19 Workflow, Workflow, Workflow...$ Not a glorified version of Microsoft Word..$ Ongoing training..$ Four years later! Does not make slow provider fast..$ Can make a fast provider slow!$ Can make certain tasks easier..$ Can't function without EHR!!!$ Ultimately, EHR is helping me to provide better care!!!$
20 The Opportunity
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