Physician-Centered Hospital network EHR Implementation It Can be DOne. Charles Watson DO, CMIO

Transcription

1 Physician-Centered Hospital network EHR Implementation It Can be DOne Charles Watson DO, CMIO

2 Kettering Health Network Hospital Facilities Ambulatory Sites Kettering 522 Beds Sycamore 181 Beds Kettering Behavior Medicine 60 Beds Grandview 411 Beds Southview 123 Beds Fort Hamilton 175 Beds Greene Memorial 199 Beds Soin (Opened 2/22/12) 150 Beds Today there are 60+ sites on PM and 30+ on EMR. By year end approximately 90 sites will be on the integrated Epic system, including 6 affiliated providers through the Community Connect Program Staffing Physicians: Over 1,400 Employees: Over 9,500 Volunteers: Over 1,370

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4 Epic Software Inpatient Ancillary Repository Mobile and Portals Ambulatory Prelude Registration/ADT Patient Flow Cadence Scheduling Health Info Mgmt (HIM) EpicCare Clinical System EMR Clinician Order Entry Decision Support Results Review Clinical Documentation MAR Rover Barcoding Clinical Notes & Pathways Interdisciplinary Care Plans ICU Bedside Monitor Willow Inpatient Pharmacy EpicEarth OpTime OR Mgmt Anesthesia ASAP Emergency Dept Beaker Lab Kaleidoscope General Ophthalmology Phoenix Transplant Epicenter Enterprise Data Repository Clarity and Analyst Enterprise Reporting Identity Master Person Radiant Radiology Index Beacon Oncology Call Management/CRM Cardiant Cardiology Reporting Workbench Stork OB Labor/Delivery Interconnect/Web Services MyChart Shared EMR for patients MyChart Bedside Shared for hospital patients Lucy Free-standing PHR Canto For ipad Haiku For iphone and Android EpicWeb Access for providers Radar Executive information EpicCare Link Access for affiliates Care Everywhere Interoperability to Epic and Elsewhere Prelude Registration Cadence Scheduling EpicCare EHR Charting Clinician Order Entry e-prescribing Decision Support Results Review Radiology Residency Support Coding & Benefits Nurse Triage Willow Ambulatory Pharmacy Welcome Patient Kiosk EpicEarth Managed Care Telemedicine Community Care Revenue Cycle Enrollment/Eligibility Store & Forward evisits Mental Health Resolute Hospital Billing Claims/Capitation Utilization Management Premium Billing PlanLink Video evisits Remote Monitoring Substance Abuse Group Therapy Home Health & Hospice Seniors/ Disabled Maternity & Infant Resolute Professional Billing

5 22 20 Employees per Client Series Allscripts/ Eclipsys Cerner Epic Meditech Updated 11/2011

6 11000 Number of Clients 51, ,000 8, ,400 3, Allscripts/ Eclipsys Cerner ecw 260 Epic Meditech NextGen Updated 12/2011

7 35-46% of U.S. population will be cared for by EpicCare. 108M to 142M people 250,000 EHR physicians

8 Clients

9 Clients

10 90% of HIMSS Stage 7 US Hospitals Use EpicCare

11 Improving Medication Administration Increased Patient Safety & Care 100% elimination of all transcription-related medication errors 70% decrease in delayed administration of medications 20% decrease in omitted medication administration 50% decrease in time from order to administration of first-dose antibiotics Eliminated occurrences of lost/mislaid patient charts (previously 10%) Improved patient identification; improved safety using infusion pumps; reduced risk of nosocomial infections, shortened length of patient stay; increased patient participation and satisfaction. ASHP Medication Safety Award HIMSS Davies Award

12 8 Hospitals Brought on Epic in 2.5 Years A.Meaningful Use B.Other Vendors C.Compared to PAHP

13 Average Go Live Every 3.75 Months

14 First Four Hospitals Staged Go Live A. Including largest hospital KMC B. Stage one did not include CPOM or physician documentation C. Circled back for stage two (CPOM and physician documentation) after remaining hospitals brought live

15 Next Four Hospitals Big Bang go Lives A. Full functionality including CPOM and physician documentation B. Including new hospital

16 Staged Versus Big Bang?

17 taged Pros - Navigation Familiarity Patient List Developed Refine Results View Prior To Stage Two Nurses are Familiar with System and Able to Aid Physicians

18 Staged Cons Need to Create Work Arounds Since Epic is Designed as an Integrated System Dissatisfier Among Some Practitioners Who Wish to Proceed With Full Functionality

19 Big Bang (Tear Off The Band-Aid) Pros Full Use of Integrated System Nurses and Physicians Feel Like We are all in this together

20 Big Bang Cons Big Change More Support Required (May Need External Sources) Higher Risk

21 Recommendation Big Bang If Implementation Team Has Experience

22 Preparations

23 Promote and Expect Network Build

24 Preparing Physicians Be Honest This will rock your world

25 Begin setting expectations one year prior to Go Live

26 Posters

27 Point out advantages Chart access Legibility Decreased medication errors Reporting

28 Physician Governance

29 Physician Advisory Counsel (PAC) Vice President of Medical Affairs (VPMA) Directors of Medical Quality Directors of Medical Education At large representatives from each hospital

30 IS Physician Coordinator

31 End User Support

32 Physician Work Group Physician Super Users Physician Champions by specialty

33 Validation Sessions Lead by Epic Updates lead by KHN Staff

34 Order Sets Content Clinical Quality

35 Order Sets Network Standardized Only A. Not Hospital Specific B. Not Individual Order Sets

36 Decision Support Start with Only Most Important A. Avoid Alert Fatigue

37 Training

38 Training Begin Six Weeks Before Go Live A. Training Center B. Training Team C. Staged Implementation Eight Hours Classroom D. Big Bang Implementation Nine Hours Classroom with Required E-Learning

39 With Scenario Based Training We Have Cut Classroom to Five Hours with Two Hours Required E-Learning

40 Mandatory vs. Required

41 Test Out With Epic Experience

42 Super-User Floaters A. Residents

43 Expectations for Go Live Announce in Any and All Modalities

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45 Go Live Support A. Three Weeks B. Physician Champions C. Super-Users D. House Staff E. Sub-Contractors

46 Tune Ups A. Favorites B. Documentation Templates

47 Optimization Favorite Documentation Templates

48 On Going Support A. Dedicated Physician Line to Support Center B. 24/7 Physician Support On Call

49 Lessons Learned A. Big Bang B. Train Train Train C. More Announcements 1. Posters 2. Blast s D. You Can Never Have Too Much Support

50 Questions