Breakout A: From Paper to EMR- Preparing for the Transi;on

Transcription

1 Quality Counts! Breakout A: From Paper to EMR- Preparing for the Transi;on The Maine Regional Extension Center Forum

2 Breakout Objec<ves Discuss steps to prepare for Electronic Medical Record (EMR) Define it, understand it, iden<fy benefits, determine readiness, create a plan and an<cipate barriers Describe steps to plan and organize the project GeIng started with a project team, assign a lead and physician champion, set measurable goals and ac<on plans, celebrate successes Learn about tools that help discover how the transi<on will impact the prac<ce and pa<ent care Map current workflow and processes to transi<on to improved electronic workflow Network with peers from prac<ces also in the planning phase

3 My Background Prac<cing family medicine for 10 years with two different EMR s Centricity and eclinicalworks Guided the transi<on of my current prac<ce from paper to paperless Peer to Peer educa<on Workflow design Consul<ng to other prac<ces using eclinicalworks

4 So what s the big deal? Unlike moving your office, implemen3ng an EMR involves: Significant Change Redistribu<on of work Communica<on Clinical and non- clinical Many failures (50%?) No one right path to success Adop<on issues Technical ap<tude Physical limita<ons Willingness to accept change

5 EMR represents a fundamental change to the way the office WHY handles REDESIGN the movement of pa<ents and informa<on: Assessment is essen<al Less than ideal to automate exis<ng broken processes how can you fix it if you don t know it s broken? Aber the assessment comes the redesign 5

6 Where are we now? Pa<ent flow in office Check in/check out Visit flow (Different types) Documenta<on Referrals/Test ordering Before/aber visit No<fying of results Refills/Triage Scheduling Document management Repor<ng Care Management Billing/Coding Assessment What do we do well and not so well? Where do we want to go? Pa<ent flow in office Kiosks Web visits Nurse/Pa<ent document Real <me scheduling Before /aber visit Portal Closed loop Tracking Protocols Self scheduling/payment Scanning/Preloading Structured Data Medical Home Pa<ent Educa<on

7 Assessment What s going on around me? Accessing your chart for inpa<ent care HealthInfoNet VPN private networking Wireless devices Call Coverage Read only for outside providers? What diagnos<cs are in the area? Established interfaces? If not, will they charge me? Will they pay for it?

8 Build Your Team A fully commifed leadership is vital Prac<ce management Physician Champion Clinical Champion Representa<ves from all aspects Don t forget IT! Establish a common goal that all can accept

9 Workflow Redesign Research what others are doing Call friends, colleagues Look at other sites/prac<ces Look from pa<ent/provider prospec<ve Best prac<ces/consultants Keep it superficial un<l EMR is picked Compromising with your EMR is key Be flexible you are going to get it wrong Keep it simple 9

10 Key Areas of Workflow Redesign Key areas of prac<ce workflow redesign 1. Pa<ent flow Visit flow Chronic care management - alerts 2. Point of care documenta<on Common prac<ce and responsibili<es Structured data 3. Office communica<on Prescrip<ons Telephone calls Results 4. Document management Stored, transferred and/or reviewed in electronic format 5. Referrals Management 6. Coding/Billing 10

11 U<lize Workflow Visuals 11

12 Success Factors Leadership, organiza<on & people Commifed, visible, accountable Clear goals and vision Quality, ROI, Regulatory Change management & communica<on Listen, Iden<fy issues, Sell to your staff Project management Clear <melines and milestones Vendor issues

13 Most Failures Due To. Lack of due diligence and/or exper<se; many failures could have been predicted before the project started Problem of leadership not knowing what they don t know Lack of true exper<se within the decision- making structure Inability to surface issues and deal with them (informa<on filtering during ascent) Lack of good project management and oversight Lack of buy- in and responsiveness from providers Insufficient tes<ng, pilo<ng, op<mizing, prior to full roll- out

14 Q & A