MEDSTAR HEALTH. Centricity EHR Project Assessment/Optimization

Transcription

1 MEDSTAR HEALTH Centricity EHR Project Assessment/Optimization

2 Presented by: MedStar Health Suzanne Carter, IS VP Customer Service Dawn Richmond, IS Director Ambulatory EHR

3 Topics Background MedStar Health-who are we? Centricity EHR Implementation Stats and Status Project Assessment/Optimization Project Overview Project Assessment/Optimization Results MedStar Response and Action Plan 3

4 MedStar Health Nine hospitals in the Baltimore/District of Columbia region Franklin Square Hospital Georgetown University Hospital Good Samaritan Hospital Harbor Hospital Montgomery General Hospital St. Mary s Hospital Union Memorial Hospital Washington Hospital Center National Rehabilitation Hospital $3.5 billion non-profit 26,000 employees and 5,000 affiliated physicians 3,100 beds 158,000 admissions 1.5 million outpatient visits

5 MedStar Centricity EHR Implementation Status Today 142 practices LIVE 60+ specialties 1600 providers support staff 50+ Interfaces 30 practices scheduled for go live Oct.-Jan. In the pipeline 80 practices to implement in FY providers 800+ users practice acquisitions planned for FY11 And 9.5 upgrade, superbill pilot, EMRLink, Clinical Informatics Beta

6 MedStar Initiative to Evaluate Implementation of GE Centricity MedStar engaged an outside consulting firm, Clinovations, to evaluate the Enterprise rollout of GE Centricity EMR to employed, ambulatory practices. Initiative started in February, Completed May, Clinovations 25 Employees 121 Customers 5 Health Systems Goals: Evaluate functionality and usability of GE Centricity Improve customer satisfaction Determine if modifications to processes and resources are necessary

7 MedStar Initiative to Evaluate Implementation of GE Centricity EMR Enterprise rollout of GE Centricity EMR to employed, ambulatory practices Initiative initiated in February, Completed May, Employees 121 Customers 5 Health Systems Goals: Evaluate functionality and usability of GE Centricity EHR Improve customer satisfaction Determine if modifications to processes and resources are necessary

8 Total Focus Group and Individual Customer Interviews MedStar Ambulatory Point of Care Focus Group Participants Additional Interviews Total Customer Participants Franklin Square Hospital Good Samaritan Hospital Georgetown University Hospital Harbor Hospital MedStar Physician Partners Union Memorial Hospital Washington Hospital Center Other (Not Including Centricity Team) 2 2 TOTAL 121

9 Customers Find Many Benefits from Using Centricity Available 24/7 Remote access Never lost Legible Patient communications Provider coordination Referrals erx / medication list Labs Compliance

10 Assessment Results Key Areas of Focus 1. System Performance 2. Usability 3. Support / Staffing 4. Communications 5. Training 6. Leadership / Governance 10

11 1. System Performance Customer Feedback System freezing System speed and responsiveness 11

12 1. System Performance IS Response/Plan Servers Increased physical memory Fine-tuned server configuration Migrated all scanned documents into new storage Moved to new server infrastructure and data center in Sept. Desktops Remediated PCs and servers and installed new anti-virus software Verified desk top and network settings on all PCs Reconfigured Citrix Farm Citrix technology platform has been reconfigured based upon revised vendor specifications and industry best practices. Application EMR 9.2 service pack and patches applied Prevents system locks caused by closing sessions using the "x" button. Increased overall stability of the EMR application. Performance improvement when updating large problem and medication lists 12

13 2. Usability Customer Feedback System intuitiveness Within-record multitasking (i.e., two screens open at once) Click count for common tasks Provider access/ability to generate reports Robustness/relevance of decision support Redundancy/inaccuracy of entries in provider directory Form complexity Multiple logins Dictation policies 13

14 2. Usability IS Response/Plan System Intuitiveness Centricity Informatics Enterprise Reporting Beta Project begin Sept, Centricity v10 addresses multiple usability issues: multiple windows, action oriented documentation, etc. Enhanced Clinical Decision Support Clinical Decision Support released in May/ June. CDS design for all specialties planned for FY11. Focus on PQRI and Meaningful Use. Table Maintenance Provider directory and pharmacy clean-up to be done this summer Form Complexity Active Physician added to IS Centricity team to assist in addressing usability issues. Medical Students EHR will test enhanced content for usability. Multiple Logins Improve access to data in other systems through the HIE Explore ways to reduce multiple sign ons Continue to expand voice recognition availability 14

15 3. Support Customer Feedback Transition Timing / Practice Readiness Practices transitioned to Post IA before they are ready Dramatic shift in level of Post IA support Post-Implementation Issue Resolution Help Desk responsiveness & understanding Process and point person for issue resolution Documentation and support for content updates Variability in use of local site-specific Centricity coordinators Internal resources not fully leveraged 15

16 3. Support Customer Feedback-(cont.) IS Analyst Resources Presence on site vs. in practice and continuity of relationship with practices Level of operational and clinical expertise Ability to support ongoing form development Availability of post-implementation resources Special project and application support responsibilities compete with customer-facing needs 16

17 Customer Preparedness for Go Live 3. Support IS Response/Plan Offer two implementation tracks -- Standard Content or Custom-- to insure customer proficiency before introducing increased complexity in clinical content. Move toward a ongoing point of contact for Centricity support In Practice Support Created customer workgroup to define superuser roles/responsibilities. Enhancing the super user training program and establishing a superuser forum and routine meeting schedule. Documentation and support for content updates Enhanced release documentation Offer multiple webex presentations for each release Rounding support Promoting use of customer sharepoint site 17

18 3. Support IS Response/Plan-(cont.) IS Onsite Support Established routine onsite post implementation visits. Moving Centricity team from data center to facilities Revising Centricity application team organization to provide ongoing point of contact for Centricity support regardless of implementation status. Clinical Help Desk Support Continuing to provide training to clinical support desk to address common issues that can be resolved without call back. Continuing to develop service desk scripts (guidelines for common problem assessment/resolution) 18

19 4. Communications Customer Feedback Frequency and urgency Technical nature and simplicity Rationale and implications for use Methods (e.g., flags/alerts vs. s) 19

20 4. Communications IS Response/Plan Formation of a cross disciplinary work group to develop more effective communication strategies 20

21 5. Training Customer Feedback Focus on functionality vs. clinical workflows Sharing of best practices across practices/sites Incorporation of best practices into training Scope and value of elearning content Accessibility and time to complete Timing and frequency Conflicts with clinical responsibilities Non-existent/consistent after implementation Lack of proficiency testing Effectiveness of super user training New providers Attendings / residents / medical students 21

22 Enhancing all training programs to insure the learning objectives focus on workflow and best practices. Collect feedback via customer survey. Developing physician training programs with focus on meeting criteria for meaningful use. Expanded before and after hours training offerings. Developing post implementation ongoing training programs for physicians and support staff. 5. Training IS Response/Plan Developing proficiency testing in all elearning and classroom training. Enhancing the super user training program and establish a superuser forum and routine meeting schedule. Utilizing physician support analysts to support new provider training. 22

23 6. Leadership and Governance Customer Feedback Alignment of practice goals and MedStar needs Communication of benefits realization strategy Expectations for, and amount of, practice involvement/responsibilities in pre/post-implementation Transparency of, rationale for, and customer involvement in, decision making and processes Empowerment of physician champions / superusers 23

24 6. Leadership and Governance IS Response/Plan Prepare communication plan describing current governance model Define mechanisms for accessing or escalating issues to project leadership Establish work group to delineate the site coordinators, physician champions, superusers, IS roles Establish new clinical governance group 24

25 Integration / Interfaces Hospital lab results interface rollout to all facilities in progress and expected to complete November, EMR Link kickoff August, LabCorp and Quest pilot project to begin in October. Health Information Exchange (HIE) approved as FY11 project; vendor selection is in progress. 25

26 Thank you Questions?