The PHN 212 Challenge How EMR Can Increase Productivity and Quality: One Degree at a Time.
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1 The PHN 212 Challenge How EMR Can Increase Productivity and Quality: One Degree at a Time. Sam Detwiler, DO Associate Medical Director, PHN
2 What is the philosophy? 212: The Extra Degree
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4 Getting the most out of your EMR can be accomplished with a 212 approach.
5 At PHN, we are using the EMR as more than a documentation and billing tool. We are using the EMR as a tool to launch a network-wide initiative to measure & increase the quality of our patient care and simultaneously increase our PPH. EMR CAN increase provider efficiency EMR CAN increase office efficiency EMR CAN be used to generate provider specific quality reporting EMR CAN increase quality of care PHN 212 Challenge
6 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
7 Use of Encounter Templates Disease Specific Templates Point and Click Documentation Customization Use short cuts such as GE s Quick Text Train and utilize staff to perform chart updates and prevention questions at each visit Clinical Documentation: Studies show that 70% of providers DO NOT utilize EMR as a tool.
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10 Diabetes Management History: The patient is a 109 years old male who comes in for evaluation of DM Type 2. He is (or has been) enrolled in the "Diabetic Education Program". He states understanding of dietary principles and is following his diet appropriately. No sensory loss is reported. Self foot exams are being performed. He is checking home blood sugars. He says that he is not exercising regularly. Hypoglycemic symptoms are not occurring. No hyperglycemic symptoms are reported. Symptoms which suggest diabetic complications include vision problems. The following changes have been made to his treatment plan since last visit: diet changes. Treatment plan changes were initiated by the patient.
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12 CC: Sore Throat. Acute Visit History: The patient complains of cough, nasal discharge, sinus problems, and sore throat. These symptoms began 5 days ago. The patient notes wheezing. The character of the cough is described as nonproductive. He has a history of COPD. There is no history of sleep interference, shortness of breath, respiratory retractions, tachypnea, cyanosis, or interference with oral intake associated with his cough. 'Cold' or URI symptoms have been present with the sore throat. There is no history of dysphagia, drooling, or recent exposure to strep. He complains of sinus pressure, ears being blocked, nasal congestion, and purulent drainage. The patient has had a past history of sinusitis. He denies previous sinus surgery. Urine output has been normal.
13 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
14 Best Practice Protocols Focus on Prevention Increase Revenue from Preventative Services Pay For Performance Patient Education Patient Handouts Visit Summaries Current Medication Lists Chronic Disease Management Case Management INCREASED QUALITY Health Maintenance Alerts: KEY TO INCREASED QUALITY
15 Alert Tools.
16 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
17 E-Prescribing: TIME SAVER
18 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
19 E & M Coder/Calculator: Maximize the level of service Clinical Flow-sheet: Tracking and Reporting Graphing Tools: Patient education & Clinical trending Protocol Tools: One click access to Exams Due Clinical Desktop Tools
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24 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
25 Charts, Encounters can be tracked No more piles of paper Lab results Rx refills Tracking Orders Progress Reminders Phone messages Inter-office communications PORTABILITY Desktop Maintenance: The One Stop Shop
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27 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
28 Use Custom Orders Sheets Standing Orders Protocols for acute and chronic conditions Order tracking Patient Compliance: Flags Increases Quality Measures as well as Revenue CPOE
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33 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Maximizing Your EMR: Putting the Bells and Whistles to Work for Your Office
34 Interfaces Scanning and Indexing Data entry Flowsheet entry Office Workflow analysis Training program Competencies Chart Audits Reporting Systems Integration
35 EMR CAN increase provider efficiency EMR CAN increase office efficiency EMR CAN be used to generate provider specific quality reporting EMR CAN increase quality of care PHN 212 Challenge
36 June 2010: 23,771 patient visits (PV) x 1 hour = 9,142.7 hours 2.6 PV 9,142.7 hours x 2.8 PV = 25,599.5 PV 1 hour 25,599.5 PV - 23,771 PV = 1,828.5 PV/ month 21,942 PV/ year 1,828.5 PV/month / 133 providers = 14 PV/ month/ provider That extra degree is less than one patient per day. That extra degree adds 21,942 PV/ year to PHN The Extra Degree Effect 212: Increased Access (13 months/year), Increased Revenue
37 1. Clinical documentation 2. Health Maintenance Alerts & Reminders 3. E-prescribing 4. Clinical Desktop Tools 5. Desktop Maintenance 6. CPOE 7. Systems Integration Put the EMR Bells and Whistles to Work for Your Office
38 Reporting = Awareness
39 What percentage of U.S. patients receive their primary care services from Federal Community Health Centers? Turning up the Heat with your EMR
40 FQHC Provide 25% of All Primary Care in the U.S.
41 Thank you for your time. Sam Detwiler, DO Associate Medical Director, PHN
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