Imagining the Clinical Experience: When EHR is Clinician-Centric, Providers Can Be Person-Centric

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1 Imagining the Clinical Experience: When EHR is Clinician-Centric, Providers Can Be Person-Centric John Helvey Director Information Technology Victor Treatment Centers Victor Community Support Services Joe Monastra Principle Strategist Netsmart Technologies

2 Session Outline Changing Healthcare Environment Clinician Driven Workflows vs. Medical Records Access Methods to improve the speed and accuracy of information access based on the role or functions a particular group of staff "point & shoot" information workflow Real-World Client Case

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4 A new brand of Healthcare Behavioral Health and Addiction Treatment will change more in the next two years than they have in the last two decades.

5 Drivers of Behavioral Health Change Accountable Care Meaningful Use State & Federal $ requirements Complexity of people served Providing Care

6 PAST 15+ Yrs Digitization PRESENT Semi-Automated Data FUTURE (5 Yrs? Predictive Analytics Care Documentation MEANINGFUL USE STAGE 1 Care Delivery Care Optimization MEANINGFUL USE STAGE 2 Care Integration Care Collaboration MEANINGFUL USE STAGE 3

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9 Initially there was EHR/Data Collection

10 Got us part way there Reduce Duplicate Entry Multiple staff access same chart Improved Reporting validation improve accuracy BUT

11 We did not get as far as we thought!

12 Clinician Centric Access What is it & Where do we get some? Specific Functional Workflows Point of Views for these workflows Traditional UX Mobile UX

13 Specific Functional Workflows NOT Medical Records format Based on Job Roles Focus on Workflows needed to render client care Consoles provide Point and Shoot access to Workflows Clinician presented with each step in workflow as needed all relevant info available

14 Console / Workflows Consoles (Roles) Clinician Physician Nurse Front Desk Biller Executive Intake/Call Center Tech Workflows Referrals Intake/Preadmission Golden Thread Assessment Treatment Plan Progress Notes $$$$ Medication Visit Discharge Planning

15 Point of Views for these workflows What is the best way to deliver these workflows? Fern and Plant Web Access Mobile Devices

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17 The most important part of a Clinicians job is to work with the clients and their families and be a catalyst of sustained improvement in their lives!

18 Do you think we need Workflow Consoles? Referral Process Pre-admission screening Episode Opening Treatment Process Assessment Treatment Planning Service Delivery Medication Management Process Clinical Quality Assurance/Compliance Billing

19 Where are clinicians providing the greatest value in their job? Referral Process Pre-admission screening Episode Opening Treatment Process Assessment Treatment Planning Service Delivery Medication Management Process Clinical Quality Assurance/Compliance Billing

20 The Clinical Console What do I need to do today? Look at my schedule of appointments TIER Scheduler (Natively secure for PHI) Microsoft Outlook or other calendaring (Not natively secure for PHI) Look for pending referrals that need to be reviewed Look for expiring items Comprehensive Mental Health Assessment Update Treatment Plan Update CANS Assessment Updates Etc. Document the services delivered

21 I Login and what do I see? What I need to know! Triggered Alerts Collaboration Updates FYI s

22 Next Screen is What s on my schedule today?

23 My schedule for the day! (secure)

24 Other integrated scheduling features!

25 The Clinical Console

26 What are the things that I don t have to keep track of but need to do? Let the Electronic Health Record System be your assistant!

27 Documentation Burden? What about the Golden Thread Assessment Treatment Plan Progress Notes What about Insurance Verification? Medicaid Private Insurance

28 The Golden Thread

29 TIER Progress Note

30 Clinical Supervisor s Feedback on TIER Implementation! TIER has provided a platform for us to improve the way in which our clients are being served, by allowing for more organized conversation about who our clients are and how we can play a purposeful role in their lives.

31 Clinical Supervisor s Feedback on TIER Implementation! TIER has provided living charts that are accessible, adaptable, and fluid; asking that clinicians reassess case conceptualization and evaluate the course of treatment on a regular basis. Supervision has allowed for more time to collaborate; an opportunity for clinicians to hone in on which techniques are the most appropriate and effective for each client they serve; challenging clinicians at times to learn new techniques and grow as clinicians. As clinicians become more purposeful in their work, the client benefits from treatment that is tailored to their needs, not just based on a specific skill set the clinician has.

32 Clinical Supervisor Console

33 Clinical Supervisor Console

34 What about the Psychiatrist Console? First there are some learning s that we need to embrace! What did we do well? Workflows related to: Compliance Billing Why did it work well? We flow charted these elements out What learning do we need to embrace? How do staff do there job? This is just as important as document workflow! There are tremendous opportunities to improve efficiencies when we look at what people need to do there job and when. (Story Board s) Flow chart their processes and daily routines Use the tools within your EHR to their benefit

35 What is the workflow of a Psychiatrist like?

36 Sometimes you may find other technology more function for workflow!

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39 Clinical-Centric Workflow Key Points Do your homework Be the Document Be the Staff Seek to understand and that you have understood Demand your EHR vendor to have a workflow centric solution! Push your EHR vendor to evolve! Think outside the box! Slow is Fast! Stay focused on the important stuff you and your staff making a difference in peoples lives!

40 Q & A For more information: Call: [email protected] Visit: To see upcoming events in the Netsmart Summer Series: