EHR's and Organizational Change Panelists: Melissa Larkin-Skinner, Chief Clinical Officer, Manatee Glens, FL Steve LaFleur, Chief Information Officer, Grand Lake Mental Health Center, Inc., OK Ravi Ganesan, President, Core Solutions, Inc., PA (Moderator) Title Organization Agenda Brief Introductions Transformational Impact of EHRs Case Studies Grand Lake Mental Health Center, Inc., OK Manatee Glens, FL Q&A 1
EHRs Can be Transformational Clinical Improved Quality Quality of Life Housing Jobs Medication Management Reduced Hospitalizations Financial Increased Revenue Ability to service more consumers Reduced Costs Reduction in resources required to complete certain job functions. Opportunity For Transformational EHRs Source: Physicians Views on Clinical Information Technology, Raymond A. Gensinger, Jr., MD, CPHIMS, FHIMSS. 2
Transformational Impact of EHRs Organizational Culture Transformation Change Management Resistance to change Creating a Culture of Adoption Lessons From Bill Rieger, CIO of Flagler Hospital Project vision beyond using our EMR to leveraging our EMR. Guiding Principle Such a system would improve quality, reduce the cost of healthcare, foster loyalty, and enhance our service to the community. Patient Centered Care Team Source: http://www.healthcareguy.com/2013/09/09/creating-a-culture-ofadoption-for-ehrs-and-health-it/ 3
Creating a Culture of Adoption Lessons From Bill Rieger, CIO of Flagler Hospital There s power in ceremony. People don t forget. They talk about them and relive them. Adoption results and goals centered on Quality, Efficiency, and Cost. Culture is not just for Google or Apple. You are creating a culture whether you like it or not. You can lead your culture towards adoption or not. There will be a culture either way. Resistance To Change Impacts Project delays Budget overruns Underutilization Theoretical Research Equity Implementation Model Status Quo Bias 4
Equity Implementation Model Level 1 +/- Outcomes Net Equity +/- Inputs Level 2 Level 3 Perceived outcome for the user compared with perceived outcome for the employer Perceived outcome for the user compared with perceived outcomes for other users Equity Implementation Model Source: Use of the Equity Implementation Model to Review Clinical System Implementation Efforts. Thomas W. Lauer, PhD,1 Kailash Joshi, PhD, and Thomas Browdy, PhD 5
Change Management Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf Change Management Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf 6
Change Management Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf Change Management Source: Change Management in EHR Implementation, National Learning Consortium http://www.healthit.gov/sites/default/files/nlc_changemanagementprimer.pdf 7
Case Study A CLINICAL LEADERSHIP PERSPECTIVE Melissa Larkin-Skinner, MA, LMHC Chief Clinical Officer Manatee Glens Leadership Commitment Vision Communication Resources Support Empowerment 8
Organizational Project vs IT Project Executive Clinical Finance IT Data Records QI Compliance Goals Intent Direction Revisit often Avoid mission creep 9
Why? Really Why 10
Interpreters Needed IT Finance User Readiness Introduction Skills Training Expectations 11
Manage Expectations! How? 12
The Forever Project Case Study A CHIEF INFORMATION OFFICER S PERSPECTIVE Steve LaFleur Chief Information Officer 13
Grand Lake Mental Health Center Outpatient Behavioral/Physical Health Services Serving NE Oklahoma (over 5,000 square miles) since 1979 3,160 Active Clients 2266 Adults and 894 Children 10 Physical Locations - 255 Staff Grand Lake EHR Evolution Early adopters of EHR Initial focus on billing and A/R (1995) Moving EHR in a strategic direction Upgraded Billing Software (2000) Decision to Bring on CIO in 2010 Accelerated Clinical Implementation (2010) Moved from doubting data to leveraging data 14
Strategic Goals Time To Market Changes at the state level required GLMHC to be able to respond rapidly to survive and thrive. GLMHC choose to thrive! Focus on Performance Intense focus on performance (billable hours, outcomes) at all levels of the organization. Decentralization Move to a decentralized organization by empowering supervisors and staff with data. Organizational Change Culture Resistance To Change Change Management Performance Oriented Commitment to continuous improvements and incremental changes Well defined performance metrics Willingness to enforce standards Benefits of negative thinking Simple, logical, incremental changes Willingness to make mistakes and correct 15
Q&A THANK YOU 16