CPOM:
What’s Up With That?
Craig Joseph, MD, FAAP
Chief Medical Information Officer
Agnesian HealthCare
Know & Go Friday
....
Question 1
CPOM means:
1. Clinical pearls of management
2. Computerized program of medicine
3. Computerized physician orde...
What?
• Computerized physician order management
• Formerly known as CPOE
• Remove paper from the ordering process
• Orderi...
What’s An Order?
Outpatient Inpatient
Medications
Lipitor to Walgreens
Amoxicillin to CVS
Flu shot
IV ceftriaxone
Nitrogly...
CPOM
Stop
Start
• Entering orders by CPOM using PowerPlans
(planned or initiated)
• Limiting use of phone orders
• Electro...
CPOM
• Viewing results in Elmer
• Communicating (talking) with the team
• Validating the correct patient chart is open
whe...
Who?
• Physicians
• Nurse practitioners
• Physician assistants
Where?
• St. Agnes Hospital
• Waupun Memorial Hospital
• Ripon Medical Center
• Fond du Lac Surgery Center
• All Fond du L...
When?
Sunday, September 22, 5 a.m.
Waupun Memorial Hospital and Fond du Lac Regional
Clinic sites located nearby
Sunday, O...
Stage 1
Waupun Memorial Hospital and Associated Clinics
• Sunday, September 22, 5 a.m.
• Clinic sites:
– Brandon
– Conveni...
Stage 2
St. Agnes Hospital and Associated Clinics
• Sunday, October 20, 5 a.m.
• Clinic sites:
• Fond du Lac Surgery Cente...
Stage 3
Ripon Medical Center and Associated Clinics
• Sunday, November 17, 5 a.m.
• Clinic sites:
– Agnesian Cancer Center...
When? A Recap
• This year.
• 2013.
• In a few months.
• I know, right?
Question 2
Why are we moving to CPOM?
1. Why should HUCs have all the fun?
2. CPOM helps improve patient care.
3. We disli...
Why?
• CPOM can improve care
– Eliminate transcription errors
– Eliminate delays while moving paper
– Offer real-time clin...
What’s In It For Me: Improving Safety
Clinical Decision Support
• Only possible with real-time ordering
• Leads to improved care
• Requires a complete electroni...
Clinical Decision Support (contd.)
Types of CDS:
• Order sets
• Alerts
• Formularies
• EHR configuration
– Make it easy to...
Order Set
Alerts
Formularies
Formularies
Question 3
All paper ordering will be eliminated by the
end of 2013.
1. True
2. False
Question 4
Verbal orders will no longer be accepted after
CPOM go-live.
1. True
2. False
Question 5
Everyone at Agnesian HealthCare is ecstatic
about our move to CPOM.
1. True
2. False
CPOM Policies
St. Agnes Hospital, Waupun Memorial
Hospital, Ripon Medical Center and the Fond du
Lac Regional Clinic have ...
Verbal/Telephone Orders
• Verbal/telephone orders will always need to
exist
• These orders should be minimized
• Appropria...
Question 6
Is there really such a thing as a “verbal order”
at Agnesian HealthCare? Note: trick question
1. Yes: there are...
Verbal/Telephone Orders
• Currently, communication types include:
– Verbal order with read back
– Telephone order with rea...
Question 7
Is it more important to take care of the
patient or take care of the computer?
1. The patient
2. The computer
Go Live Help
• Reduction in clinic schedules
• Reduction in elective surgeries
• Outside help from Cerner and others
• Ins...
GlaSS Folks
• Go-live support staff
• Agnesian HealthCare associates who have
extra training on workflows and policies
• R...
Meaningful Use
• Congress authorized the government to
incentivize physicians and hospitals to
“meaningful use” healthcare...
CPOM Road to Activation – Key Activities
April May June July August September
GO-LIVE
Clinician Workflow Standardization B...
Question 8
Which Elmer are you?
1.
2.
3.
4.
Questions?
josephc@agnesian.com
@craigjoseph
(920) 926-WasteOfYourTime
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Agnesian HealthCare Know & Go Showcase: CPOM

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Dr. Craig Joseph discusses the implementation of CPOM )Computerized Provider Order Management) at Agnesian HealthCare.

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Agnesian HealthCare Know & Go Showcase: CPOM

  1. 1. CPOM: What’s Up With That? Craig Joseph, MD, FAAP Chief Medical Information Officer Agnesian HealthCare Know & Go Friday . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  2. 2. Question 1 CPOM means: 1. Clinical pearls of management 2. Computerized program of medicine 3. Computerized physician order management 4. Craig’s project of misunderstanding
  3. 3. What? • Computerized physician order management • Formerly known as CPOE • Remove paper from the ordering process • Ordering providers: – Write new orders – Modify existing orders – Discontinue existing orders
  4. 4. What’s An Order? Outpatient Inpatient Medications Lipitor to Walgreens Amoxicillin to CVS Flu shot IV ceftriaxone Nitroglycerin patch Non-medications Cholesterol level Chest x-ray Cardiology referral Cardiac enzymes Kidney ultrasound Cardiology consult
  5. 5. CPOM Stop Start • Entering orders by CPOM using PowerPlans (planned or initiated) • Limiting use of phone orders • Electronic medication reconciliation • Electronic discharge process for diagnosis, follow-up and discharge instructions • Documenting and validating the Problem/Diagnosis List • Handwritten paper orders • Paper medication reconciliation
  6. 6. CPOM • Viewing results in Elmer • Communicating (talking) with the team • Validating the correct patient chart is open when working in the record • Validating the correct encounter for the patient (listed on the Banner Bar) • Utilizing Message Center to sign phone orders Continue
  7. 7. Who? • Physicians • Nurse practitioners • Physician assistants
  8. 8. Where? • St. Agnes Hospital • Waupun Memorial Hospital • Ripon Medical Center • Fond du Lac Surgery Center • All Fond du Lac Regional Clinic offices • Consultant’s Laboratory
  9. 9. When? Sunday, September 22, 5 a.m. Waupun Memorial Hospital and Fond du Lac Regional Clinic sites located nearby Sunday, October 20, 5 a.m. St. Agnes Hospital, Fond du Lac Surgery Center and Fond du Lac Regional Clinic sites located nearby (including main campus) Sunday, November 17, 5 a.m. Ripon Medical Center and Fond du Lac Regional Clinic sites located nearby
  10. 10. Stage 1 Waupun Memorial Hospital and Associated Clinics • Sunday, September 22, 5 a.m. • Clinic sites: – Brandon – Convenient Care – Fond du Lac EZ Care – Fond du Lac Regional Clinic (608 W. Brown Street campus and any traveling specialists) – Fox Lake – Markesan – Waupun EZ Care
  11. 11. Stage 2 St. Agnes Hospital and Associated Clinics • Sunday, October 20, 5 a.m. • Clinic sites: • Fond du Lac Surgery Center • Mount Calvary Clinic • North Fond du Lac Clinic • Center for Pain • Plastic Surgery • Fond du Lac Regional Clinic South • Sports, Spine & Work Center • Campbellsport Clinic • Clinic at Wal-Mart • Dermatology & Skin Care Services • Fond du Lac Regional Clinic West • Fond du Lac Regional Clinic (420 E. Division campus) • Agnesian Foot Clinic
  12. 12. Stage 3 Ripon Medical Center and Associated Clinics • Sunday, November 17, 5 a.m. • Clinic sites: – Agnesian Cancer Center – Brownsville Clinic – Mayville Clinic – Ripon Clinic
  13. 13. When? A Recap • This year. • 2013. • In a few months. • I know, right?
  14. 14. Question 2 Why are we moving to CPOM? 1. Why should HUCs have all the fun? 2. CPOM helps improve patient care. 3. We dislike doctors, NPs and PAs. 4. Everybody’s doing it.
  15. 15. Why? • CPOM can improve care – Eliminate transcription errors – Eliminate delays while moving paper – Offer real-time clinical decision support – Allow ordering to occur anywhere at any time • CPOM is becoming a standard of care • Payers are rewarding (soon requiring) CPOM
  16. 16. What’s In It For Me: Improving Safety
  17. 17. Clinical Decision Support • Only possible with real-time ordering • Leads to improved care • Requires a complete electronic health record (EHR) • Needs to hit the sweet spot
  18. 18. Clinical Decision Support (contd.) Types of CDS: • Order sets • Alerts • Formularies • EHR configuration – Make it easy to do the right thing!
  19. 19. Order Set
  20. 20. Alerts
  21. 21. Formularies
  22. 22. Formularies
  23. 23. Question 3 All paper ordering will be eliminated by the end of 2013. 1. True 2. False
  24. 24. Question 4 Verbal orders will no longer be accepted after CPOM go-live. 1. True 2. False
  25. 25. Question 5 Everyone at Agnesian HealthCare is ecstatic about our move to CPOM. 1. True 2. False
  26. 26. CPOM Policies St. Agnes Hospital, Waupun Memorial Hospital, Ripon Medical Center and the Fond du Lac Regional Clinic have adopted the following policies: • CPOM is required of all ordering providers • CPOM training is required of all ordering providers • CPOM proficiency testing is required of all ordering providers
  27. 27. Verbal/Telephone Orders • Verbal/telephone orders will always need to exist • These orders should be minimized • Appropriate use includes: – Life and death emergencies – Driving – Doing a procedure – “One off” orders in the middle of the night
  28. 28. Question 6 Is there really such a thing as a “verbal order” at Agnesian HealthCare? Note: trick question 1. Yes: there are verbal orders. 2. No: there are not verbal orders.
  29. 29. Verbal/Telephone Orders • Currently, communication types include: – Verbal order with read back – Telephone order with read back • Nurses must read back the order to ensure its accuracy • With CPOM, ordering provider must stay on the phone or be immediately available to respond to any clinical decision support
  30. 30. Question 7 Is it more important to take care of the patient or take care of the computer? 1. The patient 2. The computer
  31. 31. Go Live Help • Reduction in clinic schedules • Reduction in elective surgeries • Outside help from Cerner and others • Inside help from Agnesian HealthCare associates
  32. 32. GlaSS Folks • Go-live support staff • Agnesian HealthCare associates who have extra training on workflows and policies • Roam through many user training sessions to offer one-on-one help • People who like free shirts
  33. 33. Meaningful Use • Congress authorized the government to incentivize physicians and hospitals to “meaningful use” healthcare information technology (HIT) • Via Medicare and Medicaid, physicians and hospitals get extra payments if they can show they’re using HIT
  34. 34. CPOM Road to Activation – Key Activities April May June July August September GO-LIVE Clinician Workflow Standardization Breakouts Transition Sustain Go/No Go ACTIVATION 4 Months To Go 3 Months To Go 2 Months To Go 1 Month To Go Facility Kickoff Physician Workflow Standardization Breakouts Physician Favorites Fair Clinician Sneak Preview Readiness Rounds G.L.A.S.S. Tips Planning/ Logistics Integration Testing Clinician and Physician Training
  35. 35. Question 8 Which Elmer are you? 1. 2. 3. 4.
  36. 36. Questions? josephc@agnesian.com @craigjoseph (920) 926-WasteOfYourTime

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