Electronic Health Records: Implications for IMO State's Healthcare System


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Very high level overview and benefits of Electronic Health Records systems and a multi-phased approach to implementation. By Michael Loechel & Joy Gupta.

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  • What are they?How do they work?How might they help improve the quality of care for IMO State?EHR Key FindingsImplicationsKey PlayersConsiderations / Requirements
  • What is an EHR?
  • Why EHR?#1 Goal: Improve the Quality of Patient Care.#2 Goal: Improve the Efficiency of the Practice.Having patient history available to all doctors, hospitals, and/or clinics treating a particular patient.To understand what tests have been performed, diagnosis, learn how patients were treated in the past, avoid potentially dangerous drug-drug interactionsClinical Decision Support – understanding disease outbreaks / prevalencePredictive Modeling – how much medicine do we need? Where do we need it?Evaluate current state to determine what is working well and areas for improvementTo ensure treatment protocols are beingfollowed to ensure proper diagnosis andtreatmentTo measure patient outcomes to determinewhat is working vs. notSave time and overall cost of careStreamline prescribing, billing
  • Electronic Health Records: Implications for IMO State's Healthcare System

    1. 1. Electronic Health Records Implications for IMO State’s Healthcare System Presented by: Michael Loechel & Joy Gupta IMO State Congress Business Forum Atlanta, GA August 2, 2013
    2. 2. Context IMO State recognizes the need for setting up an EHR as they consolidate their healthcare infrastructure, and have approached Axioma Group & Research Solutions, LLC to help in this process.
    3. 3. Agenda • Electronic Health Records (EHR) Overview & Benefits • Approach to EHR in IMO State • Questions & Answers
    4. 4. EHR: Definition A longitudinal health record that: • Contains all personal health information • Is entered and accessed electronically by healthcare providers over a person’s lifetime • Includes multiple care settings – inpatient and outpatient • Allows a patient’s health record to travel with them • Reflects the entire health history of an individual across his/her lifetime including data from multiple providers Sources: World Health Organization; HealthIT.gov
    5. 5. EHR is Comprehensive Electronic Health Records (EHR) All personal health information Electronic Medical Records (EMR) Diagnosis and treatment information Electronic Prescribing (EP) Drugs written and dispensed
    6. 6. EHR: Goals • Improve quality and convenience of patient care • Increase patient participation in their care • Improve accuracy of diagnoses and health outcomes • Improve care coordination • Increase practice efficiencies and cost savings Source: HealthIT.gov
    7. 7. EHR in IMO State: Approach Patient Flow •Process Mapping: Current vs. Future State •Gaps EHR Plan & Process •Tweaks System requirements based on Healthcare practices •System Selection System Implementation & Training •Phased rollout Ongoing Technical Support
    8. 8. Patient Flow & EHR Origination Evaluation/ Diagnosis Treatment Assessment & Options Symptomatic/ Asymptomatic Chronic/ Episodic Management of Treatment and ongoing Care Emergency/ Non-Emergency Hospital Clinic/Primary Health Center Home visit Physical Examination Lab tests Other diagnostics Drug therapy Screening Surgery Acute Care Hospitals (inpatient & outpatient) Clinics Primary Care Institutions Non-acute Care Primary Care Institutions Home Care Devices EHRs can, and should, encompass the continuum of patient care Doctors Traditional Healers Nurses and other healthcare providers Other
    9. 9. Planning an EHR Guiding Principles for Implementing National, Regional and/or Provider EHR Lessons Learned  Clinical Value: EHR capabilities should have high clinical value. The identification of capabilities and priorities should be clinician led.  Pragmatism: The foundations for EHR need to be built; capabilities need to be realistic for the timeframe of each release.  Staged Development: Evolve capabilities over time to achieve greater sophistication.  Balance Risk and Reward: Manage the degree of difficulty in each release. Source: Accenture Global Survey Accurate patient identification is the backbone of an effective and efficient health record system. This should be addressed first before moving forward to automation.
    10. 10. Setting up an EHR System Review Current Health Record System Identify Issues and Challenges Plan for Introduction Coverage Type and form of records How maintained & by whom Quality and consistency To what extent centralized/ localized Extent of sharing & Process Policies and guidelines Data entry accuracy Communication & Training Literacy/attitude toward computer technology Cost and funding Concerns of providers Knowledge of disease classification systems Human resources adequacy Infrastructure – power, wiring, space Involvement of clinicians and administrators It is extremely important that there is support from the anticipated users of the system who need to be involved from the onset of discussions. Form a Steering Committee Determine type of EHR Set achievable outcome goals that will meet the needs of both users and consumers Devise strategies in preparation for an EHR Develop policies for use in an electronic health record system Source: Based on WHO EHR Manual & Experience
    11. 11. Implementation Team Source: WHO EHR Manual
    12. 12. Implementation Plan A sound implementation plan can mean the difference between success and failure ① Working Groups to Address – Information Security – Education and Training – Competent, committed users – Quality Assurance of data collected and processed ② Consider Key Factors Including – What computer systems does the institution currently have? – What form should the implementation take? (full/phased) – How will past data be integrated and old data retained? Source: Based on WHO EHR Manual & Experience
    13. 13. Measuring Success Key areas of measurement (examples) • Efficiency – Patient turnover – Patient records available at point-of-care – On time receipt of labs/diagnostics – Speed of diagnosis – Clinical alerts – Speed of medical fulfillment • Outcomes – Accuracy of diagnosis – Accuracy of treatment – Persistency and compliance with drugs – Persistence of follow up visits – Patients receiving preventive exams/procedures – Distribution of education materials Source: Based on Experience and Multiple Source
    14. 14. Contact Information Michael Loechel President Axioma Group, Inc. michael@axiomagroupinc.com (646) 415-8107 Joy Gupta President Research Solutions, LLC Joygupta@earthlink.net (203) 994-4784