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Users of 3 different EMRs (Wolf Medical, Nightingale and Healthscreen) explain how they use their EMRs for chronic disease patient populations and discuss some of the benefits and challenges of using ...

Users of 3 different EMRs (Wolf Medical, Nightingale and Healthscreen) explain how they use their EMRs for chronic disease patient populations and discuss some of the benefits and challenges of using EMRs for complex patient care.

Host: Dr. Alan Brookstone


Dr. Michelle Greiver - Family Physician, North York Family Health Team (Nightingale)
Dr. Nora Curran-Blaney - Family Physician, Appleby College Medical (Healthscreen)
Mike Brand, Clinic Manager, Associate Medical Centre, Taber, Alberta (Wolf Medical)
David Mosher, Healthcare Business Manager, Hewlett-Packard (Canada)



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  • Imagine a world where you had unlimited access to medical intelligence – not just information but information assembled in a way to provide actionable intelligence. At HP we believe that technology can help to make this possible and that it can even lead the way in the transformation. It will take: Connecting silos of data across physicians and hospitals or other caregivers, Providing anywhere/anytime access to that information with the right device and form factor, and Together with our reseller partners ringing you the right services to reduce costs and providing value through every step of the way Value doesn’t come from connecting alone. For without ACCESS to the information, connecting just creates a bigger silo. Access requires client devices with intuitive interfaces and the right form factor for tapping into the information infrastructure within your digital hospital and your affiliated medical offices. At every touch point in the system, there must be the right device at the right time to access and interact with the relevant medical information. Finally, the ultimate goal with this equation is that of creating Medical Intelligence – the intelligence needed to make the best medical decisions possible. By medical intelligence we mean the convergence of information such as the presenting patient information, the patient’s medical history, medical databases and medical research all to create actionable medical intelligence. And with using Business Intelligence to help you to drive more cost out of the equation while increasing patient care. Key Takeaways: Again, connecting silos of information is just the first step and not the end goal. It takes a connected system with anytime/anywhere access by your medical staff and the aggregation of a variety of information in order to deliver medical intelligence. And, as always, the goal we are all focused on is providing better patient outcomes at the lowest cost possible.
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CanadianEMR-webinar-march3-final CanadianEMR-webinar-march3-final Presentation Transcript

  • Webinar – Using EMRs for Chronic Disease Management
    • March 3, 2011
    Funding to support this Webinar has been provided by Hewlett-Packard
  • Dr. Michelle Greiver
    • Practice description:
      • Community-based family practice in Toronto
      • 1,300 patients
      • Part of interdisciplinary team (North York Family Health Team)
      • 3 physicians, 1 nurse practitioner in the office
      • 60 physicians are members of the NYFHT
    • EMR used:
      • Nightingale EMR, since 2006
  • Practice Profile
    • Practice description (1092 adult patients)
      • 77% female
      • Taking part in a Quality collaborative since 2009
      • Part of national primary care EMR chronic disease surveillance system (CPCSSN)
    • Chronic Disease prevalence (adults)
      • 80 patients with diabetes (7%)
      • 89 COPD (8%)
      • 207 hypertension (19%)
      • 16 CHF (1%)
      • 27 confirmed asthma (2%)
  • Benefits of EMR for CDM
    • You cannot improve what you cannot measure
    • We decided to code important chronic conditions so that we could build disease registries
    • We enter data consistently in the EMR so it can be measured
    • We invested time and resources in measurement and audits
    • All team members use the EMR
    • We have CDM flowsheets and templates, with associated alerts and reminders
    • We use the EMR to audit and mail reminders to patients who are overdue (diabetic, no eye exam for 2 years)
  • Screenshot
  • Screenshot
  • CDM reminders for any chronic conditions this patient has: “HM button”
  • Screenshot
  • Take Home Points
    • Decide and agree: which chronic conditions you would like to focus on?
    • Involve everyone in your practice
    • Enter your data carefully and consistently
    • Use the features that your EMR offers
    • Try small steps to improve care
    • Measure what you did and see if it worked, then keep going
    • Use what you learned in one chronic condition to improve other conditions
  • Dr. Nora Curran-Blaney
    • 3 Physician Family Practice – Oakville, ON
      • 2 physicians work concurrently – flexible schedule
    • 30 years practice experience
    • EMR used: Healthscreen
    • Remote access version
    • Experience using tablet computers
  • Practice Profile
    • 1348 rostered patients
    • 519 over 50 yrs
    • Chronic Disease prevalence
      • Hypertension – (400 pts.)
      • Obesity – BMI over 33 (100 pts.)
      • Diabetes Mellitus – (30-40 pts.)
      • Heart failure – (10 pts.)
  • Benefits of EMR for CDM
    • Ability to develop clinical queries
    • Active use of a patient profile
      • Hand printed copy of profile to patient
    • Used of coded data display
      • Requires discipline of data entry for future use
    • Colour coding
    • eFax directly from EMR
    • Simplification of referrals
    • Cancer surveillance
  • Take Home Points
    • EMR usability is critical
    • Encourage patient self management
      • Not yet using a patient portal
    • Record information during the encounter
    • Patient feedback
      • Most feel management is improved with EMR
      • Less chance for error or that information has been forgotten
      • Worry about privacy and power outages
  • Michael Brand, Clinic Manager Associate Medical Centre, Taber, Ab.
    • 12 Physician Family Medicine Clinic
    • Member of Chinook Primary Care Network
    • Using Wolf EMR since 2007
  • Practice Profile
    • Approx. 18,000 patients in catchment area
    • Team based Care
    • Physician is team lead with mix of NP, RNs, LPNs, Psychiatric RN, Psychologist, Dietician, Health Coach & MOAs
    • Large Senior & “ESL” Populations
    • 19 bed Acute Care Hospital
    • 100 bed LTC Facility
  • Benefits of EMR for CDM
    • All CDM Monitoring is managed through use of “Rules” within EMR
    • Rules define a population and provide alert at Point of Care
    • All Clinic Staff are tasked with dealing with relevant rules when in contact with a patient
    • CDM Run charts are used to track performance over time
    • Results are posted for all to see
  • Take Home Points
    • Rules are constantly changing and evolving based on population and updates to CDM guidelines
    • Patients appreciate the comprehensive level of care & develop trust in the team.
    • Staff feel strong sense of accomplishment when they see positive results.
    • Overall system costs decrease (ER Visits & Admissions) through comprehensive clinic based Chronic Disease Management
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  • Questions & Discussion
  • Webinar – Using EMRs for Chronic Disease Management
    • March 3, 2011
    Funding to support this Webinar has been provided by Hewlett-Packard