Terry Field, Lawrence Garber, Shawn        Gagne, Jennifer Tjia, Peggy Preusse, Jennifer               Donovan, Abir Kanaa...
   Problems with continuity of care   High risk transitions   Poor communication between physicians    caring for patie...
1.   Can out-patient medical group EMRs be     used to provide information to PCPs when     patients are discharged to hom...
   Medical group practice   330 clinicians   Approximately 180,000 patients   Epic ambulatory EMR   In-house medical ...
   Automated system to facilitate information    flow to PCPs about patients discharged to    home from hospital or SNFs...
Admission, discharge, Discharge      transfer registrationnotification       (ADT) interfaceScheduling        EMR integrat...
Primary Care                     ProviderLocally producedinterface engine         Support   distributes            Staff  ...
Category                      Hours       Cost ($)   % of Total                                                       Cost...
   Linkages to hospitals, SNFs, outside labs   Scheduling system integrated within the EMR   Real time access to claims...
   Linkages to hospitals and labs through ADT    and ORU interfaces   Information about dispensed drugs through    Sures...
   Feasible   Requires strong internal informatics expertise   Cooperation from hospitals and SNFs   Electronic linkag...
Technological Resources & Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians when...
Technological Resources & Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians when...
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Technological Resources & Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians when Patients Transition from Hospitals to Home FIELD

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Clinical Informatics: Using Information Technology in Health Care

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Transcript of "Technological Resources & Personnel Costs Required to Implement an Automated Alert System for Primary Care Physicians when Patients Transition from Hospitals to Home FIELD"

  1. 1. Terry Field, Lawrence Garber, Shawn Gagne, Jennifer Tjia, Peggy Preusse, Jennifer Donovan, Abir Kanaan, Jerry GurwitzFunding: AHRQ R18 HS017203 and R18 HS017817
  2. 2.  Problems with continuity of care High risk transitions Poor communication between physicians caring for patients in and out of the hospital Existing methods to overcome these problems: ◦ from the hospital side ◦ labor intensive ◦ or based on integrated EMR for out-patient clinics and hospitals
  3. 3. 1. Can out-patient medical group EMRs be used to provide information to PCPs when patients are discharged to home?2. What are the technological resources and personnel costs needed to develop an automated system providing information about patient transitions to PCPs?
  4. 4.  Medical group practice 330 clinicians Approximately 180,000 patients Epic ambulatory EMR In-house medical informatics team
  5. 5.  Automated system to facilitate information flow to PCPs about patients discharged to home from hospital or SNFs Includes information about: • new drugs added during hospital stay • warnings about drug-drug interactions • recommendations for dose changes and lab monitoring • reminders to support staff to schedule an office visit
  6. 6. Admission, discharge, Discharge transfer registrationnotification (ADT) interfaceScheduling EMR integrated Information is linked to Info scheduling system data in the EMR database. Program applies rules to New construct messages and EMR pre-discharge Meds direct their flow. Claims post-discharge LabMonitoring Lab results interface
  7. 7. Primary Care ProviderLocally producedinterface engine Support distributes Staff messages
  8. 8. Category Hours Cost ($) % of Total CostPhysicians 614 55,340 47Operations research analyst 370 12,561 28Research assistant 202 3,885 16Nurse 58 1,873 4Computer software engineer 40 1,692 3Database administrator 17 597 1Pharmacist 7 367 1Total 1,308 76,314
  9. 9.  Linkages to hospitals, SNFs, outside labs Scheduling system integrated within the EMR Real time access to claims for dispensed drugs Locally written interface engine application EMR with a flexible database Internal informatics expertise HIT-experienced physician leader
  10. 10.  Linkages to hospitals and labs through ADT and ORU interfaces Information about dispensed drugs through Surescripts Internal message delivery through commercially available interface engine
  11. 11.  Feasible Requires strong internal informatics expertise Cooperation from hospitals and SNFs Electronic linkages to external facilities Extensive physician time
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