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Ehr Optimization Tepr 2008


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Matt and Erin's presentation at TEPR 08.
Guidance on how to optimize and standardize during the implementation process to promote utilization of an EHR.

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Ehr Optimization Tepr 2008

  1. 1. Optimization and Standardization to Promote Utilization in an EHR Matthew J. Davis and Erin Sain TEPR 2008 - Ft Lauderdale April 2008
  2. 2. The focus of this lecture is to provide guidance on how to optimize and standardize during the implementation process to promote utilization of an EHR. June 4, 2009
  3. 3. Session Outline <ul><li>The mission of the session </li></ul><ul><li>Basis of Presentation Material </li></ul><ul><li>Importance of Educated build decisions </li></ul><ul><li>Understanding the Impact an EHR will have on your Organization.  </li></ul><ul><li>The Necessity of Participation and Inclusion for Buy-in Balanced with Standardization </li></ul>June 4, 2009
  4. 4. Session Mission <ul><li>Project teams, existing and future, would be able to walk away with an enlightened vision and an increased knowledge of how to more successfully execute an EHR implementation. </li></ul>June 4, 2009
  5. 5. Presentation Material Basis <ul><li>The material for this presentation is based on a collection of positive experiences and lessons learned </li></ul><ul><ul><li>Positive Effects </li></ul></ul><ul><ul><ul><li>Physician and Staff Satisfaction </li></ul></ul></ul><ul><ul><ul><li>Immediate Benefits </li></ul></ul></ul><ul><ul><ul><li>Buy-In for Believers and non Believers </li></ul></ul></ul><ul><ul><ul><li>Smooth Go-Live </li></ul></ul></ul><ul><ul><li>Negative </li></ul></ul><ul><ul><ul><li>Symptoms </li></ul></ul></ul><ul><ul><ul><ul><li>Formerly Simple Tasks become more effort </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Rough Initial part of Go-Live despite Training </li></ul></ul></ul></ul><ul><ul><ul><ul><li>80/20 Flip </li></ul></ul></ul></ul><ul><ul><ul><li>Causes </li></ul></ul></ul><ul><ul><ul><ul><li>Inadequate Time to Properly Execute </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Inaccurate Representation of Population </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Invalid Data </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Poor Understanding </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Poor Participation </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>Proper Tools Unavailable </li></ul></ul></ul></ul>June 4, 2009
  6. 6. Importance of Educated Build Decisions  <ul><li>Efficient Workflows </li></ul><ul><li>Opportunistic Re-engineering </li></ul><ul><li>Consolidation </li></ul><ul><li>Functionality and Consequences </li></ul><ul><li>Testing </li></ul><ul><li>Sounding Boards for Feedback </li></ul>June 4, 2009
  7. 7. Understanding the impact an EHR will have on your organization <ul><li>Quite Possibly Biggest Project ever in Organization to affect Revenue Generating Clinical Staff </li></ul><ul><li>Potential for Bottlenecks to Patients </li></ul><ul><li>Potential for Revenue Disruption </li></ul><ul><li>Potential for Unlimited Positive Transformation </li></ul>June 4, 2009
  8. 8. The necessity of participation and inclusion for buy-in balanced with standardization <ul><li>Everyone has an Opinion </li></ul><ul><li>Every Opinion has a Cost and a Benefit </li></ul><ul><ul><li>Buy-In </li></ul></ul><ul><ul><li>Maintenance </li></ul></ul><ul><li>Tiered Approach to Meet organizational needs </li></ul><ul><ul><li>Adds Structure and Governance </li></ul></ul><ul><ul><li>Helps to Communicate Organizational Decisions/Challenges </li></ul></ul>June 4, 2009
  9. 9. Standardization Level Matrix June 4, 2009 Required EMR Content Subgroups   Level of Standardization     Level of Appeals   User User Functions   Database Specialty Sub-Group Database Specialty Sub-Group Favorites Override     (NMG)   (Practice) (NMG)   (Practice)                         Chart Notes Note Type Naming X     X     No No   Structure of Index   X       X No Yes   Input Forms   X       X No Yes   Output Forms   X       X No No   Output Style X       X   No No Allergies Medications X¹       X   Yes Yes   Non-medications X     X     Yes Yes Vital Signs   X       X   No Yes Medications     X¹     X   Yes Yes Immunizations     X¹     X   Yes Yes Problems (PMH/PSH/FH/SoH/etc.) (Master²) X³   (Master²) X³   Yes Yes Assessment     X     X   Yes Yes Orders Laboratory   X     X   Yes Yes   Radiology   X     X   Yes Yes   Procedures   X     X   Yes Yes   Referrals   X     X   Yes Yes   Other   X     X   Yes Yes Charges Charge   X¹       X Yes Yes Care Guides* Category Structure X     X     No No   Content X     X     No Yes   QuickSets   X¹     X   Yes Yes HMP Screening X     X     No Yes   Disease Management X     X     No Yes Tasking Task Naming X     X     No No   Workflow X   X X X No Yes ChartViewer Scan/Document Naming X     X     No No   Views   X¹     X   Yes Yes   Chart Sections X     X     Yes Yes Reviewed 03/09/08 Definitions: A. Required EMR Functions - areas of ehr that require full adoption by all users in order to ensure successful communication and database sharing throughout Sample Medical Group. B. Level of Standardization - the organizational level at which ehr content will be standardized at the time of implementation . This may occur at the Sample Medical Group, specialty, or practice levels. C. Level of Appeal - the organizational level at which ehr content may be modified after implementation . D. User Favorites/User Override - identifies the areas of ehr that allow for customization at an individual level. Notes: 1. Denotes a starter set that might be modified by the user over time. This requires less individual feedback up front. 2. These areas will have a standardized &quot; master &quot; list to help problem list organization in the medical chart. 3. A personal &quot; Quick List &quot; of about 50 terms will additionally be available to each user for easy access to common conditions & terms. This can be modified by the user over time. * This function is not required. The subsets of functions within the Care Guides are required and utilized in other modules.
  10. 10. Standardization Committee Decision Calendar June 4, 2009