Early benefits and impacts of Electronic Patient Record implementation: Findings from the UK. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 11 November 2014, 12pm, Marlborough Room 3
The document outlines CDHB's Vision 2020 which focuses on supporting people to take greater responsibility for their health through primary care and community services while making specialist services more responsive to primary care. It then discusses the development of clinical pathways through clinician-led workgroups to improve referral processes, access to investigations, and clinical management across the health system in Canterbury.
The emerging healthcare environment requires expanded patient access while delivering optimal outcomes and cost. As healthcare moves form a fee for service model to alternative delivery and payment models, there are opportunities for physical therapy to revolutionize the delivery of musculoskeletal medicine. Physical therapists are uniquely qualified to spearhead musculoskeletal care through direct access with the potential to improve patient satisfaction and outcomes while limiting unneeded medical care. While this model has been described in the military, there are few descriptions of this PT First approach in the private payer arena. This session will provide the attendee with a multifaceted perspective on the impact of physical therapy in emerging, collaborative healthcare models. Approaches to payers and employers with the business implications will be presented that influence these new models. Key strategies to implement a scalable, best practice model will be discussed including the logistical challenges and corollary solutions in the private arena. We will discus our experience implementing novel delivery models for management of neck, back, shoulder and knee pain. The session will deliver practical solutions to the challenges of implementing, assessing, and adapting a theoretical construct to a working viable program. Finally, the session will discuss how the use of a a large Patient Outcomes Registry and analysis of “big data” can drive best practice and inform development of the program.
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Digital engagement of discharged ED patients through asynchronous surveys is important for several reasons:
1) Contacting patients after discharge through digital means rather than phone calls improves patient safety and satisfaction while reducing costs. Automating the process allows clinicians to efficiently address patient wellbeing issues.
2) Surveys that check on patient status and experience provide opportunities to identify care gaps, prevent return visits, and improve care quality over time based on patient feedback.
3) Hospitals are increasingly focused on patient experience metrics that link to value-based reimbursement and consumer loyalty. Digital surveys can enhance hospitals' understanding of the patient perspective in a low-cost, consistent manner.
The Beryl Institute 2013 State of the Patient Experience Benchmarking StudyEngagingPatients
This document summarizes the key findings of a survey of over 1,000 US hospitals regarding their efforts to improve the patient experience. It finds that while patient experience remains a top priority, hospitals feel somewhat less positive about their progress than two years ago. Most hospitals now have a formal definition and structure for patient experience. Leadership support and HCAHPS scores are the top factors driving patient experience work. Hospitals continue focusing on communication, noise reduction, and discharge processes to improve patient experience.
In this webinar, you will learn:
How we approach intervention campaigns: a framework
The science of behavior change and how it can be applied to increase the probability of desired outcomes
How Altarum’s ACE Measure can help predict consumer behaviors and design successful intervention campaigns
Speakers:
Ryan Rossier, Medullan
Chris Duke, Altarum
Josh Klapow, ChipRewards
This document summarizes a presentation on using data and informatics to improve allied health services. It discusses the history of allied health and challenges with data collection. Examples are provided of projects in New Zealand that used data to enhance patient and clinician experiences, reduce hospital-acquired infections, and inform staffing needs. The presentation emphasizes standardizing data to facilitate benchmarking and applying knowledge gained from data analysis to drive improvements in allied health.
Objectives
1.Understand the importance of measurement in driving improvement
2.Introduce Patient Safety Metrics: a cloud-based tool for data collection and performance monitoring.
3.Demonstrate new auditing tools designed to reduce the burden of measurement
4.Outline the application of Patient Safety Metrics beyond Safer Healthcare Now!
The document outlines CDHB's Vision 2020 which focuses on supporting people to take greater responsibility for their health through primary care and community services while making specialist services more responsive to primary care. It then discusses the development of clinical pathways through clinician-led workgroups to improve referral processes, access to investigations, and clinical management across the health system in Canterbury.
The emerging healthcare environment requires expanded patient access while delivering optimal outcomes and cost. As healthcare moves form a fee for service model to alternative delivery and payment models, there are opportunities for physical therapy to revolutionize the delivery of musculoskeletal medicine. Physical therapists are uniquely qualified to spearhead musculoskeletal care through direct access with the potential to improve patient satisfaction and outcomes while limiting unneeded medical care. While this model has been described in the military, there are few descriptions of this PT First approach in the private payer arena. This session will provide the attendee with a multifaceted perspective on the impact of physical therapy in emerging, collaborative healthcare models. Approaches to payers and employers with the business implications will be presented that influence these new models. Key strategies to implement a scalable, best practice model will be discussed including the logistical challenges and corollary solutions in the private arena. We will discus our experience implementing novel delivery models for management of neck, back, shoulder and knee pain. The session will deliver practical solutions to the challenges of implementing, assessing, and adapting a theoretical construct to a working viable program. Finally, the session will discuss how the use of a a large Patient Outcomes Registry and analysis of “big data” can drive best practice and inform development of the program.
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Digital engagement of discharged ED patients through asynchronous surveys is important for several reasons:
1) Contacting patients after discharge through digital means rather than phone calls improves patient safety and satisfaction while reducing costs. Automating the process allows clinicians to efficiently address patient wellbeing issues.
2) Surveys that check on patient status and experience provide opportunities to identify care gaps, prevent return visits, and improve care quality over time based on patient feedback.
3) Hospitals are increasingly focused on patient experience metrics that link to value-based reimbursement and consumer loyalty. Digital surveys can enhance hospitals' understanding of the patient perspective in a low-cost, consistent manner.
The Beryl Institute 2013 State of the Patient Experience Benchmarking StudyEngagingPatients
This document summarizes the key findings of a survey of over 1,000 US hospitals regarding their efforts to improve the patient experience. It finds that while patient experience remains a top priority, hospitals feel somewhat less positive about their progress than two years ago. Most hospitals now have a formal definition and structure for patient experience. Leadership support and HCAHPS scores are the top factors driving patient experience work. Hospitals continue focusing on communication, noise reduction, and discharge processes to improve patient experience.
In this webinar, you will learn:
How we approach intervention campaigns: a framework
The science of behavior change and how it can be applied to increase the probability of desired outcomes
How Altarum’s ACE Measure can help predict consumer behaviors and design successful intervention campaigns
Speakers:
Ryan Rossier, Medullan
Chris Duke, Altarum
Josh Klapow, ChipRewards
This document summarizes a presentation on using data and informatics to improve allied health services. It discusses the history of allied health and challenges with data collection. Examples are provided of projects in New Zealand that used data to enhance patient and clinician experiences, reduce hospital-acquired infections, and inform staffing needs. The presentation emphasizes standardizing data to facilitate benchmarking and applying knowledge gained from data analysis to drive improvements in allied health.
Objectives
1.Understand the importance of measurement in driving improvement
2.Introduce Patient Safety Metrics: a cloud-based tool for data collection and performance monitoring.
3.Demonstrate new auditing tools designed to reduce the burden of measurement
4.Outline the application of Patient Safety Metrics beyond Safer Healthcare Now!
This presentation was used for the Ryan White Part B Quality Management Committee to support more effective recruitment of patients for quality management activities
RQHR developed a strategic approach to improve patient flow based on best practices. Short term initiatives included implementing Allscripts patient flow software, establishing governance structures for patient flow, developing standard work and care planning processes, and leveling demand through surgical targeting. The results were reduced admit no bed numbers, decreased system occupancy and wave times, and closed hallway beds. RQHR's framework was adopted provincially to improve ED waits and flow.
The document discusses creating highly adoptable improvement initiatives to engage clinicians and sustainably implement medication reconciliation. It introduces a model that assesses initiatives based on perceived workload and value. Initiatives with low workload and high value for clinicians are most likely to be adopted. The document provides a guide to apply this model, including evaluating initiatives based on end-user involvement, alignment with goals, estimated workload, complexity, and evidence of effectiveness. Applying this guide can help identify opportunities to simplify initiatives and increase adoption of medication reconciliation and other improvements.
At the RACMA Conference Talked about how to use machine learning to improve patient feedback as well as building the rules engine to advise on patient experience improvement. Here are some of the slides and stories shared at the conference which seem to be received very well.
Prof Devlin discusses the rationale for the PROMs programme and provides an overview of the various uses of the EQ-5D in England—for example by NICE in health technology assessment, in population surveys and in the English NHS PROMS program. The presentation also reviews how EQ-5D data are collected, analysed and used in the UK to inform decisions by health care providers, payers and patients.
Texas Tech University Health Sciences Center is transforming their population health management through implementing care teams enabled by technology. They are focusing on chronic conditions like diabetes and cardiovascular disease. Their goals are to improve outcomes, decrease costs, and reduce disparities for their large patient population in West Texas. They are using the Kryptiq CareManager platform to integrate data, risk stratify patients, coordinate care among teams, and engage patients to help achieve these aims. The webinar discussed best practices for clinical redesign around care teams and how technology can help overcome barriers to effective chronic disease management.
Patient-Centered Care Requires Patient-Centered Insight: What We Can Do To C...Health Catalyst
Health systems and providers are inundated with measurement systems and reporting. Why would we want to add to the measurement mayhem? The real question is, “Are we measuring what matters?”
Carolyn Simpkins MD, PhD, chief medical informatics officer, will discuss how putting the patient at the center of the measurement matrix can bring coherence and completeness to the picture of care delivery performance across the patient journey, and therefore the performance of the healthcare ecosystem.
She will describe the building blocks for patient-centered measurement and how other metrics, patient-reported outcomes, and patient satisfaction fit into this approach. Carolyn will also review the challenges that have kept health systems from completing a patient-centered outcomes approach and why we are poised to break through. Finally, she will share case studies of organizations who have begun to pioneer the use of patient centered metrics to improve care and outcomes.
Patient Engagement Strategies for Post COVID Success - Chris Nicholson | mPul...VSee
For more info: visit https://bit.ly/2TijLrV
Google gets over one billion health-related searches a day. Now is the time to leverage patients’ growing expectations for telehealth options to engage more deeply with them. Join our guest CEO of mPulse Mobile, Chris Nicholson and learn about effective patient engagement strategies you can put in place to create highly personalized healthcare experiences that drive patient outcomes--especially for the elderly and underserved populations.
Provided to you by: https://vsee.com
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
The document discusses the potential roles and applications of wireless technology in healthcare. It describes how cell phones are becoming ubiquitous personal computing devices well-suited for delivering healthcare applications. Some current uses include monitoring physiological functions and providing patients with health information and feedback to encourage self-management of chronic conditions. Challenges include establishing reimbursement, proving benefits, ensuring privacy and developing standards.
Telemonitoring involves the ongoing remote monitoring of a patient's condition through sensors that detect physiological indicators and wirelessly transmit data to healthcare providers. It allows for the remote assessment of conditions like heart failure without in-person visits. The document discusses different types of telehealth including telemedicine, which provides clinical care via telecommunications, and telemonitoring, which passively monitors health indicators. Telemonitoring has been used with older adults and can benefit access to care, but faces challenges with technology, privacy concerns, and replacing in-person interactions. Research shows telemonitoring may reduce mortality and hospital readmissions for heart failure patients.
Dr Nic Woods discusses tools for early recognition and management of sepsis using the electronic medical record (EMR). Sepsis poses a major global health challenge and burden. Tools discussed include a sepsis predictive model built into the EMR that can detect signs of sepsis with sensitivities of 68-91% and specificities of 91-97.6%. Clinical decision support and workflows in the EMR are also used to alert clinicians and guide treatment. Evaluations found these tools helped reduce mortality from sepsis by 4.2-17% and lower length of hospital stays. Key points emphasized that predictive models integrated into clinical workflows can positively impact outcomes, but more progress is still needed.
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
An outpatient practice performance program was shown to significantly improve delivery of guideline-recommended care for heart failure patients. The IMPROVE HF study found underuse of heart failure guidelines in many cardiology practices. The practice improvement program measured adherence to quality measures and provided feedback to help increase adherence. Participating practices saw improvements in delivery of heart failure therapies like ACE inhibitors, beta-blockers, and aldosterone antagonists.
BiomedHealthtech is engaged in serving the healthcare industry since 1989 and now introduce Remote Monitoring Technologies (RMT) which is a new concept of Patient Monitoring designed to meet the demands of Modern Healthcare and thus reduce the Mortality Rate.
Presentation by Alan Dubovsky, Chief Patient Experience Officer, Cedars Sinai Medical Center, about their Patient Experience Program. Begins with a review of patient satisfaction scores, clinical performance initiatives, medical outcomes, ongoing research, academic programs, and national awards. Next is a timeline of activites, from building the PX Infrastructure, PX Improvement Projects, Launching PX Skill Building Programs and introducing PX Innovation. Includes details about the Primary functions of the office of Patient Experience:
The measurement, reporting, and analysis of all Patient Feedback and the coordination and implementation of all Patient Experience improvement efforts across the health system. The patient voice is captured through Solicited Feedback, Patient & Family Advisor Programs and Verbatim Feedback. Presentation finishes with a discussion about the Future Of Patient Feedback. Some of those areas: Using patient segmentation to group patients into distinct segments, Asking patients unique questions to understand their primary concerns, Asking planned admissions who helped set their expectations?
Asking new patients what was their prior perception compared to reality?
5 Reasons the Practice of Evidence-Based Medicine Is a Hot TopicHealth Catalyst
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
This document discusses best practices for implementing and improving telemedicine services. It addresses project management processes, billing guidelines, maximizing physical exams during telemedicine visits, integrating ancillary services like nurses and social workers, ideal settings for telehealth, developing patient-physician relationships remotely, and provides examples of telemedicine modalities like telephone, video and portable carts. The document aims to help optimize clinical workflows and revenue cycles while maintaining standards of care.
The impact of high-capability electronic health records on length of stay. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 12 November 2014, 11.15am, Marlborough Room 3
This document summarizes the background and work of Prof. Steven H. Shaha, who has published over 100 peer-reviewed publications and presentations on using analytics and clinical decision support systems to improve healthcare quality and outcomes. Some key points discussed include using analytics of electronic medical record data to reduce sepsis rates and length of ICU stays, developing alert systems to more quickly recognize and treat at-risk patients, and creating connected networks between healthcare providers to better monitor population health and improve outcomes for conditions like diabetes.
This presentation was used for the Ryan White Part B Quality Management Committee to support more effective recruitment of patients for quality management activities
RQHR developed a strategic approach to improve patient flow based on best practices. Short term initiatives included implementing Allscripts patient flow software, establishing governance structures for patient flow, developing standard work and care planning processes, and leveling demand through surgical targeting. The results were reduced admit no bed numbers, decreased system occupancy and wave times, and closed hallway beds. RQHR's framework was adopted provincially to improve ED waits and flow.
The document discusses creating highly adoptable improvement initiatives to engage clinicians and sustainably implement medication reconciliation. It introduces a model that assesses initiatives based on perceived workload and value. Initiatives with low workload and high value for clinicians are most likely to be adopted. The document provides a guide to apply this model, including evaluating initiatives based on end-user involvement, alignment with goals, estimated workload, complexity, and evidence of effectiveness. Applying this guide can help identify opportunities to simplify initiatives and increase adoption of medication reconciliation and other improvements.
At the RACMA Conference Talked about how to use machine learning to improve patient feedback as well as building the rules engine to advise on patient experience improvement. Here are some of the slides and stories shared at the conference which seem to be received very well.
Prof Devlin discusses the rationale for the PROMs programme and provides an overview of the various uses of the EQ-5D in England—for example by NICE in health technology assessment, in population surveys and in the English NHS PROMS program. The presentation also reviews how EQ-5D data are collected, analysed and used in the UK to inform decisions by health care providers, payers and patients.
Texas Tech University Health Sciences Center is transforming their population health management through implementing care teams enabled by technology. They are focusing on chronic conditions like diabetes and cardiovascular disease. Their goals are to improve outcomes, decrease costs, and reduce disparities for their large patient population in West Texas. They are using the Kryptiq CareManager platform to integrate data, risk stratify patients, coordinate care among teams, and engage patients to help achieve these aims. The webinar discussed best practices for clinical redesign around care teams and how technology can help overcome barriers to effective chronic disease management.
Patient-Centered Care Requires Patient-Centered Insight: What We Can Do To C...Health Catalyst
Health systems and providers are inundated with measurement systems and reporting. Why would we want to add to the measurement mayhem? The real question is, “Are we measuring what matters?”
Carolyn Simpkins MD, PhD, chief medical informatics officer, will discuss how putting the patient at the center of the measurement matrix can bring coherence and completeness to the picture of care delivery performance across the patient journey, and therefore the performance of the healthcare ecosystem.
She will describe the building blocks for patient-centered measurement and how other metrics, patient-reported outcomes, and patient satisfaction fit into this approach. Carolyn will also review the challenges that have kept health systems from completing a patient-centered outcomes approach and why we are poised to break through. Finally, she will share case studies of organizations who have begun to pioneer the use of patient centered metrics to improve care and outcomes.
Patient Engagement Strategies for Post COVID Success - Chris Nicholson | mPul...VSee
For more info: visit https://bit.ly/2TijLrV
Google gets over one billion health-related searches a day. Now is the time to leverage patients’ growing expectations for telehealth options to engage more deeply with them. Join our guest CEO of mPulse Mobile, Chris Nicholson and learn about effective patient engagement strategies you can put in place to create highly personalized healthcare experiences that drive patient outcomes--especially for the elderly and underserved populations.
Provided to you by: https://vsee.com
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
The document discusses the potential roles and applications of wireless technology in healthcare. It describes how cell phones are becoming ubiquitous personal computing devices well-suited for delivering healthcare applications. Some current uses include monitoring physiological functions and providing patients with health information and feedback to encourage self-management of chronic conditions. Challenges include establishing reimbursement, proving benefits, ensuring privacy and developing standards.
Telemonitoring involves the ongoing remote monitoring of a patient's condition through sensors that detect physiological indicators and wirelessly transmit data to healthcare providers. It allows for the remote assessment of conditions like heart failure without in-person visits. The document discusses different types of telehealth including telemedicine, which provides clinical care via telecommunications, and telemonitoring, which passively monitors health indicators. Telemonitoring has been used with older adults and can benefit access to care, but faces challenges with technology, privacy concerns, and replacing in-person interactions. Research shows telemonitoring may reduce mortality and hospital readmissions for heart failure patients.
Dr Nic Woods discusses tools for early recognition and management of sepsis using the electronic medical record (EMR). Sepsis poses a major global health challenge and burden. Tools discussed include a sepsis predictive model built into the EMR that can detect signs of sepsis with sensitivities of 68-91% and specificities of 91-97.6%. Clinical decision support and workflows in the EMR are also used to alert clinicians and guide treatment. Evaluations found these tools helped reduce mortality from sepsis by 4.2-17% and lower length of hospital stays. Key points emphasized that predictive models integrated into clinical workflows can positively impact outcomes, but more progress is still needed.
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
An outpatient practice performance program was shown to significantly improve delivery of guideline-recommended care for heart failure patients. The IMPROVE HF study found underuse of heart failure guidelines in many cardiology practices. The practice improvement program measured adherence to quality measures and provided feedback to help increase adherence. Participating practices saw improvements in delivery of heart failure therapies like ACE inhibitors, beta-blockers, and aldosterone antagonists.
BiomedHealthtech is engaged in serving the healthcare industry since 1989 and now introduce Remote Monitoring Technologies (RMT) which is a new concept of Patient Monitoring designed to meet the demands of Modern Healthcare and thus reduce the Mortality Rate.
Presentation by Alan Dubovsky, Chief Patient Experience Officer, Cedars Sinai Medical Center, about their Patient Experience Program. Begins with a review of patient satisfaction scores, clinical performance initiatives, medical outcomes, ongoing research, academic programs, and national awards. Next is a timeline of activites, from building the PX Infrastructure, PX Improvement Projects, Launching PX Skill Building Programs and introducing PX Innovation. Includes details about the Primary functions of the office of Patient Experience:
The measurement, reporting, and analysis of all Patient Feedback and the coordination and implementation of all Patient Experience improvement efforts across the health system. The patient voice is captured through Solicited Feedback, Patient & Family Advisor Programs and Verbatim Feedback. Presentation finishes with a discussion about the Future Of Patient Feedback. Some of those areas: Using patient segmentation to group patients into distinct segments, Asking patients unique questions to understand their primary concerns, Asking planned admissions who helped set their expectations?
Asking new patients what was their prior perception compared to reality?
5 Reasons the Practice of Evidence-Based Medicine Is a Hot TopicHealth Catalyst
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
This document discusses best practices for implementing and improving telemedicine services. It addresses project management processes, billing guidelines, maximizing physical exams during telemedicine visits, integrating ancillary services like nurses and social workers, ideal settings for telehealth, developing patient-physician relationships remotely, and provides examples of telemedicine modalities like telephone, video and portable carts. The document aims to help optimize clinical workflows and revenue cycles while maintaining standards of care.
The impact of high-capability electronic health records on length of stay. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 12 November 2014, 11.15am, Marlborough Room 3
This document summarizes the background and work of Prof. Steven H. Shaha, who has published over 100 peer-reviewed publications and presentations on using analytics and clinical decision support systems to improve healthcare quality and outcomes. Some key points discussed include using analytics of electronic medical record data to reduce sepsis rates and length of ICU stays, developing alert systems to more quickly recognize and treat at-risk patients, and creating connected networks between healthcare providers to better monitor population health and improve outcomes for conditions like diabetes.
This document discusses quality improvement in healthcare. It begins by posing questions about defining quality, what quality improvement is, and how quality can be improved. It then discusses the safety paradox in healthcare - that despite highly trained staff and technology, errors are common and patients are frequently harmed. Several studies on adverse event rates in hospitals are summarized. The document discusses concepts for safety and quality improvement like reliability, variation, measurement, and change management. It provides examples of quality improvement tools and approaches like process mapping, care bundles, measurement, and the PDSA (Plan-Do-Study-Act) cycle. Overall, the document provides an overview of key issues and approaches related to quality and safety in healthcare.
We welcomed Dr. Andrew Feifer for a presentation about Ned, an app designed specifically for prostate cancer patients, as well as a discussion about the incorporation of data driven smart technology in the survivorship of cancer patients.
The webinar was followed by an interactive question & answer session.
Ned was conceptualized and co-founded by our webinar presenter: Dr. Andrew Feifer, a Urologic Surgical Oncologist at Trillium Health Centre in Toronto. Dr. Feifer evisioned a tool that would empower prostate cancer survivors by putting their health into their own hands and giving them more options to manage their own care.
Maxine Powers, National Improvement Advisor at Department of Health, addresses Why QIPP and why now?, Programme design, National Work stream plans for safety and the role and contribution of AHPs. COT Annual Conference 2010 (22-25 June 2010)
The document discusses challenges in healthcare transitions and coordination between different providers. It proposes a new model of care for hip and knee replacements that includes centralized intake clinics, case managers, data-informed quality measures, and case rate funding. The model aims to improve outcomes, efficiency, and reduce delays. It also describes programs for fragility fractures and hip replacements that have improved access to surgery and reduced lengths of stay.
This document discusses big data in healthcare and physical therapy. It provides an overview of ATI's use of big data through its large patient outcomes registry, which includes over 800 variables and has been accepted into federal registries. ATI leverages data on patient demographics, referrals, outcomes, satisfaction surveys, and costs to enhance care and outcomes. The challenges of evidence-based medicine in an era of big data are also examined, highlighting the need to reconcile evidence-based and precision approaches through standardized sharing of data.
Quality, Innovation, Productivity and Prevention in Primary CareNHSScotlandEvent
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
Getting started at the national level from demonstration to spreadProqualis
This document summarizes a presentation on implementing and scaling patient safety programs nationally in Scotland. It discusses how Scotland implemented a national patient safety program across all hospitals to reduce mortality and adverse events. Key points included establishing clear aims to reduce mortality by 15% and adverse events by 30%, implementing improvement programs in five areas, achieving significant reductions in outcomes like ventilator-associated pneumonia and central line infections, and creating the conditions for large-scale change through establishing aims, priorities, measurement, resources, and testing and spreading new learning.
Clinician Satisfaction Before and After Transition from a Basic to a Comprehe...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
Making Healthcare Waste Reduction and Patient Safety Actionable - HAS Session 6Health Catalyst
Multiple studies have estimated that at least 30% of US healthcare expenditures are wasteful. But how do you identify and reduce that waste? In this session, we will share with you a three-part framework for understanding, measuring and addressing waste reduction. In particular, we will highlight the importance patient safety and injury prevention, framing the importance of shifting from a system of incident reporting (which creates a culture of blame and guilt) to a system in which patient injury is regarded as a process failure rather than a person failure. To make that transition, health systems will need to 1) define process flows and metrics for each major type of patient injury; and 2) create a learning environment in which team members are engaged in process redesign to prevent process failure and injury. A leading health system in patient safety and quality will also share their best practices in how they have created a culture of patient safety and quality.
Acute hospitals end of life care best practiceNHSRobBenson
Delivering reliable best practice in an acute hospital setting for patients whose recovery is uncertain. Including details of the AMBER care bundle. Presentation from Anita Hayes and colleagues from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
The document discusses the physician voice in adopting new technologies like electronic medical records (EMRs). It notes that the physician voice has both an external role advocating for patients and an inner role considering personal impacts. Successful adoption requires addressing physician concerns about privacy, workload, and local needs through collaboration between physicians and other stakeholders. It outlines models used in Vancouver Coastal Health to engage physicians through user groups and champions to provide feedback and guide implementation.
An opportunity to hear how service redesign positively impacts on the patient experience and improves outcomes for both the patient and NHSScotland. Showcasing examples of changes to pathways of care in orthopaedics and community support for people with complex and chronic conditions.
Slides from the 'Improving access to seven day services' event June 2015NHS Improving Quality
This document provides information about an event to improve access to seven day services in the NHS England Greater Manchester & Lancashire region. It includes the agenda for the event, with presentations on topics like the national agenda for seven day services, clinical standards, self-assessment tools, and case studies from organizations implementing seven day services. Wrightington, Wigan & Leigh NHS Foundation Trust will present their experience in delivering seven day services, including how increased consultant presence on weekends and improved diagnostic and support services have reduced weekend mortality rates. Interactive polling will gather input from attendees on challenges and priorities for seven day services implementation.
The document describes the Safer Patient Flow Bundle implemented at Ipswich Hospital NHS Trust to improve patient flow and prevent unnecessary waiting. The bundle consists of 5 core components: Senior Review, All Patients, Flow of patients, Early discharges, and Review (SAFER). If all components are followed, it will improve the patient experience and support safe, timely discharges. The bundle led to an 11% increase in daily discharges, reduced length of stay, and allowed closure of an escalation ward over peak winter months.
This document outlines a proposed physical therapy at orthopedic sarcoma (PTOS) project. The project aims to improve outcomes for sarcoma patients undergoing surgery by implementing prehabilitation (physical and mental preparation prior to surgery). A key aspect is developing a 10-question screening tool called the "Shah screening tool" to identify patient risk factors and determine what pre-surgical interventions may help, such as physical therapy or counseling. The tool would be implemented using the electronic health record and assessing patients. It is believed this could help address issues like longer recovery times and poorer outcomes from factors like depression, diabetes or poor physical function. The document outlines the project team, governance, plan, process changes needed and communication plan to stakeholders like
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
NICE Master Class final presentation 25 11 14 (including workshops)NEQOS
Collaborating for Better Care Partnership Master Class with NICE: 'Putting Evidence into Practice' - complete ppt slide pack including the workshop ppts and web links.
Similar to Early benefits and impacts of EPR implementation (20)
The Diabetes Discovery Project at Austin Health aimed to use their Cerner EMR system to routinely test HbA1c levels on inpatients over 54 to identify undiagnosed and poorly controlled diabetes. Testing of over 5,000 patients found 5% had undiagnosed diabetes and 29% had known diabetes. Higher HbA1c levels were associated with increased hospital admissions and longer lengths of stay for surgical patients. The project demonstrated using health IT to identify diabetes management opportunities. Ongoing work includes refining protocols and expanding to other patient populations.
This document presents a proof of concept for using Twitter data to conduct syndromic surveillance for public health monitoring. It analyzed tweets containing the keyword "measles" between 2014-2015 and found 1,408 relevant tweets. The number of tweets mentioning measles was compared to confirmed measles cases from a national surveillance system, showing potential for Twitter data as an early warning system. However, limitations include using a single keyword and the free Twitter API. Future work proposed improving data collection, applying machine learning techniques, and validating tweets with other health data sources.
The document discusses using surface modelling and mapping techniques to analyze healthcare data. It provides three scenarios as examples: 1) Mapping KPIs regionally to identify opportunities for improvement, 2) Mapping data around a specific pharmacy to examine market penetration, and 3) Comparing the market penetration of two smoking cessation medications. Surface mapping allows easy visualization and comparison of multiple data layers, helps protect patient privacy, and can provide insights into how to optimize outcomes.
The document summarizes how providing laptop computers to clinicians in a community allied health service has enhanced clinical care. Each of the 20 clinicians was provided a laptop with mobile data and remote desktop access to complete administrative and electronic tasks in the community rather than returning to the office. This has increased efficiency by allowing timely and collaborative work, which has decreased stress on clinicians and allowed for more timely information sharing with children and families. Some challenges remain around the weight of laptops and continuing reliance on paper records. Future plans include providing iPads and moving to more paperless systems.
This document describes the development of an electronic workflow system called scope to improve surgical practice at a District Health Board (DHB) hospital. The goals were to seamlessly map the patient journey, accurately collect coded data, and leverage trusted data to inform clinicians. The system streamlines waiting lists, captures accurate operating notes, and facilitates morbidity and mortality meetings. Implementation across surgical specialties has achieved good compliance and uptake. Preliminary results found increased quality of notes, discussion of complications, and potential to change practice through advanced data analysis. In conclusion, scope has replaced a disconnected paper system with a seamless electronic solution that fully captures standardized data to improve surgical outcomes.
1. The document discusses how healthcare has progressed beyond just electronic medical records (EMRs) and is now focused on areas like mobile computing, health collaboration, cloud-based back office systems, health intelligence, and clinical grade communications.
2. It provides examples of how technology is enabling cross-campus collaboration, telehealth, clinical collaboration using medical devices and teleradiology, and clinical communications.
3. The document advocates for sustainable eHealth innovation beyond just EMRs and discusses how areas like health analytics, mobility for care, patient-centered care, and emerging technologies can further improve healthcare.
The document discusses empowering healthcare through technology that is safe, works for everyone, and leaves no one behind. It describes how digital technologies are disrupting traditional healthcare models and outlines opportunities to enhance patient and provider experiences through virtual care, remote monitoring, and analytics. Key goals are mentioned like reducing readmissions, increasing effectiveness, and improving clinical productivity. The future of healthcare is envisioned as personalized, connected, data-driven, and empowering every person and organization to achieve more through technology.
The document discusses using analytics and care coordination to reduce hospitalizations and arrests of mental health patients. It notes that around 10% of patients are readmitted to psychiatric hospitals within 30 days of discharge. Care coordination aims to break this cycle through improved outcomes, treatment adherence, continuity of care, and identifying high-risk patients. Analytics tools can provide predictive modeling, population clustering, and care quality analysis to develop insights. The goal is to engage all stakeholders to deliver an integrated care plan through data-driven insights and coordination between providers.
This document discusses allied health professionals and their role in the healthcare system. It lists various allied health roles and describes how they rehabilitate and enable patients by taking a collaborative and holistic approach focused on patient needs. The document emphasizes that allied health professionals help reduce health service needs by facilitating patients' independence and ability to remain in their communities. It argues that capturing allied health data can help provide visibility into their services, allow for quality improvement, and ultimately benefit patients through a more coordinated system where the "right intervention" is delivered at the "right time". The challenges of engaging stakeholders and integrating passive data extraction are also addressed.
This document discusses changes in clinical data collection and the role of clinical coders. It notes that data now comes from many sources through various mediums and is used for many purposes. Clinical coding translates medical descriptions into codes. While technology has improved coding efficiency, the role of clinical coders may change further as technology advances. In particular, widespread electronic health records could significantly impact current clinical coding practices and roles. The document urges clinical coders and organizations to consider how to prepare for and adapt to technological changes to ensure accurate and consistent health data collection into the future.
This document provides background information on New Zealand's national maternity system called BadgerNet. It discusses the existing national programs and governance structure in place. BadgerNet is being rolled out nationally as an end-to-end maternity information system to record information from conception to six weeks postnatal. It will be used across District Health Boards and in the community. The financial model and implementation process are also outlined.
This document summarizes a presentation given by Dr. Shaun Costello on oncology treatment patterns in the South Island of New Zealand. The presentation discusses the creation of the South Island Cancer Clinical Information System (SICCIS) to capture patient-level oncology data across multiple hospitals in the region. This includes implementation of the MOSAIQ electronic medical record system and a shared data repository called METRIQ. The goal is to analyze the treatment patterns and outcomes of cancer patients in order to improve the quality of care in the South Island. Examples of preliminary analyses of the data are shown, including cancer stages, treatments, and radiation doses for lung cancer patients.
The evaluation identified several unintended consequences of the electronic prescribing pilot including new types of errors related to prescribing workflows and system defaults. Key lessons learned were that ongoing training and engagement are needed as workflows change over time. Regular monitoring is required to identify errors and develop strategies to address them, such as simplifying multi-step processes and minimizing alert fatigue. Overall the evaluation found that electronic prescribing has benefits but also risks, and a focus on how systems are implemented and used is as important as the technology itself.
This document discusses emerging technologies in the pharmacy sector. It begins with an overview of the evolution of pharmacy and a discussion of disruptive technologies. It then examines specific emerging capabilities like online healthcare access in Switzerland, remote patient monitoring in Spain, and ingestible sensors. Exciting retail trends are also explored, such as using customer data to predict behaviors, billboards responding to airplane flights, and the potential of Li-Fi wireless networks. The document suggests several technologies may disrupt pharmacies or remain niche capabilities. Overall, it analyzes new digital innovations and how they could impact pharmacy services and the customer experience.
This document discusses the development of a smartphone app to help patients better manage their rheumatoid arthritis. Interviews with rheumatoid arthritis patients and healthcare professionals revealed key themes. Patients were enthusiastic about an app's potential to record symptoms and communicate with their care team. However, healthcare professionals were apprehensive about increased workloads. Both groups saw value in collecting patient-reported outcomes but acknowledged limitations. Next steps include piloting a new "RAconnect" app and conducting a clinical trial to evaluate its impact on disease management compared to standard care.
This document discusses various self-tracking tools and applications for health, fitness, and well-being. It mentions several companies and products including 23andMe for DNA sequencing, UBiome for microbiome sequencing, Dexcom for continuous blood glucose monitoring, and Jawbone UP and Fitbit for activity tracking. It also discusses ideas around open data, genomic APIs, geo-tracking health data, and future technologies like ingestible sensors. Overall, the document explores the growing field of self-quantification and personalized data collection for improving individual health and wellness.
The document discusses using theory-based research to improve health informatics (HI). It provides examples of testing theories from fields like communication, decision-making, and behavior change to optimize eHealth interventions before randomized controlled trials. Specific theories and studies testing things like how alert formatting impacts prescribing are summarized. The document argues this approach can help establish HI as a professional discipline by building a scientific evidence base for more reliable eHealth tools.
Unexplained variation in healthcare delivery in the US is examined through data visualization. Various charts and graphs are used to summarize data on cancer treatment, patient falls, medication management, and other metrics from different hospital sites. Effective data visualization techniques including tables, graphs, and encoding methods are discussed to help viewers understand patterns and trends in the data.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
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LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
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Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
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The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
1. Early benefits and impacts
of EPR implementation:
Immediate impact and ROI Findings
from the UK
Professor Steven H. Shaha, PhD, DBA
2. Prof. Steven H. Shaha, PhD, DBAProfessor, Center for Public Policy & AdministrationPrincipal Outcomes Consultant, AllscriptsFormer Director of Research, KLAS
100+ peer-reviewed publications, 200+ peer-reviewed presentations, 2 books
Advisory and consulting work for 11 governments on four continents
Professor or Lectured or at 14 universities and graduate schools
e.g. UCLA, Harvard, Cambridge (UK), King’s College, London University, South Manchester, Yale, Princeton, Columbia, Cornell, Zayed Univ(UAE)
Advisory and consulting to 50+ non-healthcare organisations, including
Disney, Ritz-Carlton, Coca-Cola, New Line Cinema, IBM, AT&T,
Time Warner, Johnson & Johnson, Marriott, 3 Depts. of Defense,
and Pharma: Sanofi, Aventis, Novartis
Education:
PhD, Research Methods & Applied Statistics
DBA, Business Administration (PhD)
MA, MEd, BS
Disclosures & Bio
3.
4. Sample of Peer-reviewed Journals
•Advance for Health Information Executives
•Advances in Patient Safety
•Agency for Healthcare Res & Qual(AHRQJournal)
•American Journal of Ob & Gynecology
•American Journal of Sports Medicine
•Applied Clinical Informatics
•Archives of Otolaryngology, Head &Neck Surg
•Breast Cancer Research and Treatment
•British Medical Journal of Quality & Safety
•Epidemiology and Infection
•Health Management Technology
•Healthcare Financial Management
•Healthcare Technology Management
•Intl. Journal of Medical Informatics
•Intl. Journal of Pediatric Otorhinolaryngology
•Intl. Journal for Quality in Health Care
•Journal of Arthroscopic and Related Surgery
•Journal of Clinical Ultrasound
•Journal of Emergency Nursing
•Journal of Mat, Fetal & Neonatology Med
•Journal of Neurosurgery
•Journal of Obstetrics and Gynecology
•Journal of Orthopedic Trauma
•Journal of Pediatric Emergency Care
•Journal of Perinatal Medicine
•Journal of Perinatology
•Journal of Shoulder and Elbow Surgery
•Journal of the Am Acadof PedOphth& Strab
•Journal of Ultrasound in Medicine
•Journal of Ultrasound in Ob & Gynecology
•Laryngoscope
•Nurse Executive Watch
•Nurse Leader
•Nursing Economics
•Pediatric Critical Care Medicine
•Pediatric Emergency Care
•Pediatrics
•RN Magazine
•Spine
•Intl. Journal of Pediatric Otorhinolaryngology
•The Journal of Bone & Joint Surgery
•Ultrasound in Obstetrics & Gynecology
5. The Dynamics in HealthcarePressure on every aspect of performance
“Variable demand with fixed capacity & poor patient flow.”
“Safety, quality and
value-based delivery.”
“Do more with less.”
7. 2.50
3.00
3.50
4.00
4.50
5.00
5.50
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Days
Elective LOS Trust-wide
3-Month Moving Average
Mean Pre vs Post June 2013
Elective LOS (Trust)
Lengths of Stay Trust-wide
Shaha SH, Neve M, Waktare J. (2014). Early Impact and ROI for EMR/EPR Implementation: Results from the United Kingdom. HIC 2014 –
Health Informatics Society of Australia (HISA), Melbourne, August 2014. Don Walker Award.
Elective LOS (Trust)
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
4.38 3.93 -0.45 10.3% 0.000
NOTE: Conservative estimated cases was 500 for 12 months
Impact of
pre-implementation
preparations and planning
Estimated impact: £10.1 million
36 Mo
avg.
8. Lengths of Stay Trust-wide
Impact of planned delay
in implementation
Current average
Shaha SH, Neve M, Waktare J. (2014). Early Impact and ROI for EMR/EPR Implementation: Results from the United Kingdom. HIC 2014 –
Health Informatics Society of Australia (HISA), Melbourne, August 2014. Don Walker Award.
Non-Elective LOS (Trust)
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
5.61 5.42 -0.19 3.4% 0.000
NOTE: Conservative estimated cases was 500 for 12 months
Estimated impact: £7.2 million
9. 0.00
0.02
0.04
0.06
0.08
0.10
0.12
0.14
0.16
0.18
0.20
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Days
Pre-Op LOS - Elective
Mean Pre vs Post June 2013
Pre Op LOS (Elective) TRUST
Pre-Op LOS
Pre Op LOS (Elective) TRUST
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
0.13 0.08 -0.05 38.3% 0.000
From 3.03 hrs to 1.87 hrs
Impact of
pre-implementation
preparations and planning
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Month
Current average
10. Pre-Op LOS
0.50
0.70
0.90
1.10
1.30
1.50
1.70
1.90
2.10
Apr-12
May-12
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
Apr-13
May-13
Jun-13
Jul-13
Aug-13
Sep-13
Oct-13
Nov-13
Dec-13
Jan-14
Feb-14
Mar-14
Days
Pre-Op LOS - Non-Elective
Mean Pre vs Post June 2013
Pre Op LOS (Non Elective)
Pre Op LOS (Non Elective)
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
1.84 1.53 -0.32 17.1% 0.000
Impact of
planned delay in
implementation
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Month
7.68 fewer hours
Current average
11. Did not Attend Rates
7
8
9
10
11
12
Patients
New Outpatient Did-not-Attend Rate
Mean Pre vs Post June 2013
Outpatient DNA Rate New Appts (Trust)
Outpatient DNA Rate New Appts (Trust)
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
10.53 9.44 -1.09 10.3% 0.000
Impact of
pre-implementation
preparations and planning
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Month
12. Did not Attend Rates
6
7
8
9
10
11
12
13
14
15
Axis Title
Follow-up Outpatient Did-not-Attend Rate
Mean Pre vs Post June 2013
Outpatient DNA Rate Follow Up Appts
(Trust)
Outpatient DNA Rate Follow Up Appts (Trust)
Pre Mean
Post
Mean
Net
Change
Pct Change
(+=improved) p-Value
11.56 9.25 -2.31 20.0% 0.000
Impact of
pre-implementation
preparations and planning
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Month
13. Pre Post
1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 2 3 4 5 6 7 8 9 10
Reduced Alert Fatigue and Need …
18. Average EMR Satisfaction
Average EMR Satisfaction
Shaha SH (2013). Comparative EPR Usability form the Clinician Perspective: What works and what doesn’t for impacting care. Digital Health Service Delivery – The Future Is Now. HIC 2013
Proceedings, Health Information Society of Australia, Melbourne, pg. 122.
Shaha SH (2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH (2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf & Exh, Birmingham, England, April 2013.
19. Average EMR Satisfaction
Average EMR Satisfaction
KLAS Survey Items showing
Significant Differences (p<0.05):
• Overall Satisfaction
• Ease of Use
• Supports Integration Goals
• Product Works as Promoted
• Quality of Implementation
• Money’s Worth
• Likelihood to Recommend
• Implementation on Time
• Delivery of New Technology
• Overall Product Quality
• Product Response Time
• Quality of Training
• Proactive Service
Shaha SH (2013). Comparative EPR Usability form the Clinician Perspective: What works and what doesn’t for impacting care. Digital Health Service Delivery – The Future Is Now. HIC 2013
Proceedings, Health Information Society of Australia, Melbourne, pg. 122.
Shaha SH (2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH (2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf & Exh, Birmingham, England, April 2013.
20. Average EMR Satisfaction
Average EMR Satisfaction
Shaha SH (2013). Comparative EPR Usability form the Clinician Perspective: What works and what doesn’t for impacting care. Digital Health Service Delivery – The Future Is Now. HIC 2013 Proceedings, Health Information Society of Australia,
Melbourne, pg. 122.
Shaha SH (2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH (2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf & Exh, Birmingham, England, April 2013.
Sample sentiments from IT Professionals:
• The prescriptive implementation was very effective – no arguments with users
• Clinicians adoption was assured – it’s not an option – it was mandated
• Order sets were finally reduced to where we knew they should be
• The vendor/supplier does not abide neither discontent nor dissension
• The IT workforce is prescribed and more than adequately scaled
Sample sentiments from Clinicians:
• The limited number of order sets allowed was strictly (restrictively) enforced
• We gave up many we had worked through – they prescribed the limited #
• Suggestions for improved adaptability for my practice were not options
• I cannot access my data beyond pre-programmed screens or reports
• I still need my own database for research purposes
• Innovation and integration are limited – we’re back to one-off separate systems
• Any comments regarding “something better” became intolerable
Shaha SH (2013). Comparative EPR Usability form the Clinician Perspective: What works and what doesn’t for impacting care. Digital Health Service Delivery – The Future Is Now. HIC 2013
Proceedings, Health Information Society of Australia, Melbourne, pg. 122.
Shaha SH (2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH (2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf & Exh, Birmingham, England, April 2013.
21. 21
A
• Model A
• Less with Adaptability & Customizability
• Implement & Adjust
• Applications adapt
Average EMR Satisfaction
Average EMR Satisfaction
Schism Model
More Prescriptive … versus Adaptability & Customizability
Implement & Comply
Users adapt
Schism no mystery
Who wins and
Who loses?
Shaha SH (2013). Comparative EPR Usability form the Clinician Perspective: What works and what doesn’t for impacting care. Digital Health Service Delivery – The Future Is Now. HIC 2013
Proceedings, Health Information Society of Australia, Melbourne, pg. 122.
Shaha SH (2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH (2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf & Exh, Birmingham, England, April 2013.
The Golden Rule
22. 22
•Adaptive Model
•Less Prescriptive with Adaptability & Customizability
•Implement & Adjust
•Applications adapt
Reasons for Variability:
•Internal priorities
•Application updates
Everyone wins together
Y-Axis is expanded here to enable better visibility. Actual data were LESS broad from highs to lows
Shaha SH(2013). Comparative EPR Usability form the Clinician Perspective:What works and what doesn’t for impacting care.Digital Health Service Delivery –The Future Is Now.HIC 2013 Proceedings, Health Information Society of Australia, Melbourne, pg. 122.
Shaha SH(2013). Benefits and Outcomes: Models for Getting the Most Out of Your EPR. EPR Awareness Forum: Sharing Best Practice from UK, Europe and the US, Manchester, UK, May 2013.
Shaha SH(2013). Clinical Systems Applications and Related technology: Today and into the Future. HC 2013: The National Health IT Conf& Exh, Birmingham, England, April 2013.
23. Lessons Learnt: •The EMR is not “electronified paper”
• Computers that Compute
• Programmability
• Clinical Intelligence
•Adaptability and Interoperability
• Rigidity vs. Openness
•Local Innovation then Broader
Standardization
• “What work here with our needs and capabilities”
• Try, refine, prove … then standardize … then innovate
•Access to Clinical Data
•Community Connectivity
•Outcomes-driven
• Clinical
• Efficiency
• Cash Releasing and Cost Reducing
• Clinician Satisfaction