It’s Not About The Box Improving Care at Group Health with People, Process and Technology

June 30, 2005

E-visit navigator: Pending orders for another person

Filed under: MyGroupHealth — admin @ 6:55 am

The new Orders button in the Patient Secure Message In Basket folder helps providers efficiently place orders related to messages from patients. The Orders button takes you to a visit navigator where you can place orders and route the message as an FYI to another provider’s Patient Call folder.

The routing functionality was intended only to CC messages as an FYI because it is not intuitive to have these messages show up in the Patient Call folder and we don’t have any other option at this time.

However, users quickly discovered that they can Pend orders and route them to another user. Unfortunately, the routed order goes to the second user’s Patient Call folder where it is difficult to return to the navigator to sign the order.

Instead, we recommend this workflow for flow staff:

– Pend the order and do not route

– Exit workspace, return to In Basket and forward the patient’s message to the provider

– The provider can easily sign the order after the forwarded message arrives in the Patient Secure Message folder

June 29, 2005

Study: Time-Motion Analysis pre-post EMR

Filed under: e-health news — admin @ 6:42 am

Study: Time-motion analysis of primary care physicians before and after an electronic health record

A recent article published by the research team at Partners Healthcare in Boston (click here to view it) sought to quantify the differences in time spent on patient care activities before and after the installation of an electronic medical record (EMR).

The researchers did detailed in-person observations of 20 physicians before and after the installation of the EMR (about 160 hours total of watching). They found that the overall “time spent per patient” in all activities during the clinic day (direct and indirect) was 27.55 minutes before the EMR and 27.05 after, a non-significant change.

A missing piece of data, acknowledged by the authors, is time spent after the clinic session on patient documentation activities. By self-report, 65% of physicians asked said that they did documentation after-hours on 66% of patients. This would calculate out to about 43% of patients by self-report. 71% of physicians surveyed perceived that their workload had increased.

There are key differences between the set-up at Partners and Group Health, and specific aspects of the study that affect interpretation of the results. For example, level of service and test ordering remained on paper after implementation.

These are the most significant take-aways for your Informatics Team:


June 28, 2005

User Group Meeting Presentations now online

Filed under: User Group — admin @ 6:38 am

Powerpoint presentations are now available on InContext from the June User Group meeting:

Clinical Informatics home page

Presentations are on the bottom left corner of the page.

June 27, 2005

Informatics Rounds Report: Everett Medical Center

Filed under: Informatics Team,Scanning — admin @ 12:29 pm

I visited Everett Medical Center on 6/23/05 as part of “Informatics Rounds.” This involves spending the day at a Group Health Medical Center, rounding on providers instead of patients.

I spent some time with Steve Burrows, MD, and Shauna Smith, MD. In addition, a national Webcast occurred between Epic Systems, from Wisconsin, and several key clients, to discuss the future of the In Basket. I hosted the Webcast in the EVM conference room, with Fabian Jiminez, EVM’s CIS Specialist, in attendance.


Epic Performance (Speed)

Filed under: Technical Issues — admin @ 6:46 am

The CIS team is looking at the performance (speed) of EpicCare in our clinical environments. The speed of a networked application is, unfortunately, a multi-factorial issue.

The similarity would be to something like blood pressure treatment – a patient’s response to a medication will be dependent on the chemistry of the medication, the patient’s biology, their lifestyle and adherence.

This issue is managed by both the Informatics Division, and our partners in the Information Services Division. ISD manages the network, the devices, and the software. Informatics manages the tools within the software and they way they are built.

Attached is a list of activities that ISD is engaging in now, to assess issues around performance.


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