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

January 27, 2006

Radiology Renaming

Filed under: Radiology — admin @ 10:36 am

What Follows is the beginnig work on Radiology Renaming in Epic. The work began in the Burien these last two weeks and is shifting now into high gear.

Vision Statement: The purpose of this work is to define and clarify the names of body imaging studies to ensure that the correct and desired test ordered exactly answers the clinical question at hand. The scope of this project is to make the names of commonly ordered studies understandable, to offer details about the test i.e. number of views and the indication for the study, i.e. DJD vs. Acute Fracture. The endpoints of this work are improved patient satisfaction and safety, accuracy of ordering and improved outcomes.

Issue: Epic Functionality: Where it the best place in Epic for this information to exist? Two places are obvious. In the Order field and subsequent preference lists for studies that come up. The other is SmartSets. Concern exists from a few providers that Smartsets are cumbersome and of limited use, others find them helpful. We have no current robust information on the actual use of SmartSets in the clinics.

Pros and Cons of SmartSets and Preference Lists:

SmartSet Pros:
1. Clearly organized and have more space to put useful information for indication and reason
to order the test.
2. Can be arranged by either body type or study type i.e. Chest Exams or CT tests
3. Can be ordered and information sent to Patient Instructions and AVS for ease of referral.

SmartSet Cons:
1. Change in workflow. No longer ordering Images in ‘Orders’.
2. Perception by some that sets are time consuming and cumbersome.
3. Require learning and adaptation of new process ( maybe that is a Pro )

Preference List Pros:

1. Current model. Providers are comfortable with this way of Ordering all things.
2. Look in only one place for multiple types for orders. Labs and Images etc.

Preference List Cons:

1. Limited character count to put information, paucity of free text to explain the studies
2. Difficult to organize by body location, easier by type of study
3. The ‘old’ way of doing things may not be the best way.

Summary:
We require a clean and easily adaptable way of ordering the right imaging study 100% of the time. It is posited the a third of studies are ordered incorrectly causing dissatisfaction among patients and providers. SmartSets could serve to choose the right test for the right reason. They would could educate and improve safety and quality. Preference lists from the order menu are the current standard. There is comfort there. They could be improved with more clinical information. We will build out better Radiology Orders and put them in the optimal place in Epic.The ideal process and final process for this is still being researched and discussed.

January 26, 2006

Reduced publishing schedule

Filed under: About this Blog — admin @ 7:04 am

This blog will be on a reduced publishing schedule until February 8, 2006, while your Medical Director of Informatics goes on vacation.

The Medical Director of Informatics during this period is John Kaschko, MD. He will handle any emergent issues that come up. Matt Handley, MD is also available as needed.

January 25, 2006

Burien Rapid Process Improvement: More Photos

Filed under: Burien,Optimization,Quality / Affordability — admin @ 6:18 am

More photographs from the Quality Improvement Support Team (QIST) at Burien Medical Center. Burien is helping to introduce the new Population Care Outreach Model for Group Health Cooperative.

The information technology infrastructure that Group Health has to make this work possible at a medical center is nothing short of incredible – a full Epic factory can now be located in any Group Health facility.

Click on any image to see it full size

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January 24, 2006

Burien Rapid Process Improvement Newsletter: Day 4

Filed under: Burien,Optimization,Quality / Affordability — admin @ 6:42 am

Newsletterday4

The team continues to make impressive gains, with some key “wins” on Day 4.

January 23, 2006

Burien: More Goodness

Filed under: Burien,Electronic Chart,Optimization — admin @ 1:49 pm

Because the Epic team is here with our providers and nurses, we are able to quickly act on issues. We have already done several:

1. The “Disposition soft-stop” on telephone encounters is now gone. As of this morning, whenever you close a Telephone Encounter, you will no longer be asked to complete the Disposition section of the telephone encounter.

2. A bug identified when reviewing results has been quashed. This morning when shadowing providers we noticed that the information in the “Encounter Department” column, used to find urgent care lab results, was not correct. That was immediately fixed.

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