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

April 28, 2006

Eastside Medical Center – Emergency Room Weekly Status Report – Week Two

Filed under: Rollout — admin @ 5:52 pm

What is the overall clinic assessment to date?   

Most users are becoming confident with the application and have exceeded expectations.  Smart tools were introduced this week in training.  Most providers realize the eventual value of the phrases and text, but wish more and better (ED specific) texts had been built.  Some are excited to build or modify existing tools to fit their practice.  Smart phrases were well received by the nurses and most nurses are building personal phrases on an aggressive schedule.  Daily there are fewer and fewer workflow modifications and the staff is really embracing the application into their practice.

·        Overhead from an agency nurse: “Compared to Cerner and other EMRs, EPIC ROCKS!”

·         This ED Assessment in short – Exceeding expectations
 What is the current productivity range for providers in this area (or department)?  What is the plan for increasing the number of patients seen per provider? 

As stated above, most providers have exceeded expectation.  It is realized that some extra staff has been in play for support, but as the providers have become more productive, this has caused some discussions at the trackboard like “I’ll take that one.” “No I’ll take them.” “I saw them first.”  Nurses are still very busy as the entering of tracking fluids, medications, I&O.
 

Where are the current problem areas (or departments) and/or difficult workflows?  
   

·        The biggest frustration is the access for specialist, hospitalists, Resp and PT/OT techs.  Much work is being done in this area and we expect resolution next week. 

·        All workflow problems, with the exception of PPD, have been worked out.  PPD is in final approval stage.

What are the most common concerns among clinic staff?  Do the Nurses have different concerns than providers?  

   

·        Finding out everything about the system that we haven’t trained them on. (Images etc)

Which EpicCare feature is causing the most frustration among users?  (i.e., Order Entry, Documentation, general patient flow, TEs, etc.)  

   

·        Order entry still the thorn but they are adapting and remembering what exactly to select.

What do clinic staff need most from the CIS Team to succeed in the next week?  Which RightNow incident, if resolved, would have the biggest positive impact? 

   

·        We will start shadowing next week to help identify ways to make them more efficient. 

Access:
·        We continue to work on access for those individuals who provide patient care within the ED. Next Tuesday we will be giving access to MSW, PT/OT, RT, and IV Therapy. The next group that we will work with is the remainder of the Specialists.

 

Issues:
·        Identification of issues has dropped drastically. There are suggestions for enhancements and tweaks that will be considered by the CORE Team. The CORE Team will be meeting next week to determine which of these suggestions make sense to complete prior to the next implementation.

 

Support:
Both technical support for this implementation, and continued support have been determined.    

·        An On call schedule has been determined for the remainder of this implementation from the build team.

·        CI Support has been reduced to on call at your desk during working hours of operation, and RNDB requests.

·        Continued support has been discussed between Emily Hull and MCA’s. Ambulatory CISS will provide limited support to the ED staff after the blue shirts move on to the next sites.

 

Newt Gingrich sees how GHC is Transforming Healthcare

Filed under: e-health news — admin @ 7:18 am

Newt Gingrich was in Spokane tuesday to speak on Health Transformation at the Northwest Medical Informatics Symposium. While his philosophy on funding healthcare and his comfort with pharmaceutical companies differs quite a bit from mine, he had some good things to say about the need for radical change in the healthcare environment, and the role of informatics in making those changes possible.

After his lecture he came to Sacred Heart Medical Center to see how INHS is implementing clinical data systems. I had the opportunity to demonstrate how the Group Health Hospitalists access region-wide INHS data via PDAs and wireless laptops, and how we are able to integrate this data with a regional PACS system and the various outpatient EMRs. I was also able to include a demo of how we use Epic at the bedside via remote access, and how patient and staff secure messaging fit in the overall care process.

It was a fun experience, both because Newt is quite a performer, and he and his partners are trying to push the envelope about informatics and regional health information networks, and because we at Group Health are truly at the cutting edge of this transformation.

Keep up the good work!

TS

Live From The Field

Filed under: QISTs — admin @ 5:41 am

Another step into the future!
Ted has set up the informatics Blog to allow postings from email – virtual blogging, removing the small hurdles that now exist. Debates about the wisdom of enabling Blackberry participants should be suspended as we try this out.
Today we are reviewing the work of the model of QISTs and how to improve the engagement with our delivery system colleagues, and then meet with Art Resnick of central cardiology to begin the conversation of how we can improve the care of patients with (and at risk for) cardiovascular disease.
Matt Handley MD

April 27, 2006

‘Expiring Orders’ In Basket Message Go Live

Filed under: Quality / Affordability — admin @ 1:32 pm

Today  the new Epic InBasket folder was turned on.  This functionality replaces the MyEpic report ‘Expiring Standing Lab Orders by Provider’ that was phased out in January 2006. Since that time, there have been no notifications of standing orders that have expired or are soon to expire.  Providers started seeing this function this morning and the implementation has gone without a hitch. We are now able to cancel or reorder expired standing orders.

With this new functionality in place, all expired labs prior to January 1, 2006, will be deleted from the system.  All labs that expired subsequently or are scheduled to expire in the next two weeks will be sent to the new ‘Expiring Orders’ In Basket folder

If you have any questions or concerns, please see the linked instruction sheet that outlines this process or contact your local CIS Specialist. Instructions: http://incontext.ghc.org/cis/documents/ExpiringOrdersInstructionsheet.pdf

Epic health maintenance letter – “hello, world”

Filed under: Quality / Affordability — admin @ 7:49 am
Maintenance Lettermaintenance letter 2The first health maintenance letter printed from EpicCare; Lori and Russ show off the limited edition first run.

The Epic team has been successful in generating the first health maintenance letter from our clinical information system. This first letter is capable of searching our clinical database, looking for patients with diabetes and heart disease, and generating a single letter to patients that lists several health maintenance procedures that are due soon or overdue. As designed, it will not send multiple letters to patients with multiple conditions. This is an important breakthrough.

During this ACC Quality Improvement Support Team week, we’ll continue work on this piece as well as looking at how this will interact with MyGroupHealth in the future. This is exciting progress.

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