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

October 31, 2008

Epic Optimization

Filed under: InBasket,Lab — John Kaschko @ 10:36 am

This week, David Kauff and I had an opportunity to meet with 2 members of the Epic Optimization team that traveled here from Madison.  They spent some time at the Downtown clinic observing workflow and how Epic is used as well as spending time with members of our Epic technical team.  There are two types of “optimization” to keep in mind with Epic….an individual user level optimization, helping each  person use  Epic to maximal value and efficiency, and system level optimization, having our configuration or set up of Epic be optimal for delivering care across our organization.  Obviously to the extent our Epic configuration is “optimal,” this helps individual users be most efficient. This visit was about looking at the system level optimization of Epic, based on their experience with other customers and the indepth knowledge of the capabilities of their software. (more…)

October 30, 2008

It doesn’t take technology to make a difference

Filed under: Quality / Affordability — Tags: — Matt Handley @ 7:47 am

While riding up Capital Hill on a dark, rainy morning I was listening to a medical podcast that is put on by the “InfoPOEMS” group (remember that POEMs is an acronym for “Patient Oriented Evidence that Matters”).  Of all of the articles that I have read in the past year, this one is likely to have the biggest impact on my practice – and it will be the easiest change in practice that I could imagine implementing.  It is not about a new diagnostic test or a new treatment.  It is about something fundamental and absolutely necessary for great care.  All the study tested was the impact of changing our language when wrapping up a visit – many of us ask, with good intent, something like “Is there anything else you would like to address in the visit today?”.  The researchers tested the the impact of changing one word – “anything” to “something”.  Not a big deal.

But – a surprisingly big difference in the visit.  When “anything” changed to “something” patient were much more likely to share a concern.  From the study:


October 26, 2008

American College of Surgeons

Filed under: Electronic Chart,Lab Release,MyGroupHealth — Marc Lowe @ 8:41 am

I recently spoke at The American College of Surgeons meeting in San Francisco (October 12, 2008).  The annual meeting of surgeons, from all over the world representing many different surgical specialities, is an impressive venue.  A great opportunity to showcase our accomplishments and experiences.  I was asked to speak on the topic of “what happens when you release health care information to patients”.  Because our organization has been at the forefront of this new move to release health information to the patient, we’ve built a solid reputation and it’s earned our organization well deserved respect in the area of patient focused health care.   This was evident when I was introduced to the attendees.  In general, surgeons aren’t normally considered on the leading edge of accepting and adapting to change.  Years of doing things the same way, creates mostly good, solid habits that are sometimes almost impossible to change. Nevertheless, I got the sense that the surgeons that attended my talk, were hungry for any information they could absorb regarding using technology to better care for their patients.  My talk centered around our experience with releasing health care information to our patients.  I believe my talk was well received, and as further evidence of such, many surgeons had questions for me after the talk concluded.  The myths and reality of what we have experienced, and continue to experience are great learning opportunities to the rest of the health care world.

Marc A. Lowe, MD

October 22, 2008

AHRQ- EHR Safety Conference

Filed under: Safety — Tags: — David Kauff @ 12:13 pm

I am here in Washington, DC representing Group Health at this international meeting about HIT and Safety. The Agency of Healthcare Research and Quality is a small organization under the government Agency of Health and Human Services.

Our presence here is yet another great reminder of the far reach Group Health has in the national conversation about health care and innovation. This meeting is a ‘think tank’ of sorts, getting the right people in the room to discuss and formulate the next steps for EHR venders, clinics and hospital systems to innovate around patient safety and IT.

Take home questions from this first day are:

  1. Group Health has a great ERT system and can create a Hazard Tracking system to be more proactive instead of reactive in regard to patient safety events. Some large groups have both hazard tracking, which predicts when there will be potential safety issue as well as ERT sytems like our own.
  2. Evaluation of the balance between Providor Education vs. Forcing Functions (BPA’s and HM Alerts) as to the best way to provide safe care. ( the evidence is mixed on which works best)
  3. e-Iatrogenesis – A new word to me. The study of the new social pressures on delivering care in the electronic age. Understanding the chance of harm caused by the application of health information technology. Errors of omission, commission and of dismissal when relevant alerts are ignored.

Many good questions in the room today. Will add more tomorrow

October 19, 2008

AVS Adoption

Filed under: After Visit Summary — Tags: — David Kauff @ 12:22 pm

Spreding the word about using the AVS is a story that almost tells itself.  Recent work both in Primary Care and in Genetics and General Surgery has reinforsed that the use of this tool is easy to do, increases patient satisfaction of the visit and decreases down stream work.  In General Surgery, there was great interest in using this for both preoperative and postoperative care and the seed was planted to create a shared library of smart phrases that are available to the department.  Providers can obtain CME credit for building smart tools that are placed within the body of the AVS.   The chart here shows the great strides in usage over last 2 years.  The next goals are to spread the adoption of the tool accross all departmetnts.  CIS Consultants are available to help providers both create standard tools and phrases for the AVS as well as work out workflow issues in the clinics.  AVS In Primary Care

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