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

February 25, 2009

Cleaning up the Preference Lists/changes to InBasket

Filed under: InBasket,Lab — John Kaschko @ 12:39 pm

We will soon be loading into our Production system changes to the Preference Lists which  will help make the Order Entry look-up screen “less busy” and cut down on the need to scroll to look for orders.  The current Preference Lists were built when we initally went live with Epic…there have been some minor changes/adds/deletions along the way…but basically they were built with Epic 2003 functionality in mind.  When we needed to change the Order Entry screen to “Clinician Order Entry” (in Epic-speak), that functionality changed how items on Preference Lists displayed.  In the past, the order entry screen would only display a specific order once.  The new functionality displays EVERY match,  so when a CBC, potassium, AST, etc is contained on several Preference Lists,  I’m sure you’ve noticed, the same test displays multiple times.  We have done some “clean up” to minimize the duplications and this will look much cleaner though some tests willstill display more than once (but not 4 or 5 times).   We did our best to make sure nothing got dropped off the Preference list…but apologize in advance if that occurred.

Another change we hope to get into place in the next month or so are changes to In-Basket to make it easier to deal with results.  One change will display the most recent results for the same  test you are reviewing. For example, when looking at a PSA, you will see the 3 most recent PSA results in the  In-Basket window without needed to open the chart, go to Chart Review, filter, etc.  The second change is a newer Result Note functionality.  The current Result Note functionality has a screen to place your documentation and on a second screen, you can view the actual result.  This new Result Note function will put all this in one window so you can see the result as you put in your documentation.

Personally I see these items as things that will help with workflow and efficiency and will save me clicks and scrolls.  While they aren’t going to “transform health care”…from the Informatics group, it’s nice when we feel we can give some useful enhancements to our medical group, particularly given the staff time limitations with the Practice Management project slated to go live in October of this year.

February 18, 2009

Obama’s EMR Stimulus Package and Us

Filed under: Innovation Adoption — David Kauff @ 12:44 pm

In the very near future, it is likely that healthcare information technology will be very different. In almost thirty years in this industry, there has never been an industry change of the depth and breadth that we are about to experience.

Last week saw the introduction of the first of the Congressional bills that will cause this change. These bills are part of a broader set of government efforts designed to stimulate the economy out of its distress. The healthcare IT portion of these bills intends to rapidly accelerate the adoption and effective use of information technology in healthcare. The House Ways and Means bill  describes some proposed changes:

·                Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR

·                Creation of HIT Extension Programs that would facilitate regional adoption efforts

·                Provision of funds to states to coordinate and promote interoperable EHRs

·                Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals

·                Creation of HIT grant and loan programs

·                Acceleration of the construction of the National Health Information Network (NHIN)

All of these changes are accompanied by the infusion of $20B into the healthcare sector. To put this in perspective, in 2007 the entire HIT industry in the US was $26B. It will be interesting over the next several months to investigate how this transformation in IT will affect Group Health.  As a leader of healthcare innovation, I wonder how we can both benefit from the injection of funding and how we can lead by demonstrating that our model of patient’s centered Informatics is the best way to improve quality and outcomes and diminish cost. There is an opportunity here for us, the scope in nature remains unclear, but it is gratifying to know that in times of change, our organization remains poised to continue to lead.

 (Excerpts from the EHR and HIPPA forum)

February 12, 2009

Improved Citrix performance on the Mac

Filed under: Remote Access — Tags: — Matt Handley @ 2:03 pm

I am sitting in Oakland at the KP National Quality Committee meeting, and doing secure messages with my patients and some Email as a background task – and it is a very different experience than it had been in the past.  I am working on  my personal Mac –  I have found that my GHC laptop is so burdened by the encryption (that is mandated by CMS, alas) that it is unusable for presentations outside Group Health

I had the misfortune (and silver lining) of having my MacBook Pro crash Sunday.  I had a recent backup on Time Machine (Mac’s cool back up program) and on Mozy (a great and inexpensive web based back up – $60 a year, unlimited volume in the “cloud”) so was able to easily bring all the data over to my brand new MacBook Pro (nothing like a rationalization for an upgrade!).  All good.

The “aha” that I wanted to share is that when I installed citrix on my new machine it was much better than what I had on my old mac.  I can now use the full screen, and many more keyboard shortcuts work in Epic and in Outlook.  The message – if you use citrix on a Mac and aren’t satisfied with the way it is working, consider uninstalling your old citrix client and reinstall the new one.  I would be interested in knowing if this works for others.

February 5, 2009

Social Media and Salmonella

Filed under: Uncategorized — Tags: , , — Gwen O'Keefe MD @ 4:11 pm

HHS is really moving into the 21st Century (even without Tom Daschle) – they’ve created a Center for Social Media that in 4 days developed a website packed with Web 2.0 tools in response to the peanut product contamination with salmonella.   You can get every flavor of tool here – widgets to get constant updates on the issue, podcasts, Youtube video from the CDC channel, … it’s cool.  Great site to refer patients to.

Try it from home to get access to everything.

February 4, 2009

“Googlizing” Urgent Care

Filed under: Care Management,MyGroupHealth,Quality / Affordability — Tags: , — Matt Handley @ 12:04 pm

Amazing statistic – if we could bring in the $40,000,000 in outside ED costs into the Group practice urgent cares, we could provide the same care for about $4,650,000.  That is not a typo.  The difference is $35,350,000.  Wow.

So – lets say that a patient is trying to find our urgent care.  They Google us.  And what do they get.  Well, if they Googled “Group Health urgent care”, until recently they got four GHC links – three of them to Group health Cooperative of South Central Wisconsin (a kindred spirit, but very different organization).  The one “real” GHC site just went to the front page of MyGroupHealth.  If they try “Seattle urgent care” they get a Google map image where we are one choice (about 4th or 5th), but that also goes to the front page of MyGroupHealth (where there is no obvious link to any urgent care locations).

The Web team was alerted, and in short order the “Group Health urgent care” search now is so successful that you can use “I’m feeling lucky” – that brings up the MyGroupHealth page with the the ED and UC locations.  Wow.  There is still work to be done to try to improve the choices when Google maps is represented on the page – the “mash up” still results in a poor search result.  We are hoping to at least have the GHC result get to the correct page.

Hats off to Drew Campbell and Judy Hucka of the web team – doing everything that the technology allows to help our patients find the information they need to manage theri health.  We will track the hits, along with the ED/UC utilization outside our system to see if it helps steer patients to our system.

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