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

May 29, 2009

Great Weekend Read – Atul Gawande

Filed under: Uncategorized — David Kauff @ 8:44 am

So,  I’ll admit it.  I am a Atul Gawande groupie.  The Boston based general surgeon’s musing on heathcare are uniformly excellent.  We received his book  ‘Better’ at our annual meetnig.   His last New Yorker piece, ‘ The Cost Conundrum’ is a wonderful study of why healthcare is so costly and variable.  We are mentioned, if not by name exactly, as a model  for the future:

Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina—all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved. The difficulty is how to go about it. Physicians in places like McAllen behave differently from others. The $2.4-trillion question is why. Unless we figure it out, health reform will fail.

Here is the link the the full article.  I think it is a good twenty minute read on the deck this lovely weekend.
“The Cost Conundrum by Atul Gawande”

Break the Glass and BHS

Filed under: Improvement News — David Kauff @ 8:02 am

On June 9th, the Break the Glass  (BTG) function of Epic for Behavioral Healh Encounters will be removed for Providers.  The BTG function was placed to ensure additional security on portions of the behavior health record.  This good intention, over time, became an obstacle to care and transparancy.  Providers had to sign in to each behavioral health note to read the full details.  This was slow and frustrating to many.  Removing the BTG funtion for Providers will improve the ease of visabilty of all notes in Epic and will not comprimise the already excellent security that is in place.  The BTG function will not be removed for all non-provider staff and care team members.   This will be communicated via the CIS Newletter and HIM in the next 2 weeks.

May 22, 2009

Cardiology Service Line Update

Filed under: Uncategorized — David Kauff @ 9:07 am

The Cardiology Service Line has embarked on a great intiative to improve the quality and efficiency of it’s referral process.   Starting in early June, the Cardiology referral form will have a different set of questions to help providers order the correct proceedure or consult.  The aim is to decrease the error rate of the initial consult request (around 33%) and to minimize the time spent on clinical review by our Cardiologists (around 57% of all consults).  This will ensure that our members get prompt appointments with the correct diagnostic proceedure.  This same revamping of the referral process will likely occur with GI, where there are often requests for proceedures that do not always need a formal consultation.   Great work lead by Dolly Mangla,  Senior Lean Consultant.  I will post a mock up of the new improved referral form next week.

May 20, 2009

Group Practice Improvement Network

Filed under: Uncategorized — Gwen O'Keefe MD @ 11:14 am

Otherwise known as GPIN, has some great EPIC colleagues (such as Geisinger, Harvard Vanguard, Kaiser, etc) that we collaborate with. On our call today, there were a couple of hot topics that seem to be issues for everyone.
1. How to optimize users – several groups talked about having Mentor Groups -lead by non CIS/Informatics MDs – and some great ways they have empowered docs in the groups to help bring their colleagues along in their use of Epic. My favorite group was called “No Provider Left Behind”. I have had some initial conversations with some of you on identifying excellent users – I want to move forward in figuring out how we can improve our provider support model.
2. Interesting note on using tablet PCs – Harvard Vanguard is trying it out – but having great difficulties – limitation is printing when mobile as Epic not easily configured for that to work. Maybe they will work out the kinks, but it sounds pretty rough right now. The MDs overall do like it, but support staff don’t.
3. Epic’s Model System – I haven’t checked this out – if any of you have please let me know. Harvard reports that they are trying to move away from customization and toward a more standard implementation and are trying to use some of the Specialty Starter sets that are available in the Model System.

Lastly – they want to hear about how the process we use for Advance Directives – David Kauff has volunteered to share this which is tentatively planned for this summer sometime.

May 19, 2009

MyGroupHealth Patient Ed Material

Filed under: Uncategorized — Gwen O'Keefe MD @ 12:03 pm

I just finished a great meeting with Judy Hucka from the Web team and Kim Wicklund from Quality and Improvement. They were reviewing the effort,planned to go live in the summer, of reorganizing the patient content on the web. They have made it MUCH more user-friendly with great indexing to point people where to go instead of having to search for it.
An additional benefit will be that this will be public, so easier for our patients to access. Some of our clinical guidelines for disease specific care will be available publicly too.
The Diabetes page was terrific – well organized subheadings, for every aspect of disease management. Their usability testing has told them that people want to see subheadings and know where to go, rather than search around. This will give people that ease of getting what they need when they need it!
Look for communications about this in the summer!

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