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

October 31, 2008


Filed under: — John Kaschko @ 10:29 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. 

First, they indicated how we have built and are using Epic is at a higher level of optimization compared to other customers around the country.  While it’s good to know at GHC we’re “all good looking and above average” as Garrison Keillor would put it, they were able to make us aware of some functionality we didn’t know about that we believe will be helpful to the medical group.  Some of the items seemed relatively easy to add and some would take much more time and configuration.

On the relatively easier side were a new Result Note button functionality, a “push pin” function on Problem List to indicate chronic medical conditions and an enhanced “Result” message display.

A different Result Note button functionality is available that displays more information and a better format.  Currently if you open a Result Note, to see the actual result, you need to click on the “Result Report” tab in the Result Note…then go back to “Actions” to place your note.  The new functionality displays both of these on one page, saving clicks.  There is still a second page but this page will display the 3 most recent results for the same test.

The “push pin” functionality on Problem List is basically like the red check mark indicating an active medication, but when you click in front of a diagnosis on the Problem List, it places a red pin in front of the problem to indicate this is a “chronic” problem and moves these diagnoses to the top of the list.  This allows more organzation of the Problem List in an easier fashion.

The enhanced Inbasket Result message will display the 3 most recent results for a particular lab test in addition to the current result.  Since many times the first thing we do when we look at a new result is to go to Chart Review and see how this compares to earlier results of the same test…this enhanced message helps avoid a number of mouse clicks.

Other ideas included discussion on how Reporting Workbench/population management functionality might be improved (biggest problem with this at GHC is system speed/response, and they had ideas on what could improve this) and changes to how we build Best Practice Alerts to make them display better (there are ways to sort/organize them and also have some open or collapsed based on user role).

We are excited about a few these that appear fairly easy to add to our system. Technical staff time is in short supply with the Practice Management project, so the easier a functionality is to get into Epic, the more likely we can make that happen in the near future (next 6 months).

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