Electronic Health Records:

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• Electronic Health Records
• Beyond our Wildest Dreams!
• The Institute for Urban Family Health
• 16 East 16th Street
• New York, New York 10003
• Neil S. Calman, MD
• President and CEO
• NCalman_at_Institute2000.org
• www.Institute2000.org

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The Institute for Urban Family Health

• Founded in 1983
• 7 Federally-qualified community health centers
  (FQHCs) (4 Bronx, 3 Manhattan)
• Contracted by Continuum to operate six health
  centers which are largely populated with patients
  in a risk contract with HIP
• 10 part-time clinics which provide care to people
  who are homeless including one for GLBT
  adolescents
• School health program at Washington Irving HS
• 24 Resident family medicine residency program
  co-sponsored by Beth-Israel Medical Center
• Partially supported by 23 different Federal,
  State and private grants to serve people with
  special health care needs

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The Institute for Urban Family Health

• Major Research and Development Initiatives
• Health Disparities Funded in 1999 by Centers
  for Disease Control to eliminate racial and
  ethnic disparities, now also funded with grants
  from the NYSDOH, NIH and foundations.
• Health Workforce Studies Bureau of Health
  Professions sponsored study to track workforce
  for underserved areas in the United States
• Information Technology New York Community
  Health Information Network - to spread expertise
  and technological capacity to other CHCs and
  model the benefits of electronic health
  information

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EPIC _at_ the Institute

• Installed in 12 full-time centers in Fall 2001
  with EpicCare roll-out in Spring 2002
• Sites have been paperless for almost 4 years
  now
• Installed in Residency Program July 2004
• Installed in 4 of 10 homeless health care sites
  remainder to be deployed in 2006
• School Health Site implemented in 2005
• Plan to bring on additional Federally Qualified
  Health Centers in the coming year in ASP model

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HgbA1c Progress
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The Benefit of Early Detection of Syndromes
Symptom Onset
Severe Illness

Number of Cases
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Days
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Institute patient fevers peaked 13 days before ER
visits for Fever and Flu this indicates that
health center data may be the first signal of
an impending epidemic.
Patients of the Institute for Urban Family Health
Institute fever data responded to Flu B
outbreak-ED data did not
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DOH receives signal of outbreak of diarrheal
illness in children
Practice Alert in EHR for age lt 18 yo, relevant
Sx/Dx, requests provider to do viral stool
culture and call DOH for immediate pick-up and
viral ID by DOH lab
Diarrhea