INTEGRATING EHR

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INTEGRATING EHR

• SARA MCEVOY, PA-C 4TH STREET CLINIC
• ALLAN AINSWORTH, PHD WASATCH HOMELESS
  HEALTHCARE

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DISCLOSURES

• NOTHING TO DISCLOSE

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INTRODUCTION

• SARA MCEVOY, PA-C
• INTERNAL MEDICINE PROVIDER
• 4TH STREET CLINIC, SALT LAKE CITY, UTAH
• ALLAN AINSWORTH, PHD
• EXECUTIVE DIRECTOR
• 4TH STREET CLINIC, SALT LAKE CITY, UTAH

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4TH STREET CLINIC
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HOW WE USED TO DO THINGS
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WHAT WE DO NOWEHR
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WHAT WE DO NOWEHR
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USING EHR
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ELECTRONIC HEALTH RECORDS

• OUR RECOVERY PLAN WILL INVEST IN ELECTRONIC
  HEALTH RECORDS AND NEW TECHNOLOGY THAT WILL
  REDUCE ERROS, BRING DOWN COSTS, ENSURE PRIVACY
  AND SAVE LIVES.
• PRESIDENT BARACK OBAMA, FEB 24,09JOINT ADDRESS
  TO CONGRESS
• WWW.WHITEHOUSE.GOV/THE_PRESS_OFFICE/ARRA_PUBLIC_RE
  VIEW

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GOING ELECTRONIC

• GROCERY STORES ARE MORE AUTOMATED THAN
  HEALTHCARE.
• FORMER HHS SECRETARY TOMMY THOMPSON, 2004
• 1.5 U.S. HOSPITALS HAVE A COMPLETE EHR, 7.6
  WITH A BASIC DATA SYSTEM
• JAH, ET AL,. NEJM 4/16/2009 360, 1628-38. USE
  OF ELECTRONIC HEALTH RECORDS IN U.S. HOSPITALS.

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BENEFITS OF EHR

• IMPROVES EFFICIENCY
• 81 OF RETURN VISITS PLAGUED BY MISSING INFO
• TANG,ET AL. AMIA 1994 575-579
• IMPROVES QUALITY OF CARE
• PROMOTES EBM
• LONG TERM PRESERVATION

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QUALITY OF CARE

• COMPLETENESS OF DOCUMENTATION. Plt0.001 FOR PB
  LIST AND MEDS
• TANG, ET AL., JAMIA 6245-251 1999

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BENEFITS OF EHR

• PROMOTES EBM
• PULL INFORMATION FOR STUDY/AUDIT/EVAL.
• LONG TERM PRESERVATION
• MORE LEGIBLE

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IMPLEMENTING EHR

• CHOOSE A SYSTEM
• SOFTWARE
• HARDWARE
• SET TIMELINES
• SEVERAL ALONG THE WAY

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SETTING TIMELINES
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IMPLEMENTING EHR

• CHOOSE AN IMPLEMENTATION TEAM
• MULTIDISCIPLINARY
• ANALYZE WORKFLOW
• SET POLICIES/PROCEDURE
• CREATE TEMPLATES
• REVIEW FEATURES

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IMPLEMENTATION TEAM
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IMPLEMENTING EHR
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IMPLEMENTING EHR

• PRACTICE
• MAY NEED TO REDUCE WORKLOAD
• GO LIVE
• NOT OPTIONAL
• ON HAND HELP
• BE PATIENT
• GRADUALLY INCREASE WORKLOAD
• CONTINUE TO UPDATE
• OPEN COMMUNICATION
• MEET REGULARLY

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THINGS WE LEARNED ALONG THE WAY

• USE THE SYSTEM TO ITS FULLEST
• FROM TEMPLATES TO TRACKING
• SHARE INFORMATION WITH EVERYONE
• ASK FOR HELP/ADVICE FROM EXPERTS
• LET PATIENTS KNOW ABOUT THE PROCESS
• DOCKING STATIONS
• CHECK OUT OTHER CLINICAL SITES WITH SAME SYSTEM
• BE PATIENT

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DOCKING STATIONS
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PROBLEMS YOU MAY ENCOUNTER

• TIME CONSUMING
• CONTINUED COSTS OF UPDATING/REPAIR
• SYSTEM CRASHES/FAILURES
• MEMBERS OF THE TEAM NOT READY/WILLING TO INTEGRATE

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SUMMARY

• EHRS ARE THE PRESENT AND FUTURE
• TIME CONSUMING BUT WORTHWHILE
• IMPROVE QUALITY OF CARE
• NEJM 7/3/08 A NATL SURVEY OF PHYSICIANS
• DESROCHES, ET AL. NEJM 7/3/08, 359 1

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ANY QUESTIONS?

• QUESTIONS?

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REFERENCES

• JAH, ET AL,. NEJM 4/16/2009 360, 1628-38. USE
  OF ELECTRONIC HEALTH RECORDS IN U.S. HOSPITALS.
• DESROCHES, ET AL. NEJM 7/3/08 359 1.
  ELECTRONIC HEALTH RECORDS IN AMBULATORY CAREA
  NATIONAL SURVEY OF PHYSICIANS.
• TANG, ET AL. AMIA 1994 575-579. AT THE QUALITY
  CROSSROADS. INTEGRATING ELECTRONIC HEALTH
  RECORDS AND PATIENT PORTALS.
• TANG, ET AL. JAMIA 6 245-251 1999. USE OF
  COMPUTER-BASED RECORDS, COMPLETENESS OF
  DOCUMENTATION AND APPROPRIATENESS OF DOCUMENTED
  CLINICAL DECISIONS.
• NELSON, ROSEMARIE. MEDPAGE TODAY. 6/30/08.
  IMPLEMENTING AN EHR DO A TIMELINE.
• KLUGER, JEFFREY. TIME. 3/25/09. ELECTRONIC
  HEALTH RECORDS WHATS TAKING SO LONG?