Karrie Ingram,

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Implementation and Benefits of an Electronic
Health Record

• Karrie Ingram,
• LTC IS Specialist

Parkview Healthcare Facility

• Citizens Memorial Healthcare

Citizens Memorial Healthcare Facility

Bolivar, Missouri
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Butterfield Residential Care
Implementation and Benefits of an Electronic
Health Record

• Ash Grove Healthcare Facility

Community Springs Healthcare Facility
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Implementation
Project Infocare

• Multi-year,
• Multi-million dollar
• computer system project encompassing our
  hospital, 5 LTC facilities, Home Health, and 16
  specialty and rural clinics

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Project Infocare Vision

• Citizens Memorial Healthcare will implement
  Meditech to enable a patient to enter anywhere
  into our continuum of care and have a personal
  identity that is maintained across that
  continuum.
• Physicians and other caregivers will have access
  to all of that patients medical information
  within the healthcare system.

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Patient Centered
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Project Infocare Timeline

• 2000 IS Strategic Planning
• 2001 Vendor Search Selection
• 2002 Implementation Began
• December 2002 Hospital Implementation and EMR
• October 2003 LTC Admissions/Billing and
  MDS/Care Plans
• December 2003 Hospital Paperless
• February 2004 1st LTC Facility Live on Clinical
  applications
• February 2005 5th LTC Facility Live on
  Clinicals
• May-Sept 2005 - Scanning with ImageNow to
  eliminate remainder of paper chart in LTC
• July 2006 - Butterfield Residential Care Facility
  Live on Clinicals
• Jan-June 2007 Present Bedside Medication
  Verification in 5 LTCs

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Project Infocare Costs

• Total Project 6,000,000
• Software (Meditech other)
• Computers and network structure
• Staff implementation time benefits
• Travel training costs
• LTC Costs 650,000
• 130,000 per facility, or
• 1,365 per licensed bed

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Getting Started

• Put a team in place
• Clinical team included Administrators, DONs,
  Charge Nurses, Ward Clerks, Med Techs, MDS
  Coordinators
• Financial Team included Director of Finance,
  Billing Personnel, Business Office Clerks,
  Admissions Coordinators
• Schedule your implementation
• 6 month implementation schedule for
  Admissions/Billing, MDS and Care Plans (all
  facilities live at once)
• 9 month implementation for Physician Orders,
  Nursing Documentation, Electronic MAR (one
  facility at a time-21 day in-house live coverage
  by Team members)

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Training

• Initial Training Course
• RNs and LPNs 16 hours
• RMTs 12 hours
• C.N.As 8 hours
• Continued Education
• Work closely with facility administration to
  create/ provide continuing education through
  scheduled and requested in-services and online
  learning system

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Nuts Bolts of our EHR
Status Board

• Customizable to display pertinent information
• Users can have multiple Status Boards
• Can be sorted by any field
• Provides critical info at a glance
• Resuscitation Status
• Lab results
• Accu-check Results
• Oxygen Orders
• Alerts caregivers of Medications or Interventions
  that are due or overdue.
• Alerts caregivers to New Orders, and the details
  of those orders.
• Physician Contact info available with one click.
  

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Order Entry
Med Ordering follows the 5 Rights
Includes Allergy/ Interaction checking
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Intervention Documentation
Auto- calc of risk scores

One click to protocols or policies/procedures
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e-MAR

• Flows directly from Order Entry, no chance of
  transcription error
• Provides detailed information regarding the
  residents medications to improve efficiency and
  resident safety.
• Start and Stop Dates
• Next scheduled
• Last given
• Trade and Generic name
• Dosage, route, and frequency.
• Monograph
• Detailed information regarding the use of the
  medication, side effects, interactions, etc.
• Associated Data
• The user can easily access related information
  such as recent vital signs or pertinent lab
  results.

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Bar-coding for Med Safety

• Identification of the Resident and the
  Medications with bar-coding and scanning insure
  the 5 Rights and significantly reduce/eliminate
  medication errors.

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Electronic Medical Record
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Clinical Benefits

• CNA Documentation
• MDS/Billing Integration
• DON/Administrator monitoring
• Clinical Notifications
• Key Reports
• Pain Management
• EMR-caregivers have access to residents entire
  record, not just the individual visit

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Questions? Contact me kingra_at_citizensmemorial.c
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