ehr implementation and adoption ambulatory ehr at mainegeneral medical center tuesday september 9,...
DESCRIPTION
Dan Mingle, MD, MS 14 years - Clinical Rural Family Practice 5 years - Residency Faculty –Residency Assistant Medical Director 2003 Graduate Dartmouth’s Center for Evaluative Clinical Sciences IT Project Director PI, IT Implementation Grant Director, MGH Ambulatory Clinical Informatics Healthcare Informatics’ Innovator Award, 2008TRANSCRIPT
EHR Implementation and AdoptionAmbulatory EHR
at MaineGeneral Medical CenterTuesday September 9, 2008AHRQ Annual Conference
WE HAVE A SUCCESSFUL AMBULATORY EHR IMPLEMENTATION IN RURAL MAINE
Funded by AHRQHIT Implementation Grant Number: UC1 HS15337Grant Title: Improving HIT Implementation in a Rural Health System September, 2004 – March, 2008
Dan Mingle, MD, MS• 14 years - Clinical Rural Family Practice
• 5 years - Residency Faculty– Residency Assistant Medical Director
• 2003 Graduate Dartmouth’s Center for Evaluative Clinical Sciences
• IT Project Director
• PI, IT Implementation Grant
• Director, MGH Ambulatory Clinical Informatics
• Healthcare Informatics’ Innovator Award, 2008
In my 15 minutes• I told you we were successful• I will Describe
– Project– Timeline– Utilization data
• Whirlwind tour of the ROI data that proves we failed.
• Reiterate that we were successful• Fight about it in Q&A
MaineGeneral
0% 50% 100%
Patients
Doctors
Practices
Square Miles
Rural Counties
Hospitals
Integrated Delivery …
70,000
100
30
11,000
5
2
1
70,000
156
82
Participating
It’s about Sharing
• Med List• Allergy List• Problem List• Results• Notes• Care Plans• Reminders• Communication
One PatientOne Chart
Ancillaries
Primary Care
Specialty
Patient
A Short History of a Long Project
05
1015202530354045
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010C
umul
ativ
e e-
Prac
tices
RFP
Touchworks
7 Pilot Sites
AHRQ Grant
1st Ext Pract
Tracking the Conversion
A Good Problem List is a Disease Registry
Structured Data is Key to Clinical Reporting
User Satisfaction• I rarely experience
errors in the EMR.• I rarely lose any of my
work in the EMR.• Overall, the speed and
reliability of the EMR meets my needs.
• The EMR is about as fast as other MaineGeneral systems.
• The EMR support team and website is there when I need it.
Cost
AccessQuality&Safety
Needs
WantsCommunity Individual
It’s About A Better Value for the Healthcare Dollar
It’s Not About EMR
Mixed Quality Measures
Near 100% ePrescribing• 25,000 e-Prescriptions per Month
– 1,400 Schedule II prescriptions – 2,400 Schedule III to V
Error Rates
Panel Size
Visit Volume
Revenue and Expense
Little Difference in Hospitalization
Cost
AccessQuality&Safety
Needs
WantsCommunityIndividual
•Equivocal improvements in Quality•Significant improvement in Safety•No change in Access•No attributable changes in cost or revenue
•Dr. Perspective•Pt. Perspective
In Summary
Sustainable success • 30 practices• 100 Doctors• 30 Residents and
Fellows• 12 practices in the
implementation queue• 70 more to go• Tasks
– 850,000– For 47,000 patients– To 550 users– 17 / patient; 1500 / user
• Appointments– 185,000– For 48,000 patients– With 190 Providers– 4/patient; 960/provider
• Prescriptions– 221,000– For 36,000 Patients– By 170 Providers– 6 /patient; 1900 / provider
• 1344 EMR Help tickets
Questions?
Thanks