electronic health records: implications for imo state's healthcare system
DESCRIPTION
Very high level overview and benefits of Electronic Health Records systems and a multi-phased approach to implementation. By Michael Loechel & Joy Gupta.TRANSCRIPT
Electronic Health RecordsImplications for IMO State’s Healthcare System
Presented by:Michael Loechel & Joy Gupta
IMO State Congress Business ForumAtlanta, GA
August 2, 2013
Context
IMO State recognizes the need for setting up an EHR as they consolidate their healthcare infrastructure, and have approached Axioma Group & Research Solutions, LLC to help in this process.
Agenda
• Electronic Health Records (EHR)Overview & Benefits
• Approach to EHR in IMO State• Questions & Answers
EHR: Definition
A longitudinal health record that:• Contains all personal health information• Is entered and accessed electronically by healthcare
providers over a person’s lifetime• Includes multiple care settings – inpatient and outpatient• Allows a patient’s health record to
travel with them• Reflects the entire health history
of an individual across his/herlifetime including data frommultiple providers
Sources: World Health Organization; HealthIT.gov
EHR is Comprehensive
Electronic Health Records (EHR)All personal health information
Electronic Medical Records (EMR)Diagnosis and treatment information
Electronic Prescribing (EP) Drugs written and dispensed
EHR: Goals
• Improve quality and convenience of patient care• Increase patient participation in their care• Improve accuracy of diagnoses and health outcomes• Improve care coordination• Increase practice efficiencies and
cost savings
Source: HealthIT.gov
EHR in IMO State: Approach
Patient Flow•Process Mapping: Current vs. Future State
•Gaps
EHR Plan & Process•Tweaks
System requirements based on Healthcare practices•System Selection
System Implementation & Training•Phased rollout
Ongoing Technical Support
Patient Flow & EHR
Origination Evaluation/Diagnosis
Treatment Assessment & Options
Symptomatic/Asymptomatic
Chronic/Episodic
Management of Treatment and ongoing Care
Emergency/Non-Emergency
HospitalClinic/Primary Health CenterHome visit
Physical ExaminationLab testsOther diagnostics
Drug therapy
Screening
Surgery
Acute CareHospitals (inpatient & outpatient)ClinicsPrimary Care Institutions
Non-acute CarePrimary Care InstitutionsHome Care
Devices
EHRs can, and should, encompass the continuum of patient care
DoctorsTraditional HealersNurses and other healthcare providers
Other
Planning an EHR
Guiding Principles for Implementing National, Regional and/or Provider EHR Lessons Learned Clinical Value: EHR capabilities should have high clinical value.
The identification of capabilities and priorities should be clinician led.
Pragmatism: The foundations for EHR need to be built; capabilities need to be realistic for the timeframe of each release.
Staged Development: Evolve capabilities over time to achieve greater sophistication.
Balance Risk and Reward: Manage the degree of difficulty in each release.
Source: Accenture Global Survey
Accurate patient identification is the backbone of an effective and efficient health record system. This should be addressed first before moving forward to automation.
Setting up an EHR SystemReview Current Health Record System
Identify Issues and Challenges
Plan for Introduction
CoverageType and form of records How maintained & by whomQuality and consistencyTo what extent centralized/ localizedExtent of sharing & ProcessPolicies and guidelines
Data entry accuracyCommunication & TrainingLiteracy/attitude toward computer technologyCost and funding Concerns of providers Knowledge of disease classification systemsHuman resources adequacyInfrastructure – power, wiring, spaceInvolvement of clinicians and administrators
It is extremely important that there is support from the anticipated users of the system who need to be involved from the onset ofdiscussions.
Form a Steering CommitteeDetermine type of EHRSet achievable outcome goals that will meet the needs of both users and consumersDevise strategies in preparation for an EHRDevelop policies for use in an electronic health record system
Source: Based on WHO EHR Manual & Experience
Implementation Team
Source: WHO EHR Manual
Implementation Plan
A sound implementation plan can mean the difference between success and failure① Working Groups to Address– Information Security– Education and Training – Competent, committed users– Quality Assurance of data collected and processed
② Consider Key Factors Including– What computer systems does the institution currently
have?– What form should the implementation take? (full/phased)– How will past data be integrated and old data retained?
Source: Based on WHO EHR Manual & Experience
Measuring SuccessKey areas of measurement (examples)• Efficiency
– Patient turnover – Patient records available at point-of-care– On time receipt of labs/diagnostics – Speed of diagnosis– Clinical alerts– Speed of medical fulfillment
• Outcomes– Accuracy of diagnosis– Accuracy of treatment– Persistency and compliance with drugs– Persistence of follow up visits– Patients receiving preventive exams/procedures– Distribution of education materials
Source: Based on Experience and Multiple Source
Contact Information
Michael LoechelPresidentAxioma Group, [email protected](646) 415-8107
Joy GuptaPresidentResearch Solutions, [email protected](203) 994-4784