ehr implementation: factors for success tess settergren, mha, ma, rn-bc director, clinical...
TRANSCRIPT
EHR IMPLEMENTATION: FACTORS FOR SUCCESS
Tess Settergren, MHA, MA, RN-BC
Director, Clinical Informatics
July 19, 2005
What is EHR? “A real-time patient health record with access to
evidence-based decision support tools that can be used to aid clinicians in decision-making. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting.” (Brailer, 2005)
EHR Components• Patient Data (PHI)
– Discrete, structured, sometimes coded– Textual/other non-structured– Digitized images, biomedical, other
• Clinical Decision Support– Information Displays– Rules-based Order Entry (CPOE) – “Best Practice” Reminders, Alerts, Tools
EHR Components• Clinical Messaging
– Results & Other Clinical Management– Operational Efficiency
• Personal Health Record – View Results & Reports; Add Data– Patient Education Resources– Clinical Advice & Messaging
• Support of Secondary Data Use
EHR Building Blocks
FUNCTIONAL BLOCKS
Decision Support
Multi-disciplinary Guidelines
QM/UM Scheduling
Results Reporting & Imaging
Documen-tation
Order Entry
Registration Coding & Grouping
Confidentiality and Security
Unique Patient and Provider Identifiers
ScanningAutomated Data Capture
Data Exploration and Display Tool
TECHNICAL UNDERPINNINGS
ScanningAutomated Data Capture
EHR Target: Provider Level
Patient
RIGHTINFORMATION
AT THERIGHTPLACE
TO THERIGHT
PERSON
AT THERIGHTTIME
ATREASONABLE
COSTStaggers & Leaderman, 2000
EHR Target: Community Level
Population
Interconnected Clinicians &
Informed Practice
Personalized Care
Care Quality-- Outcomes
ResourceEfficiencies
Economic Growth
Enabling Technologies
EHR “Opportunities”
• Technology & Standards Maturity
• Health Information Technology Financing
• Organizational (Cultural) Readiness
• Individual Adoption of Innovation
• Data Security & Availability
Transforming Healthcare Delivery• Installation is hard, and mainly technical
• Implementation is really hard, and mainly organizational
• Transition (lasting change) is incredibly hard and purely human
• Transformation is a state of profound new personal and enterprise behavior [which accompanies the strategic acceptance of information technology]
Cerner Corp
Diffusion of Innovation (Rogers, 1995)
EHR Evolution
CSFs for Successful Implementation
• Commitment to Redesigning Processes…a Vision• Operations-Led IT Strategy • Alignment with Strategy: Clinical/Operational,
Financial, Customer Service, & Employee Learning/Growth
• Foundational to Organizational Metrics—Integration of CLINICAL, FINANCIAL, & QUALITY Measures
CSFs for Clinician Adoption• Engaged & Credible Leaders• Managers Accountable for Success• Data Availability & Flexible Displays• Efficiency & Revenue “Hooks” • Easiest Path to “Doing It The Right Way”• Leverage Nursing Support of Providers• Report Card Transparency• Training, Training, Training; then Optimization