integrated care guidance muse presentation by dr. wesp
TRANSCRIPT
INTEGRATED CARE GUIDANCE
Clyde E. Wesp, Jr., MD, MAOMExecutive Clinical Strategist
Jacobus Consulting
OBJECTIVES
■Understand the importance of the relationship between EHR functionality and guiding evidence based care at the bedside
■Governance and processes of engaging clinicians in the evidence based content customization
■Advantages of built in evidence based care guidance with the EHR
TODAY’S AGENDA
■Why■Vocabulary■Care Guidance in action■The future of Healthcare Informatics■Questions
WHY FOCUS ON CLINICAL DECISION SUPPORT?
■It makes a difference■Decrease unnecessary variation and waste■Method of Communication among clinicians■Integration of new evidence in context of current
literature■Helps clinicians make decisions■Focus on Outcomes■Regulatory
in·te·grate [ 'intəˌgreit ]“to make into whole”
■in·ter·face [ 'intəˌfeis ](in·ter·fac·es)• “A common boundary;to touch at a point to make things
join”
■em·bed [ em'bed ], [ em'bed ](, em·beds)• “to become deeply and solidly lodged in something
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance?
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance
WHAT IS EBM?
■The revised and improved definition of evidence-based medicine is “the integration of the best research evidence with clinical expertise and patient values”
■It reflects a systematic approach to clinical problem solving.
(Sackett DL, Strauss SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd Ed. London: Churchill-Livingstone,2000)
WHAT IS EBM?
■The revised and improved definition of evidence-based medicine is “the integration of the best research evidence with clinical expertise and patient values”
■It reflects a systematic approach to clinical problem solving.
(Sackett DL, Strauss SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd Ed. London: Churchill-Livingstone,2000)
PROCESS OF CARE
• Research• Science• Publications
• Application of EBM• Add Experience• Electronic Tools
• Content• Workflow• Alert Logic
CARE GUIDANCE
■Clinical Decision Support Applied■Embedded into workflow■Point of Care■Don’t have to leave the EHR■Instantaneous feedback■Anywhere, Anytime, Any Device
BARRIERS TO CARE GUIDANCE
■Reluctance to Use■Usability■Workflow■Right information at the right time to the right
person■Over-alerting leading to “alert fatigue”■Information overload
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance
MEDITECH INTEGRATION FOR CLINICAL CONTENT
INCORPORATING STANDARDIZED ORDER SETS, CARE PLANS, PHARMACY
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance
WHY IS IT IMPORTANT TO ENGAGE CLINICIANS?
■Clinicians play key role in the entire process■Knowledge experts■Nurses are responsible 24/7 in-hospital and through
community based services. They have great responsibility to recognize and prevent complications.
■Physicians are the clinical decision makers and through ordering practices drive cost and quality
■Physicians often practice independently. Engage them where they work.
■Nurse adoption influences physician adoption■Subject Matter Experts (e.g., Rx, Rad, Lab, Case Mgt)■Can be disruptive if not involved.
QUESTIONS TO ANSWER
■What is the difference between EBM, CDS and Care Guidance?
■What is the relationship between your EHR(s) and Care Guidance?
■Why integrate your EHR(s) and CDS?■How do you engage clinicians in the customization
of content?■What can you do to enhance Care Guidance?
QUESTION # 2
■Has there been a time in your organization that the right hand did not know what the left hand was doing?
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REVIEW
Enhances the functionality of the EHRImmediate feedback to the clinician promoting safetyIntegrates documented data into decision making processSets up for mobile devices
“No one has the ability to capture and analyze data from the future. However,
there is a way topredict the future using data
from the past. It’s called predictive
analytics, and organizationsdo it every day.”
CELEBRATE
■Acknowledge success■Acknowledge leadership■Acknowledge progress■Acknowledge more often than not■Thank people for their work■Award prizes for work■A few words go a long way■Balance work with fun■Celebration decreases stress