physician considerations in cpoe...
TRANSCRIPT
Sand or Cement?Sand or Cement?Building a Physician Foundation Building a Physician Foundation
in EHR Implementationsin EHR Implementations
Stephen Beck MD, FACP, FHMISS, CPHIMS
© CSOHIMSS 2008 | Slide 2 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
ObjectivesObjectives
Understand the general state of IT
Review the need for physicians on IT projects
Learn how to find physician resources
Review hospital implementation essentials and pitfalls
© CSOHIMSS 2008 | Slide 3 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
© CSOHIMSS 2008 | Slide 4 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 5 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 6 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Patients are Seeking Health Care Patients are Seeking Health Care InformationInformation
2007 Study from the Center for Studying Health System Change
– 56% of American adults sought information about a health concern from a source other than their physician (up from 38% in 2001)
– 32% looked for information on the internet (up from 16% in 2001)
© CSOHIMSS 2008 | Slide 7 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
And Hospitals Need ITAnd Hospitals Need IT
(Tell me something I don’t already know)
© CSOHIMSS 2008 | Slide 8 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
© CSOHIMSS 2008 | Slide 9 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 10 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
ButBut……
© CSOHIMSS 2008 | Slide 11 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
© CSOHIMSS 2008 | Slide 12 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
CPOE Causes Errors??CPOE Causes Errors??
This is not plug and play technology
Proper planning and implementation is essential
You need to leverage the systems to reap the benefits
© CSOHIMSS 2008 | Slide 13 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
© CSOHIMSS 2008 | Slide 14 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
© CSOHIMSS 2008 | Slide 15 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Reasons to Use PhysiciansReasons to Use Physicians
Physician Attitudes
Peer status
Front Line Experience
“You just don’t understand…”
© CSOHIMSS 2008 | Slide 16 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Physician ResourcesPhysician Resources
Interested physicians
Consultants
Vendor references
© CSOHIMSS 2008 | Slide 17 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Finding a ChampionFinding a Champion
PC interest / knowledge
Experience is a plus
Respect of other physicians
Specialty or sub-specialty representation
Time commitment
Hospital vs. Outpatient
Stipend for work
© CSOHIMSS 2008 | Slide 18 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Physician Uses in ImplementationsPhysician Uses in Implementations
Roles:
Core team / Implementation team
Reporting to CEO/CIO
Training / Testing /Support
Sales: “Road Show”
© CSOHIMSS 2008 | Slide 19 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Physician Uses in ImplementationsPhysician Uses in Implementations
Testing / Support
Workflow development testing
Order Set and Charting development and testing
System Enhancement Recommendations
Customization for Individual Physicians
© CSOHIMSS 2008 | Slide 20 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Assembling the TeamAssembling the Team
Involve a cross section of the organization
Project manager
Clinical staff
Nursing staff
Department Managers are not always the right choice!
Good communicators are essential
© CSOHIMSS 2008 | Slide 21 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
A PhysicianA Physician’’s Priority Lists Priority List
Ease of use
Efficient system
No added time to the day
Remote Access
PACS in hospitals
Customization!
Decision Support
© CSOHIMSS 2008 | Slide 22 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 23 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Evaluation of Physician /Hospital Evaluation of Physician /Hospital ReadinessReadiness
Survey of staff and physicians
Computer skills - offer education!
Local attitudes / culture
Use of hospitalists / residents
Physician’s need to use the hospital
© CSOHIMSS 2008 | Slide 24 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Essentials of Hospital Essentials of Hospital ImplementationImplementation
Nursing Involvement
Order Sets
Training
Testing - Does it really work?
Incentives to early adopters
Resident considerations
Start with easy wins, end with CPOE
© CSOHIMSS 2008 | Slide 25 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 26 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
PitfallsPitfalls
Believing everything your vendor tells you
Waiting for consensus
Waiting too long to get physicians involved
Not providing incentives / stipends
Not being open to enhancement suggestions
Not using decision support
Not using change management principles
© CSOHIMSS 2008 | Slide 27 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
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© CSOHIMSS 2008 | Slide 28 Sand or Cement? Building a Physician Foundation in EHR ImplementationsNovember, 2008
Questions ?Questions ?