Presented byVirginia Mrizek

Electronic Health Records in the 21st CenturyA proposal

• Electronic Health Records (EHR) in mainstream medicine

• Federal mandate for incentivized Medicare and Medicaid reimbursements (“EHR incentives and certification,” 2014)

•Occupational therapy place in medical recordkeeping

• Dr. Mrizek credentials▫Board-certified Family Practice physician▫Six years instructor at Pima Medical Institute Occupational Therapy Assistant program▫Candidate for Master’s degree in Adult Education and Training

Introduction

EHR in 21st Century

• Patient care requires excellent avenues of communication between providers

• Education of EHR skills early in degree program allows for integration of computer abilities with clinical applications

• Different formats for EHR exist in provider locations

•Documentation is a vital skill in patient care

•Clinical applications are introduced at the beginning of 2nd semester in PMI OTA program

•Needs analysis indicates timing of exposure to documentation procedures should precede onset of clinical applications (L. Walters, personal communication, April 1, 2015).

EHR in the 21st Century

•Current location of documentation introduction at end of 2nd semester

•SOAP notes introduction after beginning clinical program

•Recommend insertion of training into Computer Basics course in 1st semester

•Microsoft Word review prior to course as part of Computer Basics course

EHR in the 21st Century

• Instructional design process

• ADDIE model (Brown & Green, 2011).

• Training Needs Analysis or TNA <iframe width="420" height="315" src="https://www.youtube.com/embed/X3cSAjHDeag" frameborder="0" allowfullscreen></iframe>

EHR in 21st Century

•Course proposal:•14 total hours of training in 7 sessions over one month•Classroom and computer lab methods

EHR in 21st Century

EHR in 21st CenturyGoals:

•Review documentation requirements for medical records

•Expose OTA students to a variety of EHR formats

•Provide a venue for practicing electronic formats in a safe environment

•Provide the community with practitioners who have basic EHR skills

•Objectives aligned with goals

• Instructional strategies to include lecture, group discussions, demonstrations, computer practice, and computer simulations

EHR in 21st Century

•Objectives:•Given completion of all lectures, demonstrations, practice sessions, and

clinical simulations, students will:•1. be able to define the parameters of SOAP notes with 100% accuracy.

•2. be able to pass that part of a practice ACOTE exam that covers SOAP notes with 90% accuracy

EHR in 21st Century

EHR in 21st CenturyContinued:Learners will:• 3. pass a review test of each format with a score of 90% or better

• 4. participate in practice sessions and group discussions utilizing the preloaded software for each EHR format and complete a formative evaluation

• 5. participate in group discussion of pros and cons of each EHR format and complete associated formative evaluation

• Learners will:•6. practice entering SOAP notes as provided in practice software with

100% accuracy within 10 minutes for each format

•7. analyze patient simulation data and create notes with 90% accuracy within 10 minutes

•8. be able to present documentation of achievement in basic EHR skills with 90% accuracy or better in three EHR formats

EHR in 21st Century

•Timeline•Presentation of curriculum to Program Director – June 1, 2015•Meetings with EHR representatives #1, #2, & #3 by June 22, 2015

•First day of training sessions – August 4, 2015•Meeting Tuesday and Thursday from 1:00 pm – 3:00 pm until August 25,

2015

EHR in 21st Century

•Formative evaluations will follow Kirkpatrick’s model with new revision(Kirkpatrick's 4 level evaluation model. 2012.)

Level 1 – motivationLevel 2 – learning Level 3 – performanceLevel 4 - results

EHR in 21st Century

•Design review has been performed

•Expert review is in process using IT supervisor at UMC Banner Hospital

• Learner validation using small group of 4 from prior cohort trial has been positive (Brown, A & Green, T.D. 2011).

EHR in 21st Century

•Summative Evaluation ("Summative Assessment", 2014). •Focus more on product than process

•Consists of results of tests and performances

•Did students achieve objectives and goals?

EHR in 21st Century

• In summary:•EHR training is vital for our OTA students

•Timing of training provides for integration of skills for maximum benefit

•Proposed training provides exposure to most common EHR formats

• Instructional design models have been followed in preparation for this training program

EHR in 21st Century

•QUESTIONS???

•Thank you for your attention!

EHR in 21st Century