Technology Adoption and

Change Acceleration

Karsten Russell-Wood, MBA, MPH (2015)Remedi SeniorCare

Why Adopt an EHR

Source: MHCC Adoption of Electronic Health Records amongLong Term Care Facilities in Maryland; 2013 Information Brief

Increasing Adoption

• Primary use is financial

• Despite cost (~$350k 5 yr)

Recognized Value

• Quality Assurance and Performance

Improvement (QAPI) initiatives

Further Exploration

• Common integration initiatives (Pharmacy / Lab / RAD / HIE)

Why Adopt an EHR

EHR Value to the 5 Rights:

• Medication documentation compliance

improvement

• Nursing hours to complete Month End

Changeover reduced

• Medication error reductions

• Increased clinical “leverage”

= Cost Recovery & QualityImprovement

Best Practices for Change

• Ensuring successful implementation

• Organizational leadership and vision communication

• Cultural readiness / changemanagement

• Communication and engagement

• Lasting success

• Importance of Goals: Strongaccountability and ownership ofadoption

• Monitoring

Perpetual Evolution

Paper MAR

Integrated&

PortableData

Interoperability – Objectives

Efficiency

• Single integrated system

• Longitudinal resident care

Safety & Security

• PHI / HIPAA

• State (NY I-Stop) Mandate

Accuracy

• Eliminated double entry

• Trace-ability of data

Interoperability – Setup for Success

Potential pre-requisites

• Technical readiness

• EHR & Pharmacy Interface

Certification (Regulatory Approval

per state)

• Costs / Feature requirements

• Additional quotation process

• Scheduling

• Technology acquisition

• Organizational support

• Executive sponsorship

Interoperability – Project Design

Team members:

• Internal Stakeholders

• EHR

• Pharmacy

Changes needed:

• Culture

• Workflow

Focus on Sustainability

• Communication

Interoperability – Project in Practice

Feedback

• Multiple Vendors

• Multiple States

• AL and SNF Facilities

• EHR to Pharmacy

• EHR to Pharmacy to HIE

Feedback – Pre Interface

Accuracy

• Duplicate entry risks

• Clarification requirements / calls

Timeliness

• Multi-step order process

Communication

• Technical disconnected

• People silo mentality

Feedback – Post Interface

Continuity of data• Single record minimizes data errors

• Improved processes (refills)

Bi-directional flow• Feedback on order acknowledgement

• Therapeutic interchange

• Synchronized eMAR

Collaboration• Aligned team across partners (Facility/Pharmacy/EHR)

Improved pharmacy relationship

Increased opportunities• Referral and ACO alignment

Conclusions

Preparedness

• Clear plan and frequent communication

• Check-points to calibrate progress

• Change acceptance

Support

• A vision to “fall back on”

• Facility champions /

Executive Sponsorship

• Counter-measure plan