1 / 39

Michele Miller Warm Springs Health & Wellness Center

IHS EHR. Indian Health Service Electronic Health Record. Michele Miller Warm Springs Health & Wellness Center. Preparation, Implementation and Lessons Learned. Preparing for Installation Implementation Team CAC OIT Requirements Setup EHR CAC & Implementation Training (ABQ)

yaron
Download Presentation

Michele Miller Warm Springs Health & Wellness Center

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. IHS EHR Indian Health Service Electronic Health Record Michele Miller Warm Springs Health & Wellness Center

  2. Preparation, Implementation and Lessons Learned • Preparing for Installation • Implementation Team • CAC • OIT Requirements • Setup • EHR CAC & Implementation Training (ABQ) • OIT On-site RPMS-EHR setup • Go Live • Looking Ahead

  3. Where to Start?

  4. Implementation Team • Clinical Application Coordinator (CAC) • Medical Staff (Clinician) • Nursing • Pharmacy • Lab and Radiology • Medical Records • Billing/Coding • Information Technology staff • *Administrator/Executive Leadership*

  5. Implementation Team Roles • Monitor and Execute Implementation Plan • Identify and define Policies and Procedures • Address staffing and scheduling during transition • Peer Training & Marketing • Design and Approve EHR Menus, templates,etc

  6. What’s Next?

  7. Hardware/Infrastructure upgrade • RPMS server • Backup/Training server • Thin Clients, laptops, pcs? • Network • Lab Interface Upgrade • Workstation Access-Everywhere • Backup Power

  8. Costs Associated with EHR • Workstations • Laptops, tablets, pc, thin clients • Ergonomic workstations • Backup Server • Backup Generator • Clinical Applications Coordinator GS 12 • Training / Travel Costs • Software-$0.00

  9. OIT Requirements http://www.ihs.gov/CIO/EHR/index.cfm

  10. Step 1-Site Survey http://www.ihs.gov/CIO/EHR/index.cfm

  11. Step 2: EHR Site Tracking http://www.ihs.gov/CIO/EHR/index.cfm

  12. EHR Planning & Implementation Begin pharmacy drug file cleanup for Pharm 5/7* Install/configure Radiology 5.0, Lab 5.2 Implement Adverse Reaction Tracking package Begin procurement process for hardware Begin hiring process for CAC Optimize “Point-of-Service” RPMS Packages On-site Setup with Nat’l EHR Team Establish EHR Implementation Team Install Pharmacy 5/7 and EHR GUI Begin EHR Site Tracking Record Decision to implement EHR Review EHR Website Complete EHR Site Survey Attend Lessons Learned class RPMS current, CACHE Optimize PCC Error Reports Implement Paperless Refill EHR Super User training EHR Go-Live with Nat’l EHR Team Attend CAC training Install PIMS Full rollout 24 0 1 2 3 5 6 8 10 11 12 Elapsed time (in months) Please note that this is just a general timeline of how long it might take for your site to implement EHR. Every site will be different, and the amount of time it takes to implement EHR depends upon many factors, including size of the facility, services offered at the facility, current state of RPMS and packages installed and utilized. * Most sites contract for external resources to complete pharmacy file preparation.

  13. 6 Months of Setup? After Pharmacy 5/7 installation

  14. National EHR Training and Deployment Program recommends at least 6months • Three months of Pharmacy 7.0 utilization before "Paperless Refill" • Three months of "Paperless Refill" and "Coding Queue" before beginning Provider Order Entry (POE) with EHR.

  15. Medical Clinic Preparations • Formed Teams • Practiced EHR Walk-Through(on paper) • Defined Roles • Computers everywhere

  16. Lab All Labs need to be entered in RPMS • On-site Labs • Reference Labs • State Labs • Computer Access Points Change from Esig to EHR after Go-Live

  17. EHR Setup

  18. OIT Help / Training • EHR CAC & Implementation Team (Set Up) Training in ABQ • EHR Onsite Set-Up Team • Onsite Go Live Team • EHR for Techies, EHR for Inpatient, EHR for HIM and Business Office

  19. Setup by CAC • Customize order menus • Lab, Pharmacy, Radiology • Setup Referrals/Consults • Progress Note Templates • Design your own • Share with other sites • User Setup • ICD/ CPT Pick Lists

  20. EHR beforeConfiguration

  21. EHR after Configuration

  22. Preparation-Customizing Orders

  23. Preparation-Customizing Templates • Templates can be shared with other IHS and VHA facilities • More Complete Documentation

  24. Training/Marketing • EHR Demo Movie • VA Training Modules ftp://intranetftp.ihs.gov/pub/EHR/ • Pharmacy • CPRS • WebEx Demos • Show and Tell • Newsletters • Web Updates • Meeting Updates • Email Quizzes

  25. Implementation Strategy Implementation-Who and When • Everyone at once • Lab ordering , then radiology ordering, then pharmacy ordering, then notes • Bring up one team/dept at a time

  26. Going Live

  27. Go Live Week • Intense CAC and IT Support • Make Appropriate Scheduling Adjustments • Daily Debriefings…. • Procedural Questions • Technical Issues • How did it work before EHR? • More Training-Email training

  28. How the Week First Goes Growling at CAC’s TGIF Crying, gnashing of teeth Excited Excited

  29. Change is Good

  30. Medical Records • Filing notes in chart during the transition? • Print And File Chart Copies? Batch Print? • Release Of Information? • Outside Consults? Scanning? • When to stop pulling the chart 

  31. Medical Records Supervisory • Daily Report: Unsigned Orders • Daily Report: Unsigned Notes • Retracting /Correcting Incorrect Entries • Paper P&P changed to Electronic P&P • Sensitive Pt Tracking • Medical Records Supervisor: Business rules/HIPAA • Who can view which parts of EHR • Works cooperatively with RPMS Site Manager

  32. Business Office • No Hard Copy to Wait for • No more missing E&M Codes • EHR Notes Are Legible • Great Opportunity For Improved Provider Documentation & Increase Billing/Collections

  33. Medical Clinic • Using templates/graphs instead of flow sheets • Using the Scheduling GUI for visual routing of pt flow • Selecting ICD/CPT codes • Reminders • Voice Recognition • Dragon NaturallySpeaking • Vista Imaging

  34. Staff Changes at Warm Springs • More Nurse Aids after EHR • From 2 to 7 • Medical Records Staff • PCC Data Entry (temporarily reassigned) • Benefits Coordinator (temporarily reassigned) • Medical Department (temporarily reassigned) • Nurse aids • Medical Receptionist • Shifted to scanning documents into VistA Imaging

  35. Next Steps • EHR v1.1 • CPHAD (Public Health Activity Reporting System) • Electronic Dental Record (EDR) • Visual PHN System (VPS) • VistARAD

  36. Questions?

  37. Clinical Applications Coordinator (CAC) Coordinates EHR Implementation • New Position / Role • Works cooperatively with Site Manager and Medical Records • EHR User Support • Training • Customizes EHR • Workflow back

More Related