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Ukiah Valley Rural Health Center Electronic Records Implementation

Ukiah Valley Rural Health Center Electronic Records Implementation. Darcie Antle, M.S., H.S.A. History of Ukiah Valley Primary Care. Incorporated January 1995 with six physician partners Operations begin September 1995 at four different sites

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Ukiah Valley Rural Health Center Electronic Records Implementation

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  1. Ukiah Valley Rural Health Center Electronic Records Implementation Darcie Antle, M.S., H.S.A.

  2. History of Ukiah Valley Primary Care • Incorporated January 1995 with six physician partners • Operations begin September 1995 at four different sites • Grew by 2006 to have 17 physicians and 10 mid-level practitioners • Late 2004 began planning construction of a new consolidated office space across the street from UVMC

  3. History - (cont.) • April 2006 transferred ownership of its rural health clinics to Ukiah Valley Medical Center and became provider of medical care for the clinic • March 2008 consolidated office space in new 30,000 sq. ft. facility • September 2010 - 24 physicians and 15 mid-level practitioners in 4 locations in Ukiah and 1 in Lakeport • Internal Medicine, Family Medicine, Pediatrics, Allergy, Oncology, Gynecology, Cardiology, Orthopedics, Ophthalmology, Optometry, Urology, ENT, Counseling • Over 95,000 annual visits

  4. Ukiah Valley Rural Health Center

  5. Practice Management • UVPCMG had practice management system in place running a software program (Infocure) which was purchased by Cerner • Practice Management (PM ) • Registration • Scheduling • Billing • Reports • Hosted locally at UVMC

  6. Cerner EMR System • Electronic Medical Record (EMR) • Nursing and Provider Documentation (VS, POC, Problem List, Notes, Immunizations) • Interfaced Laboratory and Radiology Results • Orders and Prescriptions • Coding; Super bill • Scanned Documents and more…… • ASP Model • Remote Hosted in Kansas City, MO

  7. UVRHC EMR History • February 2005: discussions with Cerner and other vendors • GE Centricity chosen as EMR vendor • At request of Adventist Health Cerner EMR re-evaluated • February 2006: contract signed with Cerner for PWPM • June 2006 : Practice Management implemented • Summer-Fall 2006: Cerner on site collecting forms; current state; build and training for EMR • October 2006- March 2008: Live Clinics: OB; Family Practice; Internal Medicine (partially) • March 2008 - present: Live Clinics: Family Practice, Pediatrics, Internal Medicine (partially), General Surgery (partially), Urology, Physical Therapy, Orthopedics (partially)

  8. Challenges to EMR Implementation • EMR is a MAJOR CHANGE • Users expect a perfect system - that mimics THEIR workflow and works the way they think a great EMR should work • It’s tough to give up individuality • Not everyone starts at the same beginning - computer literacy, typing vs. Dragon • Productivity will drop - compensation issues • Need for provider champions/superusers

  9. Challenges to EMR Implementation - (Cont.) • IT Support!!!

  10. Challenges to EMR Implementation - (Cont.) • IT Support!!! • Laser connection to hospital • T1 Line • Equipment

  11. Cerner as EMR Provider • The company was primarily an inpatient provider • UVRHC was an early adopter of the EMR ASP product • Growing pains • Initial training and implementation inadequate • Early software had many glitches • Difficult to extract data • Many billing issues although most unrelated to Cerner • Difficulty obtaining adequate reports

  12. Cerner as EMR Provider (Cont.) • Support services were erratic and slow • Updates to software caused new problems - inadequate testing of software

  13. Cerner EMR Today • Much improved software • Improved customer service • Updates have been smooth • IT technical issues have been resolved • Direct T1 Line to Kansas City in place • Fiber-optic cable under street to hospital • Improved training with online tutorials, webinars, hospital support staff • Monthly physician EMR telephone group

  14. Cerner EMR Today (Cont.) • October update will be fully compliant with “meaningful use” requirements • Federal regulations have increased speed and quality of improvements • Chronic disease management modules • Improved data tracking

  15. UVPCMG Status with EMR Today • We will NEVER return to paper charts • Functionality with billing is wonderful • E-prescriptions and laboratory results into EMR work extremely well • Software continually improves • Cerner has become a partner company

  16. UVPCMG Status with EMR Today (Cont.) • All new providers MUST start in EMR • As of January 1, 2011, all providers under age 65 and with content available in their specialty will be fully on EMR • We await participation in Federal EMR use incentives • IT support continues to be problematic

  17. Benefits of EMR Use • Information readily available to any user in any location • No more “where’s the chart?” • Less paper chaos • Phone messages more easily tracked • Opportunity to standardize processes • Legibility • Improved billing processes involving the Provider • Medication lists on line,allergies; e-Rx’s • We await a patient portal for lab results, appointment scheduling etc.

  18. Questions • ?????????

  19. Final Thoughts • It is not necessary to change. Survival is not mandatory. ~W. Edwards Deming • The only difference between a rut and a grave is their dimensions. ~Ellen Glasgow

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