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Clinical Leadership and Health Information Technology: “I just want to be a doctor”

Clinical Leadership and Health Information Technology: “I just want to be a doctor”. Robert “Red” Schiller, MD Institute for Family Health. HIT and Transformation of Care. System in Crisis- no clear solution Changing Role of Physician/Provider Changing Role of Patient/Consumer

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Clinical Leadership and Health Information Technology: “I just want to be a doctor”

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  1. Clinical Leadership and Health Information Technology:“I just want to be a doctor” Robert “Red” Schiller, MD Institute for Family Health

  2. HIT and Transformation of Care • System in Crisis- no clear solution • Changing Role of Physician/Provider • Changing Role of Patient/Consumer • Fragmentation of Care and Data • Healing?

  3. HIT and Transformation of Care • Mission/Vision • Leader/Champion • Overcoming Barriers • Historical Precedents • Opportunities for Improvement • Transform Care • Health Care Reform

  4. HIT and Transformation of Care: • EHR is not just an electronic chart • EHR is a new technology to provide care • New Challenges Problems • Innovative Solutions • Implementation: New Role for most Providers • Social Networking, Self Care

  5. Introducing Technology: A Few Examples New world opens New explanations New challenges

  6. Causes Lethal Epidemics

  7. Prevention and Treatment

  8. Transformative Technology

  9. Technology Enhancements

  10. Nearly Perfect

  11. Early Attempts

  12. Current Status

  13. Not There Yet

  14. Understanding ResistanceNYT March 6, 2009 Op-Ed

  15. Understanding ResistanceMotivational Interviewing • Reframe Resistance • “What do you like about patient care” • “What do you do well” • “What would make care easier” • Overcoming bad habits: what does this behavior help you do or feel

  16. Implementation • Leadership: Vision Motivation Goals • Changing Role of Providers Clinicians • Choosing EHR: Templates • Training/Abstracting

  17. Implementation • Go Live/Scheduling • Importance of Lab Interface • Provider Autonomy v Care Standards • Collaboration: IT, Practice Managers, Billing, Regulators

  18. HIT and the Office Visit: Work Flow Re-Design • Rethinking Office Visit/Communication • Revise Work Flow • Electronic References (Look it up) • Patient Portals/Access • Specialty Access

  19. HIT and the Office Visit: Office Re-Design

  20. Decision Support: Alerts, Documentation

  21. Registries/Data Management

  22. Lessons Learned • Identify Clinical Champions • May not be Usual Suspects • Involve Clinicians Early and Often • Commit to Ongoing Training • Prioritize Clinicians Concerns • Clear Transition Date: • No More Documentation in Paper Chart

  23. New Ethical Dilemmas • Privacy: Whose Information is it anyway! • Quality: Abnormal Results a Click Away • Safety: • Drug Alerts: Vioxx • Drug Interactions • Health Advisory/Disease Outbreaks • H1N1 • Measles

  24. HIT and Transformation of Care: Vision of the Future • Health Care Reform • Seamless Data Sharing (?Privacy) • Care without walls • Prevention • Healing • Collaboration • Public/Personal Health

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