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Implementing Electronic Health Records (EHR): Challenges, Strategies, and Lessons Learned

This presentation by Dr. Guillermo Diaz Jr., Chief Medical Information Officer at QueensCare Family Clinics, provides a ground-level perspective on the implementation of Electronic Health Records (EHR). Addressing key challenges encountered while transitioning from traditional systems, it explores strategies utilized, such as workflow creation, training, and support systems. The talk emphasizes the importance of clear goals, flexibility in approach, and ongoing evaluation post-implementation. With a $2.7 million budget and a focus on improving quality of care, the EHR experience reveals crucial insights for other healthcare organizations.

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Implementing Electronic Health Records (EHR): Challenges, Strategies, and Lessons Learned

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  1. Challenges and Strategies When Implementing an Electronic Health Record (EHR): A Ground Level Perspective • Guillermo Diaz Jr, MD • Chief Medical Information Officer • QueensCare Family Clinics

  2. Warning hard work ahead!!! http://bluebuddies.com/gallery/Color_Smurfs_Pictures/jpg/Smurfs_Color_Pictures_Smurf_Tug-Of-War.jpg

  3. 6 clinical sites: ~ 215 FTE employees • ~30,000 lives served/yr • ~130,000 visits/yr • 33 FTE providers (MD/NP) • Services offered include:

  4. QCFC’s Health Information Technology History: • Current Practice Management System • - 10 years • Dictation System for • 2yrs –Failed • Manual Disease registry • 3 years – becoming out-dated • Electronic Health Record (EHR) • - 2 years • - 1.5 years (Full implementation)

  5. Implementation Financing: $2.7 million to implement - California Health Financing Authority Grant ~$471,000 - QueensCare Charitable Foundation ~$550,000 - Remainder - Clinic budget

  6. Request For Proposal Defined: • What do you want out of the system and what does the system have? • 109 requirements –92% of criteria were met 6

  7. Create Workflows • Create the As-Is Workflows • How do you do what you do daily on paper? • Create the To-Be Workflows • How will you do what you do on computer? • Validate the To-be Workflows • Establish Best Practices 7

  8. Create a System of Support • Created - Support Desk • - User Groups • Trained - Trainers • - By Clinic • - Work Type • - In Groups • - 1:1 sessions • - Online • Training continues today… 8

  9. Are providers satisfied? 9

  10. Would providers go back to paper? 10

  11. Will Quality Improve (cont’d)?

  12. Will productivity ever be the same? 12

  13. Challenges & Lessons Learned • Have a predefined selection process • Be Flexible • Interfaces have inherent flaws • Scan Today’s Work Today • Patience is a virtue • Consider ROI (Return on Investment) • Be willing to self-evaluate/obtain outside evaluations • Communicate / be inclusive 13

  14. Thank You !!! 14

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