2C Williams Kim Presentation

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Slide 1: 

SCR Family Medicine EMR Project Kimberly D. Williams, M.D.

Slide 2: 

Service Area Family Medicine Clinics in: Rowan Bath Menifee Carter Elliott Also in Rowan: FM Express (Urgent Walk-in) Dr. Laura Ellis 20 Providers

Goals for the St. Claire Family Medicine EMR Project : 

Goals for the St. Claire Family Medicine EMR Project Provider buy in Make information available and accessible Use Best Practice when applicable Prepare for pay-for-performance Improve patient care! Lesson learned: It’s a clinical project, it’s a clinical project, it’s a clinical project.

FUNDING:Total Cost ~$300,000 software ~$100,000 hardware & training : 

FUNDING:Total Cost ~$300,000 software ~$100,000 hardware & training $80,000 e-prescribing grant from the Commonwealth of Kentucky Governor’s Office Used for clinician time and for hardware Promoted use of E-prescribing Estimated ARRA return = $1.3M Lesson learned: The ROI is real.

Timeline : 

Timeline Planning 2005 Narrowed to 10 choices Demonstrations and site visits and scoring survey =) narrowed to 4 choices all with the functionality we were looking for Made vendor decision late 2005 Main decision maker was cost Implementation planning 10/06 Clinical Customization 12/06 Lesson learned: Probably any CCHIT Certified vendor will work for you.

Go- Live BIG BANG! : 

Go- Live BIG BANG! Go-Live Dates Morehead 3/07 Owingsville (Bath County) 5/07 Olive Hill (Carter County) 6/07 Sandy Hook (Elliott County 7/07 Frenchburg ( Menifee County) 8/07 FM Express (Urgent Treatment Walk-in Clinic- NEW) 12/07 Dr. Laura Ellis (NEW Practice) 6/08 Lesson learned: Do not go incremental, BIG BANG is the only way to go.

Benefits/Improvements : 

Benefits/Improvements Workflow Effectiveness improved Better Communication across system Remote Access Improved Clinical Outcomes Improved Clinical Outcomes Improved Clinical Outcomes

We aren’t satisfied with the way we care for CAD patients. So: : 

We aren’t satisfied with the way we care for CAD patients. So: How many CAD patients do we have? (27,000 charts in 5 counties) 30 seconds to find we had 1000 CAD patients How many were taking anti-platelet therapy? 30 seconds to find out we had a lot – AND 53% SMOKED How do we contact them? 30 seconds to generate a letter to all the patients 30 seconds to set up an automatic reminder

Use of Electronic Medical Record to Improve Chronic Disease Management: Coronary Artery Disease : 

Use of Electronic Medical Record to Improve Chronic Disease Management: Coronary Artery Disease T Cardoso, MD; S Challa, MD; R Sporici, MD; T Hatton, DO; W Melahn, MD; L Goldstein, MD     St. Claire Regional Family Medicine Residency Lesson learned: EMR is a powerful tool for taking better care of patients.

20 providers = 20 ways to manage Coumadin : 

20 providers = 20 ways to manage Coumadin Now 1 way to manage Coumadin Lesson learned: There really is a best practice.

Zelnorm Recall : 

Zelnorm Recall 30 seconds to find out we had 20 patients taking it Calls made immediately to all 20 to stop taking the drug Lesson learned: This is a safer way of doing things.

What do our physicians love? : 

What do our physicians love? Electronic signature Remote access No lost charts E-prescribing Home earlier Making a difference for patients Any way to use it that is their idea Lesson learned: Physician involvement/control = greater success.

What do our physicians hate? : 

What do our physicians hate? Default Pop-ups Still having to hand write Scheduled narcotics Meetings Lesson learned: Meetings to determine clinical ways to use the EMR takes longer than actually doing it.

Encounters system wide : 

Encounters system wide Lesson learned: The slowdown is temporary, the payoff is huge.

How many providers want to go back to paper? : 

How many providers want to go back to paper? ZERO Lesson learned: We did the right thing. So can you.

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