Thomas Selva, M.D., chief medical information officer for University of Missouri Health Care, and Seth Katz, associate administrator of information management at the Truman Medical Centers in Kansas City, Mo., spoke at HIMSS 2017 about how IT governance structures evolved at their institutions.
The Tiger Institute strives to make MU Health Care a recognized leader in building IT-enabled workflows. These innovative workflows drive efficiencies, lead to improved outcomes, and enhance the satisfaction of providers, caregivers, and, ultimately, patients.
Our efforts to build IT-enabled workflows center on a series of steps, which include the following:
- Improving physician documentation and communication tools
- Expanding the automated delivery of patient information to the EHR
- Supporting organizational performance improvement objectives
- Aligning the EHR framework to support care team or departmental workflows
Providers recognized our efforts with a statistically significant increase in overall satisfaction with the EHR. We continue to work to make a meaningful impact on our users’ experience.
Paving the way for improvement
We reached an important milestone in December 2015. We completed the rollout of Cerner’s Physician Specialty Playbooks through the PhLOW (Physician Localization Optimization Workgroup). In this work, the project team developed specialty provider positions based on the Cerner Playbooks/Model Experience framework, and switched providers from generic accounts into specialty accounts to improve their experience. With the implementation of 20 playbooks and 66 new security positions for more than 500 physicians, these playbooks allow IT to truly tailor the EHR to the physician’s workflow. Overall, MU Health Care has an 85.4% alignment with Cerner standards.
Improved documentation experience
Because providers typically don’t enjoy documentation, we decided to make it as effortless and as integrated into their normal workflow as possible.
More specifically, the Tiger Institute and MU Health Care established the innovative Documentation Advancement Resource Team (DART). The DART project goal is to make a positive impact on primary care not only by addressing existing EHR issues, but also introducing new documentation efficiencies and make the EHR experience more personal. The team introduced the Workflow MPage and Dynamic Documentation (DynDoc), and worked directly with the primary care providers to produce a more efficient and pleasant EHR experience. These efforts included position clean-up, a special message center workflow page, improved access to nursing-documented information, and addressing other minor annoyances that had impacts on each person.
As each provider proceeds through his or her customized specialty workflow, the page connects with DynDoc. This link allows clinicians to complete nearly all of their required documentation as a byproduct of the notes they make during the patient’s appointment. Those providers who were willing to take the leap into a new documentation platform have seen dramatic improvements on documentation time after hours and time spent per note while maintaining patient volumes. The DART project will continue to work with other specialty groups to achieve similar outcomes.
In the coming year, the Tiger Institute will further improve the provider and caregiver experience by making additional tools available to them.
For example, Clairvia, Cerner’s workforce management solution, will help us enhance staffing efficiency, while the Cerner Retail Pharmacy system will more closely integrate prescriptions with patient documentation in the EHR.
Provider communication will benefit from new secure texting capabilities, and the wireless integration of patient beds will automate data flow, which predicts and prevents falls or bed-related conditions.
Finally, the integration of Cerner Millennium and Active Directory identities will ease the login process for all staff members.
Reduce unnecessary orders, reduce patient costs and increase patient safety.
Cerner’s Sepsis Identification and Management Alert System continuously screens ED and Inpatient data. Patient data is fed near real time into Cerner’s Health Intent Cloud Services. These results are then evaluated based on the St. Johns Sepsis Agent Algorithm. The Sepsis alert algorithm identifies potential SIRS and Sepsis patients. Upon the recognition of SIRS or SEPSIS criteria, alerts are then sent to the care team. Then the care team will document and take action as advised by the Sepsis advisor to begin treatment according to CMS guidelines.
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