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EESI Overview. E nterprise E picCare S pecialty I mplementation (EESI) Shared EHR across all ambulatory clinics HMC, NWH, UWMC. BY THE NUMBERS 85+ CLINICS 30+ SPECIALTIES 1000 PROVIDERS 2000 STAFF. WHY :
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EESI Overview Enterprise EpicCare Specialty Implementation (EESI) • Shared EHR across all ambulatory clinics • HMC, NWH, UWMC BY THE NUMBERS 85+ CLINICS 30+ SPECIALTIES 1000 PROVIDERS 2000 STAFF • WHY: • Opportunity to standardize & improve individual patient care & population health • Ability to collect & report on discrete data for quality management & research • Ability to achieve regulatory compliance (MU, ICD-10, PQRS, etc) • WHEN: • EESI Go Live is May 20, 2014 (167 days and counting…)
BENEFITS • Facilitates meeting organizational Meaningful Use and other regulatory requirements. • Enables cross site communication • Within UW Medicine Ambulatory Clinics • With external users of EpicCare (eg. Swedish, Valley, Group Health) • No more paper fee sheets. Billing will be electronic! • No more paper requisitions. • Prescriptions are electronically sent to the patient’s pharmacy of choice. • Facilitates patient’s access to their medical information via eCare (patient portal). • Improves communication within the clinic care team and with referring practitioners.
EESI Program Timeline WE ARE HERE • GO-LIVE • MAY 20 • 2014 • DISCOVERY • MAY-JUNE • 2013 • ALIGNMENT • JULY-AUG • 2013 • BUILD • SEPT-JAN • 2013-2014 • TESTING & TRAINING • FEB - MAY • 2014 • SPECIALTY BUILD CONTINUES • Cycle Two completed, testing in progress • FINALIZED SPECIALTY BUILD DESIGN • Completed collaborative meetings, sign off • FUTURE STATE APPLICATION DESIGNReviewed with clinic managers • COMPLETED DISCOVERY & ENGAGEMENT • Collected data required for implementation
Specialty Build • Collaborative specialty groups with representation from HMC, NWH, UWMC • Specialty Navigator Build • Common Chief Complaints • Medical History • Surgical History • Family History • Patient at a Glance (Epic Term: SnapShot) • Data Collection Over Time (Epic Term: Documentation Flowsheets) • Long Term Disease Management (Epic Term: Synopsis) • Preference lists • Note templates (Epic Term: Smart Texts) • Order sets (Epic Term: Smart Sets)
Planning for Go-live Schedule Changes • Managers & Medical Directors ensure appropriate schedule • Discourage time away from clinic during 3 weeks post go-Live • Strongly consider holding slots for urgent/semi-urgent patients • Sensitivity to learning needs: • Return to full productivity according to practitioner’s ability • Quick learners can add additional visits as requested; No increases in first week • Current EpicCare users (those who cross clinics) may not need schedule reductions; Consider impact on staff • Encourage providers to schedule more clinics with fewer patients during go-live weeks if possible to increase access and increase provider learning when support available
Schedule Reduction Guidelines Block schedules now for go-live!
What can you do to make this EESIer ? • Preparation • Clean up your problem lists (ICD-9 or SNOMED code based) and medication lists in Orca • If you are computer-challenged (typing or navigation skills), problem solve with your clinic manager or clinic chief ahead of time • Work with your clinic leadership to adopt compliant clinic workflows ahead of implementation • Training • Sign up for training • Complete the e-learnings before you go to class • Implementation • Down-schedule your clinics during go-live • Schedule as many extra clinic sessions as you can while there is at-the-elbow support available • Acknowledge that this will be hard work and the first few months will be stressful
Draft Compliance Discussion: Orders *POCT – chemstick, UA dip, urine pregnancy, EKG (probably not POCT?), rapid strep, urine drug screen, others????? (policy on other protocol orders is pending)