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EHR Implementation by Clinch River Health Services, Inc.

EHR Implementation by Clinch River Health Services, Inc. Clinch River Health Services, Inc. A Community Health Center in Dungannon, Virginia; population 400, with 3500 active users serviced by three Providers. Gary E. Michael, MD Family Medicine Physician Medical Director for 17 years

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EHR Implementation by Clinch River Health Services, Inc.

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  1. EHR Implementation by Clinch River Health Services, Inc. • Clinch River Health Services, Inc. • A Community Health Center in Dungannon, Virginia; population 400, with 3500 active users serviced by three Providers. • Gary E. Michael, MD • Family Medicine Physician • Medical Director for 17 years • National Health Service Corp Alumni

  2. EHR Implementation Plan • Phase 1 – Strategic Planning • Phase 2 – Partnerships • Phase 3 – Staff Evaluation & Education • Phase 4 – Define Measurable Outcomes • Phase 5 – Review Vendors,Select & Purchase • Phase 6 – EHR Implementation • Phase 7 – Revisit Outcome Measures

  3. Phase 1 – Strategic Planning • Board of Directors • Accurate and timely data is essential to quality, data-driven health care. • Performance Improvement – 5 year plan • EHR implementation as an organization wide effort to enhance efficiency, increase productivity, but mostly as an innovation to introduce quality tools for better health service delivery with accurate, real-time data collection and reporting. • Financial Review • Loss of Revenue due to initial loss of productivity • Funding, Grants

  4. Phase 2 - Partnerships • EHealth Committee • Developed by the Community Care Network of Virginia focused on the planning for Virginia CHCs to acquire EHR • CareSpark • A RHIO located in northeastern Tennessee – southwestern Virginia • A Champion

  5. Phase 3 – Staff Evaluation & Education • Vendor Presentations • Staff to evaluate the systems for • Flexibility • Presentation Layer • Attributes to complete the work we do • Melt away staff fears • Examples of how EHR enhances work performance or the work day. • Hunting down paper charts • Completing Tracking Logs

  6. Phase 3 – Staff Evaluation & Education • DOQ-IT • Evaluate staff skills, organization readiness • Process Analysis • Document: office management, patient/visit specific tasks • Working well, poorly, not at all • Barriers to Improvement: workflow, data entry, integration/interfacing, personnel • PDCA cycles, CQI techniques

  7. Phase 3 – Staff Evaluation & Education • Patient Flow Analysis • Visit Re-engineering • Process Conversion • Paper process converted to EHR process • an ongoing effort as staff learns more, processes can be converted • Aligning Personnel, skills, needs • Staff for scanning

  8. Phase 4 – Define Measurable Outcomes • Categories: Cost, Efficiency, Productivity, Satisfaction • Interview all staff for job functions, concerns, work flow, goals of EHR • Promotes Staff Buy-in • Provides valuable information of present status of the system/organization

  9. Phase 5 – Review Vendors, Select & Purchase • EHealth Committee Work • 25 page EMR Functional Requirements • Standards • Vendor Presentation with selected Scenario • On-site Visits • Grants – Rural Development • IT support • TechSoup – for non-profits

  10. Phase 6 –EHR Implementation • Designate a Superuser • Works closely with the Vendor before “go-live” date • Or have an on-site IT person and train the person in daily activities • Schedule Preparation • Increase load of RMC before “go-live” date • NO patients during training • Clinical Template Building • 25% scheduling & increase every 2 weeks

  11. Phase 6 –EHR Implementation • Policy Development • Chart Messaging • Chart Population • Pre-loading • Post-loading • First visit responsibilities • Second visit responsibilities • Desk Top Responsibilities

  12. Phase 6 –EHR Implementation • Policy Development (continued) • Front Desk Intake • Medical Records Request • Orders Management • Password Protected • Routine Charting • System Down • System Upkeep

  13. Phase 6 –EHR Implementation • Staff exposure to the EHR prior to “go-live” • Weekly team meetings • Share Lessons Learned • Skills development • Convert OLD processes to EHR processes

  14. Phase 7 – Revisit Outcome Measures • Outcome Measures being collected and analyzed now after 1 year of “go-live” • General Comments after looking back: • Completed the PI project 2 years early • EHR captures more information and documents more work than ever before • Lessons Learned Checklist developed and given to other centers to improve their implementation process

  15. Were We Successful? • Productivity • 2007 Total Encounters > 2006 Encounters • 2007 Diabetes Metrics = 2006 Results • Subpopulation data vs Total Population data • Efficiency • Number of daily recorded telephone messages increased by 25% • Rx refill turnaround time reduced by 50% • X-ray report turnaround >90% within 48Hours

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