Transforming Education: EMR Pathology Interface

1. Transforming Education: EMR Pathology Interface Helen Connors, RN, PhD, FAAN Associate Dean/Academic Affairs University of Kansas School of Nursing Executive Director KU Center for Health Informatics

2. Academic-Business Partnership Dean Karen Miller, RN, PhD, FAAN Senior Vice Chancellor KUMC Cerner Corporation Kansas City, MO Neal Patterson Chairman of the Board Chief Executive Officer Cerner Corporation University of Kansas School of Nursing showing the world what nurses can do Fall 1999

3. Driving Forces for Technology • IOM Reports on Quality and Safety • Automated work environments • Commitment to use technology to transform healthcare system • National Healthcare Information Infrastructure and other Government efforts • Cultural change starts in the classroom

4. SEEDS Simulated E-hEalth Delivery System Designed to provide teaching and learning tools to assist health professional students to develop competencies to harness the power of information technology, thus improving the quality, efficiency and effectiveness of healthcare. Academic Education Solution Problem based Learning

5. SEEDS Objectives • Enhance development of critical thinking and problem solving. • Integrate online patient assessment, problem identification, treatment and evaluation. • Demonstrate the impact that structured data and information have on patient care. • Provide the information infrastructure for evidence-based clinical practice. • Promote the dissemination and evaluation of knowledge and research. • Foster inter professional education

6. Florence Nightingale Mental Health Center Miller Memorial Medical Center Connors School Clinic JayHawk Public Health Dept. JayDoc Clinic Bleich Outpatient Clinic Clifford Home Care SEEDS Program

7. Seminar Group Standardized Patient Encounters One-On-One Skills Lab Independent Study Simulations SEEDS Usage

8. School of Medicine • Leverage the success of the SON • Negotiated access to PCO (“PowerChart Office” out-patient application) fall 2004 • Tool to automate office practice • Includes “view” into in-patient environment (PowerChart) • Provides tools for: • Structured Clinical Documentation • Prescription Writing • E&M Coding/Automated Note Review • Lab, Rad, PT, OT, Nursing Services, etc… • Links to Outside Resources

9. EMR Roll Out—SOM • Introduction to Clinical Skills • Overview of EHR/HIT—2nd day of medical school • Hands-on experiences in the first week • First “full H&P” documented with EHR • Skills Lab • Teaching labs and patients • i.e. dermatology examination, CV exam, etc… • other specific topics for history of PE • Group-based standardized patient experience • Individual year-end standardized patient experience

10. EMR Roll Out—SOM • Cell and Tissue Biology • Large Lecture-Hall Clinical Correlation—Pancreatic CA (where case history is presented through the EHR) with 5 faculty members participating • Large Lecture-Hall Clinical Correlation—Colon CA (presented through EMR—data about case returned to students sequentially over time) • Medical Microbiology • Multi-part, small-group, PBL (problem-based learning) on community acquired pneumonia (diagnosis and treatment)

11. University of Kansas School of Medicine Phase I (Pre-clinical Phase) • Modules versus semester-long courses • Interdisciplinary versus departmental • Normal and abnormal structure and function throughout the first two years • Active and collaborative learning – PBL, small groups, histopathology groups • Technology-based – Tablet PC, virtual microscopy, Angel • Enhanced student assessment – computer testing, tracking of student performance

12. Modules • Year 1 • Foundations of Medicine (8 wks) • Genetics and Neoplasia (4 wks) • Inflammation and Immunity (4 wks) • Cardiopulmonary (8 wks) • Gastrointestinal Tract and Nutrition (4 wks) • Renal and Endocrine (4 wks) • Sexuality and Reproductive Medicine (4 wks)

13. Modules • Year 2 • Musculoskeletal, Skin, and Soft Tissue (4 wks) • Brain, Mind, and Behavior (8 wks) • Blood and Lymphoid (4 wks) • Infectious Diseases (6 wks) • Medicine Across the Lifespan (4 wks) • Integration & Consolidation (7 wks)

14. Cell and Tissue Biology

15. Cell and Tissue Biology

16. Cell and Tissue Biology

17. Cell and Tissue Biology

18. Cell and Tissue Biology

19. Cell and Tissue Biology

20. Cell and Tissue Biology

21. Cell and Tissue Biology

22. Students • “I think familiarity with this type of technology is no longer optional but mandatory for people entering the healthcare profession.” (S. Oberhelman – Med Student) • The health care environment is quickly moving toward EHR and electronic documentation, I’m glad I’m learning in the same manner I will someday be working.” (J. Gray – Nursing Student)

23. Faculty • “I become more of a facilitator of their learning, not just a talking head.” (K. Fletcher) • “The technology engages the students on a whole different level- one that they don’t get in any other classroom.” (M. LeBlanc) • “Providing the nursing students with the EHR along with the human patient simulator gives the students more than an episodic patient care event.” (C. Zimmerman)