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Hurdles in Adopting and Implementing Integrated EHR in Community-based Addiction Treatment Clinics

Hurdles in Adopting and Implementing Integrated EHR in Community-based Addiction Treatment Clinics. Ron Jackson, M.S.W. Evergreen Treatment Services Seattle, WA. Agency Description. Private non-profit, founded 1973 $7.7 M annual budget; staff of 110 Clinical programs

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Hurdles in Adopting and Implementing Integrated EHR in Community-based Addiction Treatment Clinics

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  1. Hurdles in Adopting and Implementing Integrated EHR in Community-based Addiction Treatment Clinics Ron Jackson, M.S.W. Evergreen Treatment Services Seattle, WA

  2. Agency Description • Private non-profit, founded 1973 • $7.7 M annual budget; staff of 110 • Clinical programs • Opioid Treatment Programs (OTPS) • 1400 patients at three fixed sites (two in Seattle & one in Olympia) a mobile medication unit and a primary care-based program (both in Seattle) • Intensive Case Management (REACH) • homeless, chronic public inebriates • Research projects

  3. Why are we doing this? • Better able to track staff productivity on contract and regulatory deliverables • Easier access by staff to patient information • Clinic performance evaluations made easier • Interoperability with other EHR systems, research and clinical

  4. Vital Considerations If you are not moving towards EHR you will be in a competitive disadvantage Do your homework; vendors must add value Realize once you take the steps towards an EHR you must challenge the way you conduct your business

  5. A Paperless Approach Gather Patient Information Electronic forms Electronic & Digital signatures Organize Treatment plans and progress notes Manage doctor orders & medical notes Interface with toxicology labs Maintain medication inventories Bill 3rd party payers' and manage co-pays

  6. Adoption Process“What are we going to do and how are we going to do it?” • What are we going to do? • Limited EHR, e.g., medication dispensing? • Complete EHR? • If complete are we going to try to enter all existing patient data or some subset? • How are we going to do it? • Vendor selection • Which staff are involved? • Budgeting for the expense • Software • Hardware • IT staff at agency • Incremental versus total immersion from Day 1

  7. Adoption ProcessVendor selection • What are the key elements? • Specificity to agency’s services’ delivery • Software’s history and acceptability to accreditation, regulatory and funding agencies • Training and on-going customer support • References from current customers • Durability of software • Customer support • Staff and patient acceptance • Price, while important, is less so than the above

  8. Implementation ProcessBefore going “live” • Selecting a core team and “champions” • Examining the differences between EHR software and agency forms and processes • What to change and what to keep • Iterative process between agency and vendor • Staff training • By vendor • By champions • Patient notification and support

  9. Implementation ProcessAfter going “live” • Incremental versus total immersion • If incremental, choosing order of element implementation • Continuing the iterative process between agency and vendor on differences between EHR software and agency forms and processes – problem solving • What to change and what to keep • Monitoring performance • Monitoring staff needs and morale • “It’s all about relationships”

  10. Other EHR Concerns • Management reports • How to integrate into agency supervisory and administrative processes • Data extraction for use in other databases • Interoperability with other EHRs? • Effect on patient outcomes?

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