Health IT Leadership Capstone ACPE Nov 8-9, 2011

1. Health IT Leadership CapstoneACPENov 8-9, 2011 K Gabrielle Gaspar, MD, MPH, CMQ Medical Director of Clinical Informatics Sutter Physician Services

2. Leadership Principles & Stragies • Adoption as Value Enabler • Align Project with Organizational Goals • Engaging Leadership • Leveraging Physician Champions • Role of Governance • Use Root Cause Analysis -> PDSA • Align training efforts with adoption goals • Provide prompt feedback

3. Improving the Quality of Clinical Data in an Electronic Medical Record What Mammography results as structured data in shared chart EMR – One patient/One chart Why Sutter Health’s Destination 2012 goals Independent Practice Association dashboard goals Meaningful Use How PDSA focusing on standardized workflows, improved clinical content forms 3

4. Current State

5. Model for Improvement Capture 100% of Mammography Results in Flow Sheet Results are accurate and available to clinicians in timely fashion Improve work flow and available forms

6. Test of Change

7. Assessing Outcome TOC1 TOC2 TOC 1 Mar 2, 8 TOC 1b Mar 15 TOC 2 April 19 Rules violated – Point above Zone A Point below Zone A

8. Assessing the Process TOC2 TOC1

9. Checking for Unintended Consequences Average Days: 3 (March, April) Rules violated: Point above Zone A 4-5 points in lower Zone B

10. Holding Gain…

11. Lessons Learned • Important to provide context • Speak the language of your users • Keep it simple • Value of rapidly incorporating user feedback • Be prepared to adapt workflows based on user preference • Move upstream when possible • Administrative and EMR data may not reconcile 11

12. Thank You Kevin Sapad, Clinical Quality Project Coordinator T H E T E A M Leslie Bouillette, Sr Technical Analyst Julie Cooper, EMR Manager K Gabrielle Gaspar, Med Dir Clinical Informatics 12