HIT Adoption University of Utah Experience Michael Strong, MD Chief Medical Information Officer
EMR Implementation • Two year clinic implementation plan • Anticipated a follow-up optimization schedule that would mirror the implementation roll-out – Didn’t work – Competing priorities and projects
Specialty Provider Satisfaction Score Fall 2012 Dermatology 82 %tile Nephrology 68 %tile Gastroenterology 21 %tile Obstetrics 44 %tile Orthopaedics 49 %tile Internal Medicine 43 %tile Neurosurgery 25 %tile Surgery 25 %tile Rheumatology 1 %tile Family Medicine 28 %tile Neurology 25 %tile 13 th % Pulmonary 16 th %tile Pediatricians
You are Here
Needed a new paradigm: Implementation vs. Adoption • Implementation is a discrete point in time • Adoption is forever
There is No “Silver Bullet”
Three Areas of Optimization Focus Epic Care Optimization Providers Support Staff Application Enhancement
Provider Optimization Plan • Physician Leads (Super User) – Identify 1 provider for each clinical group – Provide modest financial support (one time) – Expectations: • Become Super User • Meet with colleagues to help them learn the application with their unique workflows • Be long- term “point of contact” to provide updated information regarding enhancements/changes to the system • One “ superest ” user to oversee these leads – Melissa Briley, PA – 0.5 FTE • Jointly funded by Hospital and Medical Group
Outpatient Provider Leads Community Clinics OB/GYN Cardiology Rheumatology General Surgery Vascular Surgery � � Brett Clayson Erin Clark Allen Sawitzke Eric Volkman Nazem� Akoum� Dee� Jost� GI Pulmonary Infectious Disease Urology CT Surgery Ophthalmology � � � Keisa Lynch Elisabeth Carr Terri Hancock Claudia� Goulston� Norm� Zabriski� Andy� Southwick� General Medicine Endocrinology Neurology Neurosurgery Plastic Surgery PM & R � � Nathan Ragle Ann Haynes Noah� Kolb� Erica Bisson Jaron McMullin Michael� Henrie� Pediatrics Renal Psychiatry ENT Orthopedics Dermatology Carole Stipelman � � Elizabeth Smith Arsalan Habib Mike� Lowry� Chris Pelt Tyler Nelson Dan� Ward� Pain� Clinic� Jill� Sindt�
Supporting the Supporters • One on One Training • Monthly Webinars • Slide decks • How- To’s and FAQs • Provide data
EPIC Tips
Feedback “In terms of improving the adoption of EPIC, I think our department is using EPIC more efficiently with the user dictionaries and autocomplete, the records review and reporting is now being used and the shortcut key use has really made a change for me. I pass on these tips but I am not sure how many of the urology staff end up using them. In terms of EPIC upgrades, the split screen is used by everybody and is a huge game changer. Most people now have the preview and filters configured and use the wrench to change the order of reports. I don't know if those are wins, but we are more efficient and happier with EPIC since you have started helping me .” Andrew Southwick, MD
Clinic Support Staff Optimization Plan • Informatics Medical Assistants – Currently 4 FTE – Divided clinics into 4 groups with one informatics MA assigned to each group – Regularly and repeatedly trains and reinforces workflows with clinic staff • EMR trainers – Also divided clinics into assigned groups – Round in clinics regularly to provide additional training support – Shadowing – leads to conveying “tips & tricks”
Message to CMIO
EPIC Optimization • We have seen a 20% reduction in average time to close encounters over the past 6 months
Staying on the same page • EpicCare Adoption Work Group – IT – Nursing: MA informatics – Training Team – Provider Champion • Meet monthly – Pick topics – Discuss what is working
Lessons Learned • End users felt deserted, just when they started figuring out what they needed • A lock step approach to “circle back” did not work • Using embedded players creates an infrastructure that is ongoing and sustainable
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