HIT Adoption University of Utah Experience Michael Strong, MD - - PowerPoint PPT Presentation

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 Pulmonary 13th% Pediatricians 16th%tile

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 Brett Clayson GI Keisa Lynch General Medicine Nathan Ragle Pediatrics Carole Stipelman Elizabeth Smith Rheumatology Allen Sawitzke OB/GYN Erin Clark Pulmonary Elisabeth Carr Endocrinology Ann Haynes Renal Arsalan Habib General Surgery Eric Volkman Cardiology

• Nazem

Akoum Infectious Disease

• Claudia

Goulston Neurology

• Noah

Kolb

Psychiatry

• Mike

Lowry Vascular Surgery

• Dee

Jost

Urology

• Andy

Southwick

Neurosurgery

Erica Bisson

ENT

• Dan

Ward

CT Surgery

Terri Hancock

Plastic Surgery Jaron McMullin Orthopedics Chris Pelt Ophthalmology

• Norm

Zabriski PM & R

• Michael

Henrie

Dermatology

Tyler Nelson

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