Presentation is loading. Please wait.

Presentation is loading. Please wait.

The Electronic Medical Record at Carilion Clinic.

Similar presentations


Presentation on theme: "The Electronic Medical Record at Carilion Clinic."— Presentation transcript:

1 The Electronic Medical Record at Carilion Clinic

2 Tools for building the Clinic Plan Leadership Board Governance Physicians Standards Infrastructure Integrated Electronic Medical Record

3 An Integrated Electronic Medical Record (EMR) Same look and feel inpatient and outpatient Ability to share records across the enterprise True continuum of care delivery with a single record Universal view of problems/medications/allergies Patients are not repeatedly asked the same questions Facilitates patient access through our system Higher patient satisfaction Better clinical outcomes

4 Electronic Clinical Tools at Carilion 1990 Radiology Management – Siemens 1990 Pharmacy – Siemens 1992 Cardiology – GE Muse 1999 Ambulatory EMR – Logician 2000 Emergency Department – EDIS 2000 OR – ORMIS 2001 PACS – AGFA 2003 Bed Scheduling – TeleTracking 2003 Transcription - MedQuist 2004 Medication Authentication – Siemens 2005 Acute EMR – CPSI

5 Carilions Commitment to Clinical Technology - Operating:75 th percentile among peers - Capital:95 th percentile among peers

6 Clinical Technology at Carilion US 50 th Percentile Time Technology

7 The Challenge Integration Time Technology US 50 th Percentile

8 Carilion Clinic Today is Best of Breed Roanoke Memorial Franklin Memorial New River Valley Giles Memorial Bedford Memorial EMERGENCY DEPARTMENT Stonewall Jackson CPSI Wellsoft EDIS Alignment within applications

9 Alignment across applications Orders Management Siemens Invision Siemens Soarian Radiology Siemens RMS AGFA PACS Pharmacy Siemens MAK Pyxis Siemens Pharmacy CardiologyGE Muse ORGE ORMIS EDWellsoft EDIS Document Imaging AMS Sovera PortalMedicity Roanoke Memorial Franklin Memorial New River Valley Giles Memorial Bedford Memorial EMERGENCY DEPARTMENT Stonewall Jackson CPSI Wellsoft EDIS Alignment within applications Carilion Clinic Today is Best of Breed

10 Primary Care Pharmacy OR ED Imaging Lab Inpatient Care

11

12

13

14 Total Interfaces: 509

15 The Challenge Time Technology US 50 th Percentile Integration of Patient Information

16

17 Benefits of an Integrated EMR Patient Safety –Checks for conflicts –Hard Stops for safety –Common Allergies List –Common Medication List

18 Primary Care Pharmacy OR ED Imaging Lab Inpatient Care

19 Benefits of an Integrated EMR Patient Safety –Conflict checking –Hard Stops for safety –Common Allergies List –Common Medication List Reduce Variation and Improve Quality –Paper orders – order sets –Protocols management –Standardized Formulary –Soft Stops for Best Medical Practices

20 Benefits of an Integrated EMR Patient Safety –Conflict checking –Hard Stops for safety –Common Allergies List –Common Medication List Reduce Variation and Improve Quality –Paper orders – order sets –Protocols management –Standardized Formulary –Soft Stops for Best Medical Practices Reduce Overutilization –CT Head –Creatinine

21 Benefits of an Integrated EMR Patient Safety –Conflict checking –Hard Stops for safety –Common Allergies List –Common Medication List Reduce Variation and Improve Quality –Paper orders – order sets –Protocols management –Standardized Formulary –Soft Stops for Best Practices Reduce Overutilization –CT Chest –Creatinine Facilitate Research –Standardize data fields –Create searchable data –Support the Research Institute

22

23

24 Benefits of an Integrated EMR Patient Safety –Conflict checking –Hard Stops for safety –Common Allergies List –Common Medication List Reduce Variation and Improve Quality –Paper orders – order sets –Protocols management –Standardized Formulary –Soft Stops for Best Practices Reduce Overutilization –CT Chest –Creatinine Facilitate Research –Standardize data fields –Create searchable data –Support the Research Institute Improved Practice –Coordinated Referrals –Coordinated Scheduling

25 Experiences of other Hospitals post Integrated EMR Implementation Radiology turnaround time reduced Pharmacist interventions reduced by 50% Duplicate ancillary tests reduced by 48% Number of delays in administering medication has fallen by 70% Omitted administration of drugs reduced by 20% Test results for mammograms take one day, down from as long as three weeks New medication procedures can be introduced in hours

26 Carilions EMR Selection Process Fast – Four Months Broad – Due diligence on four systems Deep – Participation of more than 300 Carilion employees All hospitals All therapies All administrative and support services Thorough – More than eight site visits

27 The Slippery Slope

28 Scope Acute EMR – CCMC (but not Pharmacy) Acute EMR – CCMC and CNRVMC (but not pharmacy) Pharmacy and Acute EMR – CCMC and CNRVMC (but not ED) ED, Pharmacy, Acute EMR – CCMC and CNRVMC (but definitely not Ambulatory EMR) Ambulatory EMR, ED, Pharmacy, Acute EMR – CMC, CNRVMC, CGMH, CFMH (but not CPSI sites) Ambulatory EMR, ED, Pharmacy, Acute EMR – All Hospitals and practices Ambulatory EMR, ED, Pharmacy, Acute EMR, EMPI – All Hospitals and practices Ambulatory EMR, ED, Pharmacy, Acute EMR, EMPI, Registration – All Hospitals and practices (but not scheduling or billing) Ambulatory EMR, ED, Pharmacy, Acute EMR, EMPI, Scheduling – All Hospitals and practices (but not billing) Ambulatory EMR, ED, Pharmacy, Acute EMR, EMPI, Scheduling, Billing, Registration – All Hospitals and practices

29 (but not lab) Scope

30 Clinical Information System Evaluation Process 2 August Began Selection 8 – Vendor 2 Deep Dive On Site Demos By 4 Vendors September Selected Two Vendors OctoberNovember Vendor 1 Deep Dive Somerset, NJ (Vendor 2) Evanston, IL (Vendor 1) Baystate, MA (Vendor 2) Cleveland Clinic (Vendor 1) Vendor 1 Corporate Visit Vendor 2 Corporate Visit Vendor 1 Selection 1 st Vendor 1 Contract Call 23 December Contract Signature

31 Magic Quadrant for North American Enterprise CPR 2006 Source: Gartner December 2005

32 Selection Preference Summary PHYSICIANS NURSING PHARMACY ED THERAPIES HIM IT INFORMATICS Vendor 1Vendor 2

33 MAK

34 INTEGRATED EMR

35 Carilion Clinical Application Integration Time Technology INTEGRATED EMR

36 Immediate Benefits – Carilion Clinic All physicians have immediate access to a patients entire record –From any location Standardization of order sets –Best practice adoption Tracking referral patterns

37 Accomplishments to-date Created and trained 125-person EMR team Built physician practice content and training Converted 9 years of Centricity records to new system –780,000 patient records –43 million data fields

38

39

40 Roanoke Primary Care MJFAMJJASONDMJFAMJJASONDMJFAM

41 Roanoke Primary Care 2/20Daleville 3/26Blue Ridge 4/2Vinton 4/9North Roanoke 4/16Colonial Avenue 4/16Urgent Care Roanoke 4/30Crystal Spring 5/7Northwest 5/14Southeast 5/21Roanoke Salem 5/28Brambleton MJFAMJJASONDMJFAMJJASONDMJFAM

42 Roanoke Primary Care RMH Clinics PedsSurgerySpecialtyOB / Gyn MJFAMJJASONDMJFAMJJASONDMJFAM

43 Roanoke Primary Care RMH Clinics PedsSurgerySpecialtyOB / Gyn NRV Area Practices Franklin Area Practices Giles, Lexington, Bedford Practices MJFAMJJASONDMJFAMJJASONDMJFAM

44 Roanoke Primary Care RMH Clinics PedsSurgerySpecialtyOB / Gyn RMH Peds CPOE All CPOE NRV Area Practices CNRVMC All CPOE Franklin Area Practices Giles, Lexington, Bedford Practices CFMH BMH CGMH CSJH MJFAMJJASONDMJFAMJJASONDMJFAM

45 Practice 1 Go-live February 20, 2008

46 Roanoke Primary Care RMH Clinics PedsSurgerySpecialtyOB / Gyn RMH Peds CPOE All CPOE NRV Area Practices CNRVMC All CPOE Franklin Area Practices Giles, Lexington, Bedford Practices CFMH BMH CGMH CSJH July 26 MJFAMJJASONDMJFAMJJASONDMJFAM

47 Roanoke Memorial Go-Live July 26, Inpatient Order Sets being built Trained Staff –5,000 clinical, financial, and administrative staff –More than 1,000 classes Installed more than 500 new computers Created command center

48 Physician Training eLearning – Self paced Classroom – Two 4 Hour Sessions Simulation Sandbox – Practice on own Findings – Leadership first is significant to ensuring compliance – Physicians who spend more time in preparation are most effective Day 1

49 5/5 – 5/16 Train Physician Leaders 5/26 – 7/19 Train All Physicians 7/14 – 7/18 Dress Rehearsal MarchAprilMayJuneJulyAugustSeptemberOctoberNovember Go-Live at Roanoke Memorial 7/26/08 CRMH Go-Live 10/18/08 CPOE Pediatrics 11/18/08 CPOE All

50 Carilion Clinic Technology Capital $10 M $20 M $30 M 0 - Total budgeted capital spend for new EMR is $65.8 M **

51 Integrated EMR Data and control for –Best medical practices –Reduced variance –Improved quality

52 Integrated EMR Data and control for –Best medical practices –Reduced variance –Improved quality Integrated system –Every patient –Every physician –All locations

53 Integrated EMR Data and control for –Best medical practices –Reduced variance –Improved quality Integrated system –Every patient –Every physician –All locations Improved practice –Referral management –Coordinated scheduling

54 Thank you

55 Technology Trigger Peak of Inflated Expectations Trough of Disillusionment Slope of Enlightenment Plateau of Productivity Enterprise Patient Scheduling Emergency Department Information System Computer Physician Order Entry Ambulatory EMR Generation 3 EMR Next-Generation Patient Financial System Personal Health Record - Is now the time for an integrated EMR?


Download ppt "The Electronic Medical Record at Carilion Clinic."

Similar presentations


Ads by Google