1. Using an EMR to Support Screening Processes Session 2 1

2. Objectives To identify the difference between standardized and non-standardized data To identify how the EMR supports screening processes To identify how EMR practices support screening processes Where to start with our teams 2

3. Question: What health data is most encoded from physician offices across Alberta? Answer: Billing data 3

4. Types of Data Recorded in an EMR At the clinic level data can be classified as: – Structured data May be standardized at the clinic level Searchable – Unstructured data Usually unstandardized Challenging to search for, or, Non-searchable 4

5. Examples of Structured Data Radio Buttons Tick Boxes Drop Down Boxes Pick Lists Discrete fields 5

6. Examples of Unstructured Data Fields where notes can be written Includes drawings and sentences 6

7. Templates 7 Text Field amongst many discrete data fields

8. EMR Capabilities Relevant to Screening Track data over time Identify and sort patients Identify patients who are due/overdue for screening Monitor parameters, such as vaccinations and BP readings Messaging between team members Create reports Generate, print and store requisitions Fax from within EMR to lab or diagnostic imaging sites 8

9. Blue Meadow Case Study 9 Engaging the whole team in this discussion makes decisions and priorities transparent for all and builds shared commitment

10. Current State Assessment Determine what is currently being recorded in a standardized way – By individual providers/staff – Amongst all providers/staff – By the system 10

11. Data Relevant for ASaP How are the ASaP maneuvers documented? 11

12. Screening Offer Documentation 12

13. Consider Dr. Doe and Dr. Greens patterns of screening documentation Many offers occur during a Complete Physical eXamination (CPx) Mixed use of standard fields and notes – which may not be searched or reported Investigation requisitions are created and results received in the EMR (not scans) Influenza is offered seasonally 13

14. Moving Forward: Gain Agreement on Standardization 1) What does Blue Meadow want to get out of the EMR? Agree on desired outputs 2) What needs to go in to make this happen? Determine which fields in EMR need to be filled to generate the desired reports Agree on data entry Identify skill gaps and train Monitor regularly and reinforce 14

15. Getting Help EMR Help Files Vendor POSP funded VCUR 08 clinics Share with another clinic using the same system TOP resources 15

16. Key Concepts Foundationally: EMRs can – Identify target populations for screening – Remind that the screening is due – Record that screening has been offered – Fax requisitions Understand where you are in order to conduct chart review and prepare for screening process redesign Screening is not a one-time event but a process 16

17. Summary EMR will contain both structured and standardized data as well as unstructured and non-standardized data EMR for Screening Processes – Capabilities: sort, fax, search, report – Practices: standardize where possible The Chart Review will help to understand the current state and inform screening process redesign 17