telus emr practice consulting · merge strategy has been defined (sep 2015) • first test merge...
TRANSCRIPT
TELUS EMR Practice Consulting TELUS Health: Sonny Sull and Ryan Everitt South Calgary PCN: Oliver Schmid
Agenda
2 Confidential
Introductions
Practice Consulting Overview
Current State and Success
South Calgary PCN Experience
Introductions 1
Introductions
4 Confidential
Practice Consulting Team within the Company Over 80 years of Health Care experience Health Business Consultants and Senior Client Service Management Delivering Training Content and Supporting Clinical Needs Program and Project Management Experience
Organizational Overview
5 Confidential
PCS Overview 2
Practice Consulting Services Overview
7 Public
Workflow Analysis and Optimization 1 Custom Advanced Training 2 Billing Optimization 3 Site Technical Consulting 4 Onsite Change Management Activities 5
8 Confidential
Workflow Analysis and Optimization
• Assessment and Understanding of Clinical EMR Usage
• Current State and Future State process mapping
• Custom Content creation
• Supporting Remote and Onsite Analysis
9 Confidential
Custom Advanced Training
• Assessment and Understanding of Clinical EMR Usage
• Advanced EMR Content Delivery
• Examples: • Chronic Disease Management • Panel Management • EMR Security • Physician Workdesk for Staff (P4S)
10 Confidential
Billing Optimization
• Assessment and Understanding of Clinical EMR Usage
• High Return on Investment
• Supporting Provincial Billing Requirements • Incentive Billings
• Third Party and Private
• Reporting
11 Confidential
Site Technical Consulting
• Assessment and Hardware Review
• Hardware Qualification
• Network Performance
• Multi Location Enablement
• Speed Performance Benchmarking
12 Confidential
Onsite Change Management Activities
• Assessment of current environment
• Supporting EMR Adoption
• Coaching and Mentoring for Best Practices
• Go Live Support • EMR Troubleshooting • Technical Liaising
13 Confidential
All begins with the assessment
• Remote and Onsite availability
• Finalized Report • Clinical Drivers • Assessment • Recommendations • Highlights Return on Investment
14 Confidential
Overall Approach
• Understand the clinical drivers
• Analysis/Assessment (investigative)
• Recommendations
• Action plan
15 Confidential
Assessment Tools
• Case Analysis Tools
• Return on Investment (cost savings)
• Technical Performance
• Workflow Analysis
Current State 3
17 Confidential
Current State and Success with PCS
• Over 80+ projects across BC and AB
• Approval to build the program cross Platforms • MedAccess • PS Suite
18 Confidential
Practice Consulting Statistics
Category Results
Interaction with Health Business Consultant – Top 2 Box
100%
TELUS Health was successful at improving relationship with customer
95%
Customers indicated being able to use EMR more effectively
94%
Likelihood to Recommend 82%
Clinics wanting additional consulting services in the future.
95%
19 Confidential
Practice Consulting Projects/Comments
“Visits like these keep us focused on full EMR utilization”
“Support for Billing Optimization Please”
“I Just wanted to say how helpful it was to have a Health Business Consultant stop by
the office yesterday – we really appreciated picking their brains about some of the questions/issues we have had about the software. I think it is a great service.”
20 Confidential
Introduction of South Calgary PCN
• SCPCN has been with TELUS since: 2010
• 3 Managed Clinics (4 main services)
• 3 x onsite Practice Consulting visits
• Workflow Analysis and Change management
• Custom Training Plan for super users
Oliver Schmid (PhD) South Calgary PCN Director of Evaluation and IM&T
SCPCN experience with Practice Consulting
22 Public
The Need: Clinic Consolidation 1 The Approach: TELUS Health PCS Engagement 2 The Current State: Where are we now? 3 The Future State: Where do we want to be? 4 The Benefit: What did the PCS Team bring? 5
The Need: Clinic Consolidation 1
The Need: South Calgary Primary Care Network
24 Public
• SCPCN is a growing PCN with (currently) 220 member physicians
• 4 managed clinics
• Multiple centralized services and service models within 3 EMR databases • Family practice • Low Risk Maternity • Diabetes Management • Chronic Disease Management • Counselling • Pediatric Weight Management • Nutrition Counselling • Others
• Ave. 380 incoming referrals and 1,700 visits per month
The Need: What is the Issue
25 Public
• No room to expand
The Need: What is the Resolution
26 Public
• Consolidate all clinics into 1 large space
The Need: Resource Optimization
27 Public
• Going from ALL things for 1 clinic
• To 1 thing for ALL clinics
The Need: What to do with the 3 EMRs
28 Public
Option 2: Start entering into 1 EMRs
Option 3: Engage TELUS for Feasibility
Study of 1 EMR
Option 1: Keep 3 EMRs
The Need: Project Roadmap
29 Public
EMR Clinical
Processes
Buildt Clinic Process
Redesign
Training
Database Merge
Goal
Vision
The Need: Project Overview
30 Public
• Consolidate 3 Wolf EMR databases into 1
• Setup Clinical & Corporate Network at new clinic
• Equipment and connection to TELUS data centre
The Approach: TELUS Health PCS Engagement
2
The Approach: TELUS Consultancy Team
32 Public
• Sonny Sull – EMR Consolidation Program Manager • Rob Harris – Senior Project Manager • Karen Loukota – Systems Engineer Specialist • Ryan Everitt – EMR Trainer • Erik Christensen – Merge Tool Developer • Shannon Cotter –Networking Project Manager • Rod Taylor – Account Manager
The Approach: SCPCN Project Team
33 Public
• Lonnie Ellis – Project Manager • Vinh Huynh – IT Manager • Valerie Moldowin – EMR Trainer • Sarah-Joy Haggstrom – EMR Optimization Lead • Bekki Tagg – EMR Analyst • Theresa Cooke – Assistant Clinic Manager • Oliver Schmid – Director IM&T
The Approach: Current State Assessment
34 Public
3 9
2 8
7 5
4 6
Current State Assessment
The Approach: Current State Assessment
35 Public
• Karen Loukota (TELUS Systems Engineer Specialist)
• Interview cross section of staff, providers and physicians covering all roles and responsibilities
• Mapping out all EMR workflows across all clinics
• 25 different workflows
• Performed June/July 2015
The Approach: Feasibility Study
36 Public
3 9 1
Feasibility Study
8
7 5
4 6
Current State Assessment
The Approach: Multiple Clinical Business Models
37 Public
• SCPCN has a two state business model
• Family Care Clinic
• Family practice with physicians
• Standard ‘stable’ patient panel
The Approach: Multiple Clinical Business Models
38 Public
Intake Appointment
Appointment 2
Appointment x
Discharge Appointment
• Low Risk Maternity Clinic
• Health Management Clinic
• Time 2 Talk
• Specific care pathways with transient panels
• 12 months • 6 – 7 months • 6 weeks
The Approach: Frequent Patient Panel Changes
39 Public
Family Care Clinic Low Risk Maternity Clinic
Time 2 Talk
The Approach: Patients in Multiple Panels
40 Public
Family Care Clinic Low Risk Maternity Clinic
Time 2 Talk
The Approach: TELUS Future State Suggestions
41 Public
TELUS Future State Suggestions
9
Feasibility Study
2 8
7 5
4 6
1
Current State Assessment
The Approach: TELUS Future State Proposals
42 Public
The Approach: Review & Select Future State
43 Public
3 9
Feasibility Study
2 8
7 5
6
1
Review & Select Future State
TELUS Future State Suggestions
Current State Assessment
The Approach: Review & Select Future State
44 Public
• Not all Workflow Recommendations could be adopted • Move to 100% e-referral is not yet possible due to physicians in network
being on non-Wolf EMRs • Do not print day sheets /referrals not possible due to secondary data
capture for Business Intelligence work
The Approach: Re-Design EMR Workflows
45 Public
3 9
Feasibility Study
2 8
7
4 6
1
Review & Select FutureState
TELUS Future State Suggestions
Re-Design EMR Workflows
Current State Assessment
The Approach: Re-Design EMR Workflows
46 Public
Current State Future State
The Approach: Define Data Standards
47 Public
3 9
Feasibility Study
2 8
7 5
4
1
Review & Select FutureState
TELUS Future State Suggestions
Re-Design EMR Workflows
Define Data Standards
Current State Assessment
The Approach: Define Data Standards
48 Public
SCHMC SCFCC SCLRM HMC New Patient New Patient new pat
HMC Office Patient Office Patient Office Patient HMC Left Practice Acute Care Patient Acute Care Patient
Deceased Long Term Care Patient Long Term Care Patient RR- HMC Re-Referred Left Practice Left Practice
PR- HMC Discharged- Patient Request Housebound Housebound NC- HMC Discharged- Non Compliant Deceased Deceased
NI- HMC Discharged- No Initial Member Discharged PC- HMC Discharged- Program Complete Eagles Med Pts Unattached-Now Attached
GI Patient Dr 1 Previous Pt Refer to OB GI Discharge Inactive Patient Not Accepted
Nutritional Services Patient Dr. 1 PT Found FP Discharge Nutritional Services Dr. 2 PT Not Our Patient Pediatric Wellness Program Dr. 3 PT Never Seen
Discharge - Pediatric Wellness Program Pediatric Kids in Care Transferred to OB Inactive Patient Home Safe South Miscarried
COST RD Dr. 4 PT Before EMR Time To Talk new Patient Never Seen Hearing Impaired
T2T Discharged Path To Home Pelvic Floor T2T Lost to Follow Up Dr. 5 PT
T2T Never Seen HSS Never Seen T2T Discharged-Provider Left PTH Discharged
T2T Discharged- patient request HSS Discharged Nutrition Services NEVER SEEN
PWP Never Seen Pharmacy
Pharmacy Discharged Pharmacy Never Seen
The Approach: Define Data Standards
49 Public
SCHMC SCFCC SCLRM HMC New Patient New Patient new pat
Time To Talk new Patient
The Approach: Develop EMR Merge Strategy
50 Public
3 9
Feasibility Study
2 8
5
4 6
1
Review & Select FutureState
TELUS Future State Suggestions
Re-Design EMR Workflows
Define Data Standards
Develop EMR Merge Strategy
Current State Assessment
The Approach: EMR Merge Strategy
51 Public
• Erik Christensen (Merge Tool Developer)
• Select target system
• Define what to do with historical referential data
• Leave as is • Override with future data standards
• Merge instances 1 by 1 or all together
• Log what requires manual migration
• Document all decisions and sign-off
The Approach: Develop Training Strategy
52 Public
3 9
Feasibility Study
2
7 5
4 6
1
Review & Select FutureState
TELUS Future State Suggestions
Re-Design EMR Workflows
Define Data Standards
Develop EMR Merge Strategy
Develop Training Strategy
Current State Assessment
The Approach: Train the Trainer
53 Public
• Ryan Everitt (TELUS EMR Trainer)
• TELUS designed comprehensive custom training plan for local EMR trainer and EMR Improvement Lead
• 3 sessions of 2 days split over 6 weeks
• SCPCN sandbox environment for testing and familiarization
The Approach: Internal Expertise Development
54 Public
Before After
The Approach: Training Plan
55 Public
• 61 total SCPCN staff to be trained • 4 Managers • 9 Nurses • 11 MOAs • 21 Allied Health Providers • 17 physicians
• Most have no previous formal EMR training
• Customized training sessions by staff type
• Group sessions and on-on-one
The Approach: Test Merge Tool
56 Public
3
Current State Assessment
Feasibility Study
2 8
7 5
4 6
1
Review & Select FutureState
TELUS Future State Suggestions
Re-Design EMR Workflows
Define Data Standards
Develop EMR Merge Strategy
Develop Training Strategy
Merge Testing
The Approach: Same Patient in Multiple EMRs
57 Public
EMR2 EMR1
The Approach: Same Patient in Multiple EMRs
58 Public
The Approach: Similar Patient in EMR
59 Public
81.3% Match Do you want to merge this patient?
The Approach: EMR Merge
60 Public
61 Public
The Approach: What’s in the Box
• 6,947 active patients • 1,306 Low Risk Maternity • 2,535 Chronic Disease Management & Mental Health • 3,106 Family Practice
• 34,508 inactive patients • 12,663 Low Risk Maternity • 7,010 Chronic Disease & Mental Health • 14,835 Family Practice
• 494 SMART Forms
The Current State: Where are we now? 3
The current State: Where are we now?
63 Public
• EMR team has been trained (Oct 2015)
• Merge strategy has been defined (Sep 2015)
• First test merge executed (Nov 2015)
• Workflows have been re-designed - awaiting sign-off
• Data standards have been developed – awaiting sign-off
• Training schedule has been developed (Jan 2016)
• TELUS onsite support has been scheduled
• Go-live has been set (Feb 2016)
The Future State: Where do we want to be?
4
Mar 2016
The Future State: Where do we want to be?
65 Public
Train EMR Team
Test Merge (test environment)
Data Cleansing & Manual Migration
Sign-Off Future State
Current State Assessment
Future State Development
Physical Clinic Move
Train Staff & Providers
EMR Merge (live)
Feb 2016 Jan 2016 Dec 2015 Nov 2015 2015
The Benefit: What did the PCS Team bring?
5
The Benefit: Team Work
67 Public
• Bi-weekly project calls with PMs
• Weekly EMR Merge calls and constant Q&A access to system developer (Erik)
• Expert Wolf capabilities/limitations knowledge
• Comprehensive custom made and flexible training plan from Ryan (the EMR team/girls loved this part)
• Constant access to Systems Engineer (Karen)
• Early start Network project kick-off
• Smooth behind the TELUS scenes coordination of projects
• Pro-active project input from TELUS team • Break training into multiple sessions` • How to handle different clinical business models • Onsite change management support during migration • Direct access to key staff to resolve project issues during go-live • Programmatic bulk data corrections • Training support • Etc.
TELUS Health PCS
68 Public
To learn more about PCS: [email protected] Feel Free to Connect with us at the conference this weekend Please take a PCS Brochure and Case Study