ugm presentation 2014 - roh attending, midlevels and residents

Topic

Level

Presenter(s):

Confidential—Proprietary Information—For use by authorized NextGen clients and employees only. Not for public distribution. Copyright 2014

Mid-levels, Residents and Students, Oh My!

Client

Candice DouglasDiane McGarry


Things our lawyers make us say...

Neither NextGen Healthcare nor any presenter at the ONE User Group Meeting is engaged in rendering legal or other professional advice and this presentation is not a substitute for the advice of your attorney, accountant and/or other professional advisor.


Session Guidelines

• Silence all cell phones • Questions will be addressed at the end of the

presentation• Refrain from personal discussion


Topics

In this presentation we will cover:• Our Healthcare Organization • Challenges faced• Solutions• Future State• Questions


Regional One Health

• ROH Center of Excellence in Trauma, Burn, High-Risk Obstetrics and Neonatal Intensive Care.

• Over 25 Outpatient Specialty Clinics and 6 Satellite Clinics

• Serves Tennessee, Mississippi and Arkansas


Regional One Health

• Outpatient clinics designed to deliver a wide range of primary care and specialty services within one network

• Satellite locations have broadened the reach of services and create need for the use of an EHR system


Provider MakeupA

ttend

ings •Faculty of

UTHSC, the affiliated teaching institution of ROH

•Functions in role of supervisor to midlevels, residents and students

•A select number of our attendings also see patients as the sole provider for patients

Mid

leve

ls •Fellows•Nurse Practitioners

•Render services in the subspecialty areas R

esid

ents •Practices

under the supervision of an attending or fellow

•Provides clinical care

•Documents in EHR system as rendering provider

Stu

dent

s •Gain clinical experience in the outpatient setting

•Works under the immediate supervision of residents and /or fellows

•Limited documentation in EHR system


Challenges

In our ambulatory setting, there are many factors that play into our day-to-day experiences.


Challenges: Education and Training• Dedicated NextGen trainer• Time available from start

of project planning to implementation

• Tools and resource materials for staff

• Culture change


Challenges: Attendings

I refuse to use this system

This is impacting

patient care

All of this is because of

Obama Care!

HMPF!


Challenges: Attendings

• Some Attendings refuse to use the system.

• Attendings often require their residents to do all the work and prefer to never log into an EHR.

• Many Attendings have been practicing at ROH for several years and are adamant to using old paper processes.


Challenges: Residents & Students

• Partnership with teaching hospital – UTHS

• Providing timely access to the system

• Handling transitions of residence

• Where does the student fit in the documentation process?


ChallengesLicensure

Licenses to meet demand

No identified UTHSC liaison

Knowing who will be on staff and

when


Solutions

Solutions in the land of

Mid-levels, Residents and

Students


SolutionsEducation and Training

• WBTs – Web Based Training• Super User Program• Educators• Manuals & Job Aids• Key relationships with management and administration


Solutions: Licensure

• Increase communication between Residency Program administration and I.T.

• Run reports for inactivity• Complete annual assessment

of licenses and break downs• Purchase more licenses


SolutionsAttendings- Leadership involvement and

partnership Accountability from above

- Fostering Relationships- Bridging the Gap between Old and

NewResidents- Identifying and Involving Key

Stakeholders- Onboarding Letter and FormStudents- Work in Progress

- Specialized/Customized Template for Histories and Review of Systems Providers


Future StateObjective Details Responsible

PartyWorkflow Considerations

1. Education: Improve WBTs In addition to maintaining our current WBTs, we plan to create more WBTs, specific for our specialties.

Information Technology

New required Physician Training.Maintaining new WBTs with system upgrade and workflow changes.

2. Physicians: PAG or Advisory Board

We are working to develop a Advisory Board for NextGen users. This board will consist of Physicians as well as administration and supporting staff.


Chief Medical Information Officer

UTROP physicians

Will need to incorporate members from other areas of clinical support

3. Education: Hire more Educators Need staff of 1-2 educators that focus on education, material development, implementation support


Seek educators that are well rounded and have analytical skill sets; would help in environment we service

4. Licensure: Buy more licenses There are constant provider additions and need supply available to support increased number of practicing providers



Future StateObjective Details Responsible

PartyWorkflow Considerations

5. Physicians: On- boarding physicians

Establish written policy and procedures that will streamline preparedness in regards to license availability and adequate training


6. Medical Students: On- boarding physicians

To institute documentation for medical students in clinical setting


UTHSC Leadership

Must determine what is allowable for documentation and oversight of students when using electronic medical record


Any Questions?