Ultimate Blogging Championship

Tag: Effective Use of EMRs

  • Priority issues identified by PSS users in Family Health Teams

    Click here to access the PSS User Group report on FHT PSS Priorities. It presents a list of the 10 most common issues experienced by PSS Users in terms of frequency of the problem and its detrimental impact on FHT operations.

    Following from these, the PSS Users identified the following four items as the priorities for action:

    1. Data Extraction: FHTs are interested in extracting data to inform quality improvement initiatives. Health Quality Ontario is defining data requirements for quality reporting. The user group will seek support from PSS to assist FHTs in accessing usable data.
    2. Interfaces (eg. Lab, e-prescriptions): FHTs are and will be involved in health systems planning and innovation, the EMR should be innovative as well. The user group would work with PSS to determine what works needs to move ahead, and what work needs to wait for province-wide or LHIN-wide rollouts.
    3. Communications: FHTs would like to have a single point of contact within PSS who will have the authority and ability to speak for FHT issues and will coordinate priority issues for FHT clients.
    4. FHT Working Environment: The user group will work with PSS to increase their awareness of and responsiveness to the fact that the FHT working environment is different from that for physicians working in more traditional environments.

    This report was sent as the “Prioritized list” to OntarioMD CEO Brian Forster, as he requested, and to Dennis Ferencz (OMD’s head for change management and the peer leader program) whom Brian identified as AFHTO’s key contact.  Brian and Dennis will go through the list. OntarioMD has identified the following tactics for moving forward with the results:

    • For issues that indicate PSS is failing to meet any of the standards for the latest spec, OMD can send them a “cure letter”. If they don’t meet the spec, then their status is suspended and the vendor can’t proceed with any further installations.
    • If the issue is not related to the current specs, OMD could potentially add requirements to future specs to deal with it.
    • For other issues – e.g. finding solutions to common operational needs, addressing overall poor communications – OMD can use its relationship to add more pressure to get problems solved.
    • At the same time, OMD + the user group could go through staff of CMA + CMA Holdings (Brian Peter is President) to apply pressure.  (Apparently some PSS physicians have threatened to drop their CMA membership over this issue. If the other avenues fail, perhaps this threat could be organized more widely and escalated if needed.)

    The FHT PSS User Group will receive all updates on developments with OntarioMD and PSS.

     

  • AFHTO’s EMR survey – March 2012 survey results

    The EMR survey was completed by 160 respondents from 121 FHTs (65% of all 186) in the period April 10 – 30, 2012. Thank you to all who took the time to respond.

    Click on the links below to find:

    Findings from responses indicate:

    • 93.7% of respondents use only 1 EMR system in their FHT, with 6.3% using 2 or more.
    • Almost half of FHTs (49%) use Practice Solutions Software (PSS) and account for 52.5% of all EMR users.
    • The next most-frequently used EMRs are OSCAR and Bell EMR (formerly xWave) with about 12% of FHTs for each, then HealthScreen and P&P Data Systems with about 6% of FHTs each.
    • Looking at aggregate scores for the 9 EMRs rated by more than one FHT:
      • 3 EMRs received average or good ratings in all evaluation questions (OSCAR, Jonoke and Accuro(R))
      • 3 EMRs receive average or poor ratings in all evaluation questions (Nightingale, HealthScreen and York-Med)
      • The remaining 3 had ratings ranging from poor to good (PSS, Bell and P&P)
    • About 91% of FHTs report their physicians and other staff are using the full range of functionalities (ie. scheduling, billing & patient charting), and 97% of FHTs have a messaging function for internal communication.
    • 95% of FHTs have remote VPN connection to the EMR, but only 46% can access the EMR via WiFi during hospital rounds and/or LTC visits and/or home visits.
    • Over 93% of FHTs use desktops in exam rooms, but only 39% use tablets or laptops during patient encounters.
    • Patient access to a Patient Portal or Patient Health Record is still in early stages, with about 15% of FHTs who have this in place. About 70% have printers in patient rooms.

    Respondents who had indicated an interest in being part of a user groups for their EMR received contact information of all others who had signed up for the same EMR user group.  Having been linked in this way, user groups are encouraged to act as resources for one another to learn how to get the most from their EMR, and join together as needed in working with their vendor.

  • Using IT to Solve Process Problems

    2011 AFHTO conference presentation PRESENTER (S): Dave Sellers, Director of Operations; Dr. Mark Fraser, Lead Physician FHT/ORG: West Carleton FHT ABSTRACT: This presentation will describe how innovative approaches within the FHT IT infrastructure have been used to solve process issues and improve efficiencies and data quality. The quality of the data in your EMR has a direct impact on quality of care and your ability to identify care issues, promote self care and identify population care needs. The presenter will demonstrate approaches that have been used and the impact that they have made in the FHT using tools that you may already have and did not know it. This is a highly technical presentation; therefore you should have a good understanding of your current Information Technology Infrastructure and processes to glean the most from this presentation. This presentation is not specific to single vendors EMR. Click here to view presentation.

  • FHTs in the Intelligent Community

    2011 AFHTO conference presentation PRESENTER (S): Tim Iredale, Stratford Family Health Team; Paul West, Rhyzome Networks FHT/ORG: Stratford FHT ABSTRACT: The Stratford FHT is located in a city that is one of the Top 7 Intelligent Communities of 2011.  The Stratford FHT has partnered with Rhyzome Networks to improve its IT infrastructure which has resulted in better access to our EMR and improved FHT collaboration.  Rhyzome Networks offers 60 kms of fiber optics which supports a city wide mesh WiFi.  This improved IT infrastructure has provided consistent and redundant connectivity and capacity for IP based voice and data communications between offices.  The Stratford FHT receives results electronically into our EMR within minutes of them being posted at our local Hospital as a result of this intrastructure.  Physicians can access our EMR securely from a WiFi enabled device anywhere within the City of Stratford.  The next step is a patient portal made available through the city wide WiFi to any Stratford FHT patient regardless of economics. Click here to view presentation.

  • Preparing for Electronic Labs

    2011 AFHTO conference presentation PRESENTER (S): Katharine De Caire, RN (EC), MN; Katalin Ivanyi, MD, CCFP, FCFP FHT/ORG: McMaster FHT, Stonechurch Site ABSTRACT: Laboratory information systems are an important component of an electronic health record. The ability to electronically access laboratory test information assists health care providers to make faster, better patient care decisions, enables timely access to information, provides better coordination of care and improves workflow Shared care is the basis of a Family Health Team. In a shared care environment a team’s Physicians and Nurses are both accountable for managing patient lab results and these accountabilities need to be clearly defined, communicated, and documented. In 2011 Stonechurch Family Health Centre began to prepare for the implementation of electronic labs. Our team recognized that managing test results effectively is vital to quality patient care and a failure to follow up on test results can lead to patient harm. In this presentation we will highlight our team’s paper-based process for results management, discuss our journey to prepare for electronic labs and present our final plan. Click here to view presentation.

  • Managing Medications

    In 2008, the Queen’s Family Health Team began to wonder just how accurate its medication lists were in our EMR. A medical student audit conducted that summer found a lot of room for improvement, particularly for patients on multiple medications or those seeing multiple providers. Since then, Queen’s FHT has developed numerous processes and policies focused on medication safety and, specifically, on how to maintain accurate medication lists.  The project has grown to include reviewing and tracking of prescription refill processes and clarifications from pharmacies, community pharmacy outreach, resident education, ordering and stocking of medications, and medication reconciliation at the patient-level. Their approach has been comprehensive and multi-faceted – it has relied on raising awareness, focused teaching sessions with providers, patient education, data collection, and engagement of all staff, from clerical to pharmacy to physician. Follow-up audits in January and August 2010 found great improvements in the accuracy of medication lists. This slide presentation from the AFHTO 2010 conference highlights their journey to date and “lessons learned” from their approach to medication safety. PRESENTER: Karen Hall Barber ORGANIZATION: Queen’s Family Health Team Click here to view.