White Coat Many Hats Reggie D. Lyell, MD Medical Information Officer, Floyd Memorial Medical Group Laurie Drennan Director, EMR Services, Quatris Health
Agenda Strategies for gaining provider and staff buy in Strategies for training across a large multispecialty network Strategies for leveraging your vendor relationships
Background About Floyd Memorial Medical Group FMMG Multi specialty Group Family Medicine Internal Medicine Pediatrics Urgent Care General Surgery Vascular Surgery Bariatric Surgery Spine Surgery Pain Management Cardiology Psychiatry Neurology Endocrinology Podiatry Oncology Hospitalist
Background FMMG started EHR with 25 providers No Physician Champion Initially set up by RN, Administration, IT (none who are still with the group) No Providers had EHR experience Many customizations to satisfy complaints Rapid growth to 70 providers
Background Many provider complaints were not necessarily about Centricity but about computerization process This has significantly tied our hands for making changes Connectivity issues Firefighter approach Herding cats
Background Add to that the history of regulatory changes and GE issues over the past 2 years
Progress FMMG Core Team 1 Systems Analyst 1 partial IT FTE Most support on connectivity and hardware through hospital IT department (i.e. outpatient is not a priority) Added Physician Champion (volunteer) in summer of 2014 Migrated Physician Champion to Medical Information Officer in July, 2015
Progress Migrated Physician Champion to Medical Information Officer in July, 2015 Empowered direct staff (IT and Clinical Analyst) Decide and act more quickly With more authority comes more blame
Initiatives Mission Statement Improve the delivery of patient care by increasing the effectiveness of providers while complying with appropriate coding initiatives and third party reporting requirements
Initiatives ICE (Improving Centricity Experience) Monthly Meetings led by MIO Physician involvement Support and administration involvement Keep up with issues Assuring providers they are being heard
Initiatives
Initiatives FEMUR (Floyd Electronic Medical record Utilization and Reorganization) Weekly meetings with FMMG clinical core team and EMR vendor (Quatris) Ticket process goes through one single channel at Vendor Project tickets are separate from Support tickets
COMMUNICATE COMMUNICATE COMMUNICATE COMMUNICATE COMMUNICATE COMMUNICATE COMMUNICATE Advice
Communicate Regularly Quarterly network meetings Monthly reports to administrative management team Monthly provider meetings Sampling of each specialty Weekly meetings with EHR vendor on projects Weekly meetings on projects (i.e. ICD-10)
Buy In Develop Administrative buy-in first Convince them of the necessity of keeping clinicians happy they are the ones who actually bring in the revenue Utilize the IT and Analyst services available to you
Buy In (cont.) Involve Clinicians Physicians, mid-levels, nursing staff, CMAs Support staff Listen to coders, billers, administrators but YOU drive the system
Organize a way to be sure every clinician complaint is addressed Even if the answer is that won t work be sure to let them know why
OneNote is the tool used to keep track of all issues Can be updated from different sources on the fly so nothing is lost
Throw them a bone Listen for the real issue not always evident Find something that troubles almost everyone (across specialties) and fix it This builds trust
Standardize where possible Makes supporting and troubleshooting easier Makes reporting better Harder to do with multi-specialty, but there are areas (i.e. HPI-CCC)
Know enough to be dangerous Understand form edits Don t have to make them, but understand what is and isn t possible Can head off requests from clinicians Can make more educated requests, saving time and the ping-pong effect
Admit when you don t know No one (least of all physicians) likes a know-it-all Better to check than give incorrect information Leverage your vendor relationships Just because it doesn t currently doesn t mean it can t
Have a sound, diverse training plan One-on-One Spend time with clinicians who are struggling Allow administrative staff to focus on support staff Documentation Document the process so you have reference (manual) for later
Have a sound, diverse training plan (cont.) Training videos Set up videos on our hospital internal website for staff and providers SHORT (3-4 minutes) Well defined names (for future reference)
Use a provider-friendly screen-shot capture software Screencast-o-matic http://www.screencast-o-matic.com/screen_recorder
Meaningful Use/PQRS/ICD-10/Quality Measures Clinicians are tired of hearing the lingo They want help in assisting them taking care of patients, not accumulating data Help them bridge the gap
Vendors are your partners Meet often with key vendors Weekly meeting with Quatris on EHR project Webex for show and tell Status of issues (on both sides) to keep everyone honest Weekly meeting with Quatris on support items
Vendors are your partners Encourage vendors to visit your clinic Seeing is believing Yankees tickets never hurt
Questions and Discussion
White Coat Many Hats Reggie D. Lyell MD Floyd Memorial Hospital Laurie Drennan Quatris Health