Robert “Red” Schiller, MD Institute for Family Health Clinical Leadership and Health Information Technology: “I just want to be a doctor” Robert “Red” Schiller, MD Institute for Family Health
HIT and Transformation of Care System in Crisis- no clear solution Changing Role of Physician/Provider Changing Role of Patient/Consumer Fragmentation of Care and Data Healing?
HIT and Transformation of Care Mission/Vision Leader/Champion Overcoming Barriers Historical Precedents Opportunities for Improvement Transform Care Health Care Reform
HIT and Transformation of Care: EHR is not just an electronic chart EHR is a new technology to provide care New Challenges Problems Innovative Solutions Implementation: New Role for most Providers Social Networking, Self Care
Introducing Technology: A Few Examples New world opens New explanations New challenges
Causes Lethal Epidemics
Prevention and Treatment
Transformative Technology Simple design, Don’t need to know how it works to use it, didn’t start this way
Technology Enhancements
Nearly Perfect
Early Attempts
Current Status
Not There Yet
Understanding Resistance NYT March 6, 2009 Op-Ed
Understanding Resistance Motivational Interviewing Reframe Resistance “What do you like about patient care” “What do you do well” “What would make care easier” Overcoming bad habits: what does this behavior help you do or feel
Implementation Leadership: Vision Motivation Goals Changing Role of Providers Clinicians Choosing EHR: Templates Training/Abstracting
Implementation Go Live/Scheduling Importance of Lab Interface Provider Autonomy v Care Standards Collaboration: IT, Practice Managers, Billing, Regulators
HIT and the Office Visit: Work Flow Re-Design Rethinking Office Visit/Communication Revise Work Flow Electronic References (Look it up) Patient Portals/Access Specialty Access
HIT and the Office Visit: Office Re-Design
Decision Support: Alerts, Documentation
Registries/Data Management
Lessons Learned Identify Clinical Champions May not be Usual Suspects Involve Clinicians Early and Often Commit to Ongoing Training Prioritize Clinicians Concerns Clear Transition Date: No More Documentation in Paper Chart
New Ethical Dilemmas Privacy: Whose Information is it anyway! Quality: Abnormal Results a Click Away Safety: Drug Alerts: Vioxx Drug Interactions Health Advisory/Disease Outbreaks H1N1 Measles
HIT and Transformation of Care: Vision of the Future Health Care Reform Seamless Data Sharing (?Privacy) Care without walls Prevention Healing Collaboration Public/Personal Health