Presented by Virginia Mrizek Electronic Health Records in the 21 st Century A proposal

Electronic Health Records (EHR) in mainstream medicine Federal mandate for incentivized Medicare and Medicaid reimbursements (“EHR incentives and certification,” 2014) Occupational therapy place in medical recordkeeping Dr. Mrizek credentials ▫ Board-certified Family Practice physician ▫ Six years instructor at Pima Medical Institute Occupational Therapy Assistant program ▫ Candidate for Master’s degree in Adult Education and Training Introduction

EHR in 21 st Century Patient care requires excellent avenues of communication between providers Education of EHR skills early in degree program allows for integration of computer abilities with clinical applications Different formats for EHR exist in provider locations

Documentation is a vital skill in patient care Clinical applications are introduced at the beginning of 2 nd semester in PMI OTA program Needs analysis indicates timing of exposure to documentation procedures should precede onset of clinical applications (L. Walters, personal communication, April 1, 2015). EHR in the 21 st Century

Current location of documentation introduction at end of 2 nd semester SOAP notes introduction after beginning clinical program Recommend insertion of training into Computer Basics course in 1 st semester Microsoft Word review prior to course as part of Computer Basics course EHR in the 21 st Century

Instructional design process ADDIE model (Brown & Green, 2011). Training Needs Analysis or TNA <iframe width="420" height="315" src=" frameborder="0" allowfullscreen> EHR in 21 st Century

Course proposal: 14 total hours of training in 7 sessions over one month Classroom and computer lab methods EHR in 21 st Century

Goals: Review documentation requirements for medical records Expose OTA students to a variety of EHR formats Provide a venue for practicing electronic formats in a safe environment Provide the community with practitioners who have basic EHR skills

Objectives aligned with goals Instructional strategies to include lecture, group discussions, demonstrations, computer practice, and computer simulations EHR in 21 st Century

Objectives: Given completion of all lectures, demonstrations, practice sessions, and clinical simulations, students will: 1. be able to define the parameters of SOAP notes with 100% accuracy. 2. be able to pass that part of a practice ACOTE exam that covers SOAP notes with 90% accuracy EHR in 21 st Century

Continued: Learners will: 3. pass a review test of each format with a score of 90% or better 4. participate in practice sessions and group discussions utilizing the preloaded software for each EHR format and complete a formative evaluation 5. participate in group discussion of pros and cons of each EHR format and complete associated formative evaluation

Learners will: 6. practice entering SOAP notes as provided in practice software with 100% accuracy within 10 minutes for each format 7. analyze patient simulation data and create notes with 90% accuracy within 10 minutes 8. be able to present documentation of achievement in basic EHR skills with 90% accuracy or better in three EHR formats EHR in 21 st Century

Timeline Presentation of curriculum to Program Director – June 1, 2015 Meetings with EHR representatives #1, #2, & #3 by June 22, 2015 First day of training sessions – August 4, 2015 Meeting Tuesday and Thursday from 1:00 pm – 3:00 pm until August 25, 2015 EHR in 21 st Century

Formative evaluations will follow Kirkpatrick’s model with new revision (Kirkpatrick's 4 level evaluation model ) Level 1 – motivation Level 2 – learning Level 3 – performance Level 4 - results EHR in 21 st Century

Design review has been performed Expert review is in process using IT supervisor at UMC Banner Hospital Learner validation using small group of 4 from prior cohort trial has been positive (Brown, A & Green, T.D. 2011). EHR in 21 st Century

Summative Evaluation ("Summative Assessment", 2014). Focus more on product than process Consists of results of tests and performances Did students achieve objectives and goals? EHR in 21 st Century

In summary: EHR training is vital for our OTA students Timing of training provides for integration of skills for maximum benefit Proposed training provides exposure to most common EHR formats Instructional design models have been followed in preparation for this training program EHR in 21 st Century

QUESTIONS??? Thank you for your attention! EHR in 21 st Century