JJSH Clinic Management for Prostate Health Heather Begley Jaimie Bubb Joanne Rimac Stephanie Wong JJSH Healthcare Consulting MED INF 405 Group Project

Background Prostate cancer is the most common cancer in American men. ( To serve the community JJSH needs to ensure the maximum number of patients are seen and treated Reduce financial burden by operating clinics efficiently and effectively

Project Purpose Electronic Patient Record Radiology Lab System Pharmacy Financial Dictation Scheduling Patient notification

Assumptions Financial Computer Access Resistance to Change Computer Savvy

Current Workflow

Future Workflow

Scheduling System Snail Mail Reports Dictation/Transcription System Pharmacy Patient Health Scheduling e-Prescription Clinical Application Linkages Electronic Patient Record Auto fax system Patient Appointment Reminder System Voice Recognition Laboratory SystemRadiology System Patient Portal Clinical Trials Database Referral/Consultation Portal Patient Check-in Kiosk Financial System Patient Tracking (RFID) Legend Uni-directional interface Bi-directional interface Faxed Requisitions Phone reminder

Stakeholders Patients (who follow up at clinic for prostate health) Family members of patients Physicians-including referring physician, clinic MDs, NPs, PAs, hospital MDs as well as surgeons, specialty MDs (and their associated NPs/PAs), anesthesiologists/nurse anesthetists, Physician Review Board

Stakeholders  Clinic/Hospital clinical personnel including RNs/LPNs, nurse’s aides/techs  Clinic/Hospital clinical ancillary staff including pharmacists/pharmacy staff/techs, lab staff/techs, radiology staff/techs, nutritionists/dietary staff, social workers, case managers, discharge planners  Clinic/Hospital administrative staff including registration and unit clerks, medical records staff, billing staff  Clinic/Hospital Executive staff including COO, management, and other executives within facilities  Hospital/Home Health adjunct staff including PT/OT, home health/hospice care

Stakeholders  Government  Community/Public  Vendors supporting clinic  Insurance companies  Familial Registry  Clinical Trials  Tumor Registrar

EPR Integration Related to Prostate Health  2/3 of patients diagnosed are over the age of 65  The number of Americans age 65 and older will more than double by the year 2030  The cost of providing health care to older Americans is three to five times > those younger than 65  Financial benefits: transcription costs reduced, lab, pharmacy, radiology, billing and scheduling automated  Clinical benefits: Accuracy of documentation which enhances billing charges, data gathered quickly and efficiently  Organizational benefits: Increased clinician satisfaction due to enhanced workflow and patient satisfaction related to immediate access of clinical and educational information

ROI related to EPR Implementation  Cincinnati Childrens (2003) experienced an improved registration process because records were prepared electronically before arrival  Queens Health Network (2002) 50% decrease in pharmacist intervention with medication orders in ambulatory care due to improved legibility, system alerts and increased completeness of prescriptions  Maimonides (2002) duplicate testing dropped dramatically, ancillary tests by 48.9%, U/A by 41.6%, microbiology by 40.6%and hematology by 6%  Citizens Memorial (2005) Automatic charge capture increased revenue by $34 per patient  Patil, Puri & Gonzalez (2008) Implementation of EMR and eliminating transcription costs coincides with increased revenue per provider  Kaiser Permanente (2009) A patient satisfaction survey found that nearly all patients utilizing a kiosk had a successful experience. Opportunity for revenue cycle management at the front end.

Conclusion  Incorporate evidence-based practice guidelines related to prostate health  Promote an informed decision-making process for prostate screening exams  Optimize opportunities for patient and staff education regarding prostate health  Utilize information technology standards to complement high quality cost effective care  Maintain data integrity for outside investigators and stakeholders