1. 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

2. 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?

3. HIT and Transformation of Care
Mission/Vision
Leader/Champion
Overcoming Barriers
Historical Precedents
Opportunities for Improvement
Transform Care
Health Care Reform

4. 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

5. Introducing Technology: A Few Examples
New world opens
New explanations
New challenges

6. Causes Lethal Epidemics

7. Prevention and Treatment

8. Transformative Technology
Simple design, Don’t need to know how it works to use it, didn’t start this way

9. Technology Enhancements

10. Nearly Perfect

11. Early Attempts

12. Current Status

13. Not There Yet

14. Understanding Resistance NYT March 6, 2009 Op-Ed

15. 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

16. Implementation Leadership: Vision Motivation Goals
Changing Role of Providers Clinicians
Choosing EHR: Templates
Training/Abstracting

17. Implementation Go Live/Scheduling Importance of Lab Interface
Provider Autonomy v Care Standards
Collaboration: IT, Practice Managers, Billing, Regulators

18. 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

19. HIT and the Office Visit: Office Re-Design

20. Decision Support: Alerts, Documentation

21. Registries/Data Management

22. 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

23. 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

24. 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