Empfohlen
Empfohlen
Weitere ähnliche Inhalte
Was ist angesagt?
Was ist angesagt? (20)
Ähnlich wie Healthcare Networks
Ähnlich wie Healthcare Networks (20)
Healthcare Networks
- 1. Strengthening the bonds of healthcare networks Natalia Hajnas & Michelle Busching Loyola Univeristy Chicago HONR 204, Fall 2010 George K. Thiruvathukal, Course Professor
- 2. Part one: Establishing the Network of Study
- 3. The Practice We Observed
- 4. The individual practice as a network within itself Visual: organic chemistry molecular model analogy Molecule represents the “network within the greater healthcare network” Cyclopropane = the 3 family physicians Acetylene = the 2 OB/GYN physicians Connecting double bond = links the separate specializations (family medicine & gynecologic oncology) Communication & referrals to the family doctors from the OB/GYNs occurs on a daily basis
- 8. Reasons for referrals From our data (written referrals): Consultation Treatment Evaluation Pre-op testing Ultrasound Colposcopy Colonoscopy
- 9. Efficiency of referrals Folder where copies of all written referrals are kept to reference if need be How could there be improvement in communication between physician’s offices? Referral system – works fine Effectiveness of sharing patients’ medical records between medical offices – could be better….. HOW?
- 10. Part two: A proposal for change (electronic medical records)
- 11. Our Proposal Adoption of EMRs in all healthcare settings Specifically, to the practice we collected network data from
- 12. First hand comparison of EMRs vs. PMRs Survey distributed to medical offices within the same hospital as the practice of focus Originally 20 handed out, then ~15 more because of poor return from the 1st distribution Final sample size = 16 Overview of the questions asked
- 13. Results of the survey Average satisfaction: EMRs = 4.44, PMRs = 4 In general those surveyed were satisfied with their current record keeping system despite what they wrote pros and cons of each. 0 physicians/ physician reps. who use PMRs have used EMRs in the past. All those who use EMRs, prefer EMRs to PMRs (one respondent who currently uses PMRs prefers EMRs…)
- 14. Results (cont.) Advantages A- Ease of use B- Organization C- Time efficient D- Thorough documentation E- Nothing F- Accustomed to it G- Tangibility H- Legibility
- 15. Results (cont.) Disadvantages A- Space B- Time C- Poor organization D- Illegibility E- Nothing F- Everything G- System Failure H- Cost I- Poor interoperability J- Error prone
- 16. EMRs vs. PMRs Decreased risk of clerical errors Tangible Ability to integrate information from other sources Chart accessibility and retrieval Accurate and legible Organized Security features Pros of PMRs Pros of EMRs
- 17. EMRs vs. PMRs Expenses of storage Unorganized Illegible Continuity of care Increased amount of time spent charting Inability to integrate information from other sources Continuity of care System failures Initial costs Cons of PMRs Cons of EMRs
- 19. Government push: input from president Obama http://www.youtube.com/watch?v=qEb6FrSuUJs&NR=1
- 22. VITL Vermont Information Technology Leaders Non-for profit Aids in the transition from PMR to EMR Health Information Exchange EMRs can be exchanged between different healthcare entities throughout the entire state Consolidate medical history to one location
- 23. One step further Genealogies of Medical Records A thorough family history of disease, health related traits, and responses to treatments and medications Used for research Could be used as a diagnostic and treatment guide
- 24. Electronic medical records V E R S A T I L I T Y
- 25. Sources http://pn.psychiatryonline.org/content/38/9/34.full http://www.edocscan.com/reducing-costs-for-scanning-medical-records http://en.wikipedia.org/wiki/Medical_records http://miwww.acog.org/departments/dept_notice.cfm?recno=47&bulletin=4882 http://www.compete-study.com/documents/Measuring_the_Success_of_Electronic_Medical_Record_Implementation_Using_Electronic_and_Survey_Data.pdf http://www.chcf.org/~/media/Files/PDF/E/PDF%20EMRLessonsSmallPhyscianPractices.pdf http://www.youtube.com/watch?v=1Nv4Q5-Iij4&feature=related http://www.vitl.net/about-us http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839727/ http://www.openehr.org/specifications/spec_strategy.html http://www.e-mds.com/solutions/chart/chart.html http://www.hemidata.com/emr.html http://www.bcbs.com/blueresources/mcrg/2007/chap3/pay-for-performance/slide5.html http://www.aafp.org/online/en/home/publications/journals/fpm.html http://www.openclinical.org/emr.html Information packet from EMR seminar at Alexian Brothers Hospital in Elk Grove Village, IL hosted by Conomikes Associates, Inc.
Hinweis der Redaktion
- Our “experimental” practice, from where all data will be collected.
- - Communication- not necessarily literal face-to-face (referrals are “communication”)
- Additional edges: relationships determined by looking up which practice each referred physician is a part of (same practice, there must be a connection, edge), also based on the OBGYNs’ (of WCHA) knowledge of which other physician’s collaborate with each other. In graph: color of nodes = specialization, length (distance) of edges = frequency of referrals (interpreted as weaker or stronger relationships, as opposed to just weak vs. strong with dotted vs. solid lines), thickness of edges = thick signifies the physicians are part of the same practice.
- Interpretation of Cartoon: working individually, it’s like physicians have on a blindfold, they can only rely on their own knowledge. Physician networks are crucial to thorough treatments and diagnoses, or even just patient assurance. Other factors may include: type of insurance
- First bullet: mostly helpful because patient’s lose them and it’s convenient to keep them all in one spot (referral is taken note of in the individual patient’s chart as well) Second: Oftentimes, once a patient is referred somewhere, medical records need to be shared, in the case of the practice we looked at, faxed (b/c use PMRs)
- Overview: have survey in hand and mention what kind of questions there were
- Q2 – Question of relativity, those who are satisfied with PMRs, might be MORE satisfied with EMRs, but wouldn’t know because they’ve only dealt with one type. Those who use EMRs, have a better sense of “real world” implementation of EMRs, and can compare that with what they had in the past.
- Significant advantage of EMRs – organization
- PMR: major issue is space, illegibility EMR: system failure
- Pros of PMRs:Pros of EMRs: Chart accessibility and retrieval-often MR can be retrieved from any location, locally or remotely, 24/7. Allows for multi-user use.Organized-can search for specific information such as medication changes, allergies, bp over the course of visits
- Cons of PRMs:Continuity of care-inability to pass on complete set of information from one health care entity to the next ex. From hospital physician to hospice careCons of EMRs:Inability to integrate information from other sources-cannot link information such as clinical laboratory data to EMR unless within same practice. Goes down over time with practice with system.Initial costs-can be upwards of $30,000-$50,000 per physician
- Annual Per-Physician Costs of Paper Charting for Three Physicians
- Basic Medicare offering for office-based physicians: range from $20,000 to $44,000Higher amounts go to physicians who meaningfully use EHRs early Penalties through lower reimbursements for those who don’t use a system by 2015 (ex. 2015 would be ~1%)
- Informationfrom hospitals, private physicians, nursing homes etc. can all access information about a patient.Benefits: Referrals do not have to continue to fax over all related information/ results of lab tests arrive in an “inbox”Medication lists from many physicians are shared which can prevent prescribing drugs with detrimental interactions.