Implementing Computerized Physician Order Entry (CPOE): A Rural Experience
Bob Humphrey, Evergreen Medical Center, Evergreen, Alabama
Many healthcare executives and professionals have heard about the large health systems' journey to the electronic medical record including Computerized Physician Order Entry (CPOE) but how are rural facilities accomplishing this within their unique technical and financial constraints? When a rural facility makes an investment, it can't afford for the initiative to fail. That is why when Evergreen Medical Center, a Delta RHPI site, began this process they realized that it was not something that could be implemented overnight. It took a couple of years of planning and cultural changes before EMC saw the success they have seen since "going live" in August 2009.
Investment in technology has been a guiding principle of EMC's for many years. There is no doubt within the organization as to which direction EMC is heading in regards to technology. A culture of innovation has been created and the staff is excited and enthusiastic about the possibilities. An electronic medical record is the ultimate goal of the entire staff and they realized that the implementation of CPOE and getting the doctor's "buy-in" was crucial to the organization accomplishing its goal. EMC's IT Team is made up of the Director of Materials Management/IT, the Network Administrator, and the Director of Education/Clinical IT. The IT steering committees, led by the IT Team, were formed and specific IT strategic plans were formulated. The steering committee is made up of a cross section of affected departments, allowing their input into hardware, software, and processes. The committee plays a role in setting the deadlines associated with implementation of goals. Taking implementation of previous initiatives such as bedside charting, chart link, med verify and order entry in phases has allowed our staff including physicians to become comfortable and proficient with technology over time. This familiarization with computer technology gave the steering committee the knowledge to develop a successful implementation plan.
This is an evolutionary process that needs to be open to change when needed. The EMC IT team is actively listening to the physicians as they are using it and making enhancements when possible. The super users (people trained on the system) are continuously being trained on the systems capabilities and the benefits of usage are constantly being promoted to the physicians. These efforts will hopefully sustain the progress that EMC has made. It is the goal of the organization to have all physicians, including consulting staff, trained and using CPOE by March 2010. The IT team and physicians are positive that CPOE is something they can do, long-term.
For the complete story, please contact Bob Humphrey or visit the Evergreen Medical Center Web site.
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Rural HIT Workforce Summit
The National Rural Health Information Technology (HIT) Workforce Summit was held Tuesday, September 22, 2009 in Washington, DC in conjunction with National HIT Week. The Summit brought together key stake holders including educators, state offices of rural health, health and information technology (IT) organizations, rural providers, and federal agencies to provide input and guidance on rural HIT workforce challenges.
The National Rural HIT Workforce Summit worked to identify rural HIT workforce shortage issues, as well as develop an understanding of the gaps in rural HIT workforce, and what needs to be done to reduce or eliminate those gaps. The meeting resulted in recommendations for policy makers to support HIT workforce development efforts and funding; provide input on the American Recovery and Reinvestment Act and other federal/state opportunities to support HIT workforce
development; define resources needed for successful rural HIT implementation and recommend methods for tracking national HIT workforce data.
For a copy of the Workforce Summit Summary, Outcomes and Recommendations from the Summit or for more information on the Rural HIT Coalition, please visit the Rural Health Resource Center Web site.
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HIMSS Electronic Medical Record Adoption Model
EMR Adoption ModelSM
Health Information Management System Society (HIMSS) Analytics, the authoritative source on EMR Adoption trends, devised the Electronic Medical Record Adoption Model to track EMR progress at hospitals and health systems. The EMRAM scores hospitals in the HIMSS Analytics Database on their progress in completing the 8 stages to creating a paperless patient record environment.
EMR Adoption Model Structure Ensures Objectivity
- All application capabilities within each stage must be operational before that stage can be achieved.
- All lower stages must have been achieved before a higher level will be considered as achieved.
- A hospital can achieve Stages 3-6 if it has met all of the application requirements for a single patient care service (e.g. single nursing floor, cardiology service).
- Hospitals are advised to follow the EMR Adoption Model closely, however, other implementation paths that that prescribed by the stages above can be taken into consideration for correlation with quality and financial research.
Read a detailed description of the stages
This slide above dexcribes HIMSS Analytics United States EMR Adoption Model in the recommended stages hospital should implement EMR. In Stage 0 there are no EMR tools installed, Stage 1 EMR ancillaries are installed in lab, radiology, and pharmacy. As a hospital moves up the stages, additional EMR tools are added such as health information exchange capabilities in Stage 2, error checking and flowsheets in Stage 3, and Computerized Physician Order Entry (CPOE) in Stage 4. Stage 7 is a complete EMR. It is anticipated that the Meaningful Use definition in 2011 will be approximately Stage 4. For more information on Meaningful Use, click here.
For more information on the EMR Adoption Model, please visit the HIMSS Analytics Web site.
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Sign up for the New Delta RHPI Performance Management Group (PMG)
Delta RHPI has started a Performance Management Group (PMG) to help support hospital staff in their performance improvement efforts. Hospital administrators, DoNs, COOs, hospital networks, hospital executive teams, and mid-level managers are all encouraged to join!
Reach organizational excellence by aligning people, processes, and resources to achieve goals that benefit your community and the bottom line by joining the Delta RHPI Performance Management Group (PMG).
By joining PMG, hospital administrators, DoNs, COOs, hospital networks, hospital executive teams, and mid-level managers, will be provided with free performance management tools and models such as: leadership development, mid-level management and succession planning, lean planning and value stream mapping, Balanced Score Card development, Studer, and Baldrige frameworks. These tools have been proven to increase rural hospital performance that achieves organizational excellence.
PMG members will discuss and share professional experiences with peers and experts about performance improvement projects and lessons learned. In addition, PMG members will have the opportunity to network with other Delta RHPI participants.
Convening via Conference Call, PMG members will direct what areas of performance improvement they would like to focus on and will identify the frequency and level of commitment required for participation.
JOIN NOW
Don't miss out on this great opportunity! Space is limited, The first conference call begins January 2010. Details to follow. For more information or to join contact Allison Hartl at ahartl@ruralcenter.orgor (218) 727-9390 ext 251.with the Rural Health Resource Center.
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