As we end the calendar year and look forward to many new clinical IT development projects in 2014, I would like to take this opportunity to review our recent accomplishments and future plans.
After a successful new tower go live and associated post go-live issues, we implemented electronic documentation in our primary care clinics before turning our attention to inpatient physician documentation. We have moved all (13) specialties currently live on ambulatory PowerNotes to electronic inpatient consult and progress notes. This has allowed for improved workflows, time saving, easier charge capture, and better availability of information. This last improvement has a very positive impact on patient care.
This year, we’ve made significant progress improving referring provider communications – particularly important given our large volume of ED visit summaries, as well as radiology and lab results. Planning has been completed for an overhaul of how we update provider information, how we identify referring providers and how the information is sent out via fax, and soon, secure email.
This next year is filled with new enhancements. With a major Cerner code upgrade completed this fall, we can now implement a medication reconciliation system that should substantially reduce the work of reconciling medications and developing accurate med lists across the care continuum. Along with this, we will implement a streamlined process for discharging patients and doing electronic prescribing on the inpatient side. Work on inpatient documentation will continue, and the PICU and hospitalists will be going live in June with Cerner’s new documentation tool, Dynamic Documentation. In preparation for this, we will pilot voice recognition software to increase the ease of entry of narrative information in the notes.
This spring also brings a patient portal; “Direct” secure email communications between providers; a secure texting solution; expansion of our Health Information Exchange capabilities; and other activities important to the early development of our population health platform. We will also continue our preparation for a conversion from ICD-9 to ICD-10 coding which must be completed by Oct. 1, 2014 — please stay tuned for more information on this. In addition, Meaningful use readiness and reporting continues.
Planning is currently underway for our FY 2015 capital budget, for projects starting or continuing for the fiscal year beginning July 1, 2014. We intend to continue our implementation of electronic documentation in ambulatory clinics and hospital supported practices not yet live (primarily surgical specialties, allergy, oncology, etc.), improve clinician access to CUBS with radio- frequency identification (RFID) badge sign-in, and begin adoption of Cerner’s iPad software called PowerChart Touch (requires Dynamic Documentation). These efforts should dramatically improve the provider experience using our systems when they are fully implemented.
Having better data to manage individual patients or populations of patients is frequently requested by our providers. Cerner is now making available “registry” functionality within the electronic health record (EHR)which will allow individual providers to create lists of patients with certain diseases or conditions, and chose from a list of variables they wish to track. This should be available this Spring. We are also focusing a great deal of effort on improving our organizational analytic capabilities by expanding our in-house expertise and staffing, improving our current data warehouse, developing new analytic tools, and making more clinical data available for analysis. This is a multi-year development effort, but early work is already paying dividends.
The pace of change in healthcare is very rapid, and IT is on the leading edge of that change. Sometimes, you’d just like to stop and digest what you’ve already got. While that’s tempting, that would put us in the rear view mirror, not in the driver’s seat. The best news in all this is that you have a very skilled and committed team of individuals, including project managers, analysts, Cerner employees, and physician informaticists working closely to ensure the success of these initiatives. I want to take this opportunity to personally thank them for all their hard work and look forward to their partnership in the coming year. I also want to thank all of you for your advice, your patience, and your dedication to making CHOC the best place for the care of children.