New digital well being document rollouts are infamously fraught with danger. At finest, a they can trigger workflow disruption, confusion amongst scientific workers and different minor inefficiencies. At worst, they can necessitate a brief return to paper information, value hundreds of thousands in remedial IT tasks – or trigger severe sentinel occasions.
As John Rekart, chief of high quality administration and informatics at the California Department of Corrections and Rehabilitation factors out, “anywhere from 30 to 80 percent of EHR implementations over the past two decades failed and went back to paper.”
Health methods have gotten a lot better at it lately, however challenges associated to new workflows, spotty coaching and poor preparation proceed to place go-lives in danger.
Analytics can help. Rekhart’s expertise – he was configuration architect for the psychological well being system at CDCR, and oversaw testing and implementation of methods at 35 establishments throughout California, together with design and rollout of the EHR at a 1,700-bed correctional hospital – exhibits how sensible use of knowledge can goal help towards those that is perhaps fighting the new methods.
In his function at CDCR Mental Health, Rekart leveraged knowledge and analytics to boost the probabilities for a profitable rollout. The insights derived from how scientific end-users had been interacting with the new Cerner EHR led to profitable implementations in any respect 35 areas, he stated.
At HIMSS19, he’ll share insights into the worth of such knowledge for bettering go-live success charges, how high quality administration instruments can boost coaching outcomes for EHR rollouts, and present some of the metrics and KPIs utilized by CDCR to construct a data-driven implementation personalized for its personal explicit wants.
“Basically I used some quality management techniques of monitoring and feedback to really help the project along,” stated Rekart. “Our users go through 40 hours of training,” he added. “Our trainers go through 80. And they have to pass a knowledge check to certified.”
That check is run by way of the CDCR’s intranet, he added, enabling easy accessibility to the check knowledge. “That was one of the ways we monitored. We used that data, and if they failed, we required people to retrain.”
But a extra granular method to the check rating knowledge enabled workers to make use of one its finest property – these “super users” who actually get the new EHR system and can help their friends and colleagues do the identical.
“We wanted this test to divide people into three piles,” Rekart defined. “We wished to make use of flooring questions that nearly everybody ought to get. And ceiling questions that nearly no person can get.
“If you can’t answer the floor questions, you’ve identified people who need retraining. Then the people in the middle are competent users. And the people who answer the really hard questions are probably going to be your super users.”
Using that analytics-based method to implementation has “worked out really well,” he stated. It’s enabled CDCR workers, with help these superusers, to dwelling in on the individuals who may want the most help and optimally allocate help to the place wanted.
“We used data to look at where people were in the process, then used focused and targeted interventions to get them going in the right direction: ‘Looks like you’re struggling with this, you need to focus on this,'” stated Rekart. “After go-live we had a bunch of data flags that look at certain workflow variants, and we could see patterns and notice people who were veering from the workflow.”
The numbers converse for themselves. “We had a 25 percent reduction in sentinel events, post implementation,” he stated. “Usually there’s an increase.”
While CDCR had “spent a lot of money on this,” that cash wasn’t spent it on additional workers, he added. “I didn’t have 30 people for this, I had three. You’re basically testing people from a distance. We’re government, we needed to bootstrap. But use of the data helped us be very successful in that regard.”
John Rekart’s session, “Analytics-Based EHRs Implementation: Improved Outcomes,” is scheduled for Thursday, February 14, from 11:30 a.m. to 12:30 p.m. in room W308A.
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