Transcript What a System Looks Like

Now what….
• You carefully analyzed your office
needs
• Submitted an RFP
• Negotiated the contract
• Purchased the hardware, installed
the network and then the software
• They have tested it and trained your
staff
• You are in the process of
implementing it
• and……
It is time to tailor the system to
your personal needs
• This section is about templating
• You can customize parts of your program
• This is important because…
Smooth workflow
Saves time
Reduces errors
Tailoring - Like a fitting
• Template - Interact with database
• No two doctors work the same way
• Templates help doctors manage
patients
• They help the administrators
manage and analyze the practice
First some background
Anatomy of the Database
Dictation
Another computer
Voice Recognition
Keyboard
MACHINE READABLE MATERIAL
STORED IN CONNECTING
(RELATED) TABLES
CREATED, READ, UPDATED
OR DELETED
(CRUD)
MONITOR
FILE
PRINT
E-MAIL
Essentially, it is a form
Paper form
used by Kidney
Associates to
document
dialysis visits
Who builds the template?
Plan form
to follow
function
and workflow
Classify
by
stage
Buttons to
other
templates
Link to
web resource
mdrd.com
Can select diagnostic & therapeutic
options for CKD 1+
Modality
choice
Action plan
by stage
Anatomy of a template form - CKD
After designing the form,
it can be saved
and either used
or quickly
changed again.
Templates must be modifiable
They are not set in stone
• Not set in stone
– Avoid Macromedia Flash
– Use design object
oriented, popular design
tools
– Modifiable within a few
minutes
– Scalable - move quickly
across the Enterprise
Template relations
• Relate to a large database of medical standards
– Medcin
• Relate to laboratory/Imaging
– The template must be able to access fields in your lab
data - NPI, ID patient, lab definition, date
• Relate to your Practice management software
– Images, demographics, medications, vital signs
• Relate to the patient’s central record or PHR
HPI
Allows free text.
Boxes assure
completeness
Common
diagnoses are listed.
The browse feature
allows access
to others.
Form includes
Common treatment
options
Buttons link to
additional forms
for each CKD
component
Completed form
for CKD
Templating Practice Analytics
• Database reports
–
–
–
–
Demographics
Filters
Diagnoses
Labs
• Assist in marketing, trend analysis, planning
• Extra cost for application from some vendors
Example: Using a template to capture dialysis billing
Drag and Drop file into right box in order you
want reported. Will sort ascending if box is
checked
COMMENTS 
HOSP 
Number Visits 
Practice ID 
Health Plan 
Vascular surg 
Guest 
Shift day 
Shift time 
Location 
Name 
Age 
ZIP 
FDOD 
Report name____________________
The Future:
From paper to
algorithm to
system
Efficient
Safety
Equitable
Patient
Centered
Effective
Timely
Corrigan, JM.;Donaldson, MS.;Kohn, LT.;Maguire, SK.;
Pike, KC. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC:
Institute of Medicine, National Academy of Sciences, National Academy Press; 2001.
Measures
• Timeliness - Does the form improve patient access, cut waiting
time, move data quickly?
• Patient centered - Spend more time, understand, explain, show
empathy and respect
• Effectiveness - Will it facilitate practicing evidence based
medicine?
• Patient safety - improve workflow and information exchange,
reduce distraction, improve volume
• Equity - Expand access to service
• Efficiency
– Technical - increase functionality through technology
– Productive - improve operations and increase value/time
– Allocative - can reassign resources doing duplicative tasks
Take home messages
• The template is a form structure that you
or your staff modify to increase the value
quality of your practice, efficiency and
effectiveness of your service.
• The form must follow your workflow, be
easily modifiable, and will be changed
frequently as you discover better ways to
handle your patients.