Webinar – Using EMRs for Chronic Disease Management March 3, 2011 Funding to support this Webinar has been provided by Hewle7-Packard Dr. Michelle Greiver • Practice description: – Community-based family practice in Toronto – 1,300 patients – Part of interdisciplinary team (North York Family Health Team) – 3 physicians, 1 nurse practitioner in the office – 60 physicians are members of the NYFHT • EMR used: – Nightingale EMR, since 2006 Practice Profile • Practice description (1092 adult patients) – 77% female – Taking part in a Quality collaborative since 2009 – Part of national primary care EMR chronic disease surveillance system (CPCSSN) • Chronic Disease prevalence (adults) – 80 patients with diabetes (7%) – 89 COPD (8%) – 207 hypertension (19%) – 16 CHF (1%) – 27 confirmed asthma (2%) Benefits of EMR for CDM You cannot improve what you cannot measure • We decided to code important chronic conditions so that we could build disease registries • We enter data consistently in the EMR so it can be measured • We invested time and resources in measurement and audits • All team members use the EMR • We have CDM flowsheets and templates, with associated alerts and reminders • We use the EMR to audit and mail reminders to patients who are overdue (diabetic, no eye exam for 2 years) Screenshot Screenshot 6 CDM reminders for any chronic conditions this patient has: “HM button” Screenshot 8 Take Home Points • Decide and agree: which chronic conditions you would like to focus on? • Involve everyone in your practice • Enter your data carefully and consistently • Use the features that your EMR offers • Try small steps to improve care • Measure what you did and see if it worked, then keep going • Use what you learned in one chronic condition to improve other conditions Dr. Nora Curran-Blaney • 3 Physician Family Practice – Oakville, ON – 2 physicians work concurrently – flexible schedule • 30 years practice experience • EMR used: Healthscreen • Remote access version • Experience using tablet computers Practice Profile • 1348 rostered patients • 519 over 50 yrs • Chronic Disease prevalence – Hypertension – (400 pts.) – Obesity – BMI over 33 (100 pts.) – Diabetes Mellitus – (30-40 pts.) – Heart failure – (10 pts.) Benefits of EMR for CDM • Ability to develop clinical queries • Active use of a patient profile – Hand printed copy of profile to patient • Used of coded data display – Requires discipline of data entry for future use • Colour coding • eFax directly from EMR • Simplification of referrals • Cancer surveillance 13 Take Home Points • EMR usability is critical • Encourage patient self management – Not yet using a patient portal • Record information during the encounter • Patient feedback – Most feel management is improved with EMR – Less chance for error or that information has been forgotten – Worry about privacy and power outages Michael Brand, Clinic Manager Associate Medical Centre, Taber, Ab. • 12 Physician Family Medicine Clinic • Member of Chinook Primary Care Network • Using Wolf EMR since 2007 Practice Profile • Approx. 18,000 patients in catchment area • Team based Care • Physician is team lead with mix of NP, RNs, LPNs, Psychiatric RN, Psychologist, Dietician, Health Coach & MOAs • Large Senior & “ESL” Populations • 19 bed Acute Care Hospital • 100 bed LTC Facility Benefits of EMR for CDM • All CDM Monitoring is managed through use of “Rules” within EMR • Rules define a population and provide alert at Point of Care • All Clinic Staff are tasked with dealing with relevant rules when in contact with a patient • CDM Run charts are used to track performance over time • Results are posted for all to see Take Home Points • Rules are constantly changing and evolving based on population and updates to CDM guidelines • Patients appreciate the comprehensive level of care & develop trust in the team. • Staff feel strong sense of accomplishment when they see positive results. • Overall system costs decrease (ER Visits & Admissions) through comprehensive clinic based Chronic Disease Management Unlimited access to medical intelligence CONNECTING SILOS INCREASED VALUE AT THE POINT OF CARE ANYWHERE ANYTIME ACCESS COST REDUCING SERVICES THREE NEW webOS DEVICES FROM HP Veer Pre3 TouchPad HP TouchPAD - Power of webOS as a mul:-device Plaorm -“Instant on” produc:vity tools - webOS mul:-tasking - View and edit MicrosoH Word and Excel files - Video calling - Wireless prinng to tens of millions of HP printers - Beats Audio support -Catalogue with thousands for business, Health, fitness, fun, etc Bridging the gap between smartphones and tablets Share a URL by tapping a webOS phone to the TouchPad Available Summer HP Touchpad 2011 •1.6 pounds, 190mm x 242 mm x 13.7 mm •9.7-inch diagonal, 1024 x 768 capaci:ve display •1.3 megapixel webcam •Video Calling •Beats Audio technology •Stereo speakers •Wi-Fi, 3G, and 4G op:ons •802.11 b/g/n •Bluetooth 2.1 + EDR •16 + 32 GB storage •Gyro, accelerometer, compass •Dual Core 1.2GHz processor Choose the right instrument for the job HP TouchPad/ HP Mini Slate HP Mobile HP HP ProBook HP EliteBook Thin Client Get full PC functionality and Ideal mobility for a Ultra-compact Entry-level mobile Current technologies, Best-in-class design, maximum portability, controlled, secured mobility packed computing for added extensive leading technologies, stay connected2, plus environment with impressive productivity at low cost configurability, and feature-rich with choose from pen or features, including enhanced security greater security, touch capabilities. optional touch and support for more enhanced screen with demanding users manageability, and gesture support premium support Questions & Discussion Webinar – Using EMRs for Chronic Disease Management March 3, 2011 Funding to support this Webinar has been provided by Hewle7-Packard .