Page 18 - FOCUS December 2017

PRIMARY CARE & COMMUNITY MEDICINE
Primary care migration to integrated electronic health record standardizes workflow for optimal care
As primary care practices within The Medical Group of Christiana Care migrate
to PowerChart over the next several months, they are doing more than simply piloting an integrated elec- tronic health record (EHR) that syncs ambulatory charts with inpatient, emergency and lab notes.
Along with colleagues in cardiology and vascular services who began pilot- ing the improved system from a spe- cialty perspective in December 2016, the primary care group is also helping to standardize workflow for optimal care across the health system.
Christiana Care physicians have docu- mented electronically for several years, yet inpatient and ambulatory records were captured on separate platforms requiring primary care providers and specialists to toggle between records for complete information on their patients.
Now with the global move toward “one patient, one chart,” providers on the hospital side will have ready access
to clinical interactions and be better able to understand events leading to a patient’s presentation in the emergen- cy department or inpatient stay. Those on the ambulatory side will be up-to-
date about care provided in-house.
“An integrated record helps us achieve mutual goals of reducing read- missions and making sure we have good handoffs of care,” said Sri Donepudi, M.D., MMM,
FAAFP, associate chief medical infor- mation officer, who has informatics responsibility for the PowerChart ambulatory technology initiative.
Dr. Donepudi said the integration and the collaboration it involves will be
a huge benefit for both patients and providers as it lays the foundation to leverage the tools of clinical deci- sion-making for current and future population-health goals.
Innovative thinking, transformational practice
Primary care physician David Driban, M.D., and his team at Christiana Care’s New Castle Family Medicine office led the primary
care migration to the integrated PowerChart record in October. The Medical Group’s two New Jersey based practices, the Carney’s Point and Woodstown centers, joined the pilot in November. By the end of 2017, all of Christiana Care’s primary care practices will move to PowerChart. The rest of the health system’s specialty practices will migrate to the integrated record in 2018.
Dr. Driban, who is medical director of informatics for primary care and behavioral health and clinical leader of the Primary Care Council, said the integration puts inpatient and am- bulatory providers on the same page and demonstrates Christiana Care’s commitment to innovative thinking, transformational practice and more unified patient care.
Thanks to integrated PowerChart documentation, Dr. Driban said his primary care colleagues will find that notes are generated in real time and completed faster than in Centricity. Primary care providers will also appre- ciate the easier access to information pertaining to transitions of care, he said, including emergency department and medical aid unit notes, hospital discharge summaries and notes from specialty partners.
“All of the information we need is now forward-facing in our office notes at the time of patient visit,” he said. “If we see a patient who had labs done earlier that same day, the
results are already in the chart for our review. It is clearly easier and nicer to have all of the informa- tion in one location and no longer have to jump from system to system,” he said.
Leveraging IT to improve workflows in patient care
Changing the way an office performs daily tasks is never without growing pains. Learning a new EHR requires clinical providers and administrative staff to navigate new software and ad- just to new reporting processes. It also has the potential to change workflow, subtly or significantly, in ways de- signed to reduce unnecessary variation among practices to increase quality across the board.
Roger Kerzner, M.D., FACC, a car- diologist whose practice migrated to the integrated EHR last summer, said the heart and vascular pilot helped the rollout team understand the system and improve training, and identified ways to standardize workflow across primary care and specialty practices to increase the ability to improve outcomes.
“This ambulatory PowerChart initiative is more than just an infor- mation technology project,” said Dr. Kerzner, who is also associate service line physician leader for Primary Care & Community Medicine, clinical director for specialty services for The Medical Group of Christiana Care and a team leader on the PowerChart ambulatory project. “It’s an opportu-
18 • FOCUS DECEMBER 2017