ONC to Publish EHR Implementation Best Practices Online

The Office of the National Coordinator for Health IT is developing an online, interactive dashboard that will continuously track the performance of regional health IT extension centers and allow for the timely sharing of lessons learned.

A first-look “static” version of that progress summary should be available by the end of January, according to Mat Kendall, director of ONC’s Office of Provider Adoption and Support.

The 62 centers, spread across the US, offer a variety of services, including education, vendor selection and project management, to help health providers establish and become meaningful users of electronic health records (EHRs) and to help them redesign their workflow.

Sharing best practices of how to do that is a big part of the centers’ mission.

Beyond helping with the technology, it is critical for extension centers to also communicate a clear message to providers about the value of meaningful use and a certified EHR, boil down the information so it’s easy to understand and to engage with different segments of providers, Kendall said at a Jan. 10 meeting of a panel of the advisory Health IT Standards Committee.

Extension centers and providers described some of those experiences at the meeting.

For instance, the Arizona Health-e Connection (AzHeC), that state’s extension center, has helped providers overcome some practical problems, said Dan Nelson, practice administrator and in-house technical expert at Desert Ridge Family Physicians, in Phoenix

Although Desert Ridge previously deployed an EHR, it has updated its system and will test the functions with the assistance of the extension center to ensure that the practice can document the measures and processes to prove meaningful use.

“We want to make sure that we won’t have any hiccups once we take the system into production,” he said.

A benefit of testing through the Arizona State University and the extension center is that they can use their experience with other providers, saving time and effort by sharing the knowledge.

“They can eliminate pages of testing protocols because it’s already been tested and bullet proofed and can move onto another area, say testing those interfaces a little more than we did at Desert Ridge,” Nelson said.

He also said it was critical to have a highly functional electronic health record system that could adapt to the rigors of later stages of meaningful use and communicate and coordinate patient data.

The growth in Web-based portals used to share health information, for example, means that Desert Ridge must connect with so many different portals for such things as hospital records, claims clearinghouse, lab vendors and radiology, that the management of login names and passwords has become a necessary office improvement project, he said.

Physicians need information about patients at their fingertips. “If it’s too hard to access, they won’t use it,” Nelson said.

In another part of the country, the Regional Extension Assistance Center for Health IT (REACH) serves providers in Minnesota and North Dakota with an emphasis on rural and underserved areas.  Because hospitals with a small number of beds have fewer resources, they will take longer to accomplish meaningful use objectives, said Dr. Paul Kleeberg, REACH clinical director.

The extension center has worked to keep providers focused on the patient and the quality of health care as their guide in selecting the technology. With meaningful use boot camps, or how-to meetings, the extension center has worked with providers in small groups to explain the steps and to break down the tasks into small pieces for successful EHR deployment, the processes to be created and changes in workflow, Kleeberg said.

More than half of the time spent with a clinic is devoted to tasks that must be accomplished before the provider signs a contract with an EHR vendor. 

 “We have found that creating a firm foundation helps a clinic through the ‘valley of despair’ that occurs shortly after the excitement of going live wears off, and they realize how much work still lies ahead,” he said.

For example, a small critical access hospital in western Minnesota, which struggled with its EHR, set up teams to figure out workarounds in its system so it could successfully implement the software.

One approach that failed to attract providers was using a sense of urgency to compel physicians to sign up for extension center services, Kleeberg said. Too many other issues demanded their attention.

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