TELUS EMR Practice Consulting · Merge strategy has been defined (Sep 2015) • First test merge executed (Nov 2015) • Workflows have been re-designed - awaiting sign-off • Data

TELUS EMR Practice Consulting TELUS Health: Sonny Sull and Ryan Everitt South Calgary PCN: Oliver Schmid

Agenda

2 Confidential

Introductions

Practice Consulting Overview

Current State and Success

South Calgary PCN Experience

Introductions 1

Introductions

4 Confidential

Practice Consulting Team within the Company Over 80 years of Health Care experience Health Business Consultants and Senior Client Service Management Delivering Training Content and Supporting Clinical Needs Program and Project Management Experience

Organizational Overview

5 Confidential

PCS Overview 2

Practice Consulting Services Overview

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Workflow Analysis and Optimization 1 Custom Advanced Training 2 Billing Optimization 3 Site Technical Consulting 4 Onsite Change Management Activities 5

8 Confidential

Workflow Analysis and Optimization

• Assessment and Understanding of Clinical EMR Usage

• Current State and Future State process mapping

• Custom Content creation

• Supporting Remote and Onsite Analysis

9 Confidential

Custom Advanced Training


• Advanced EMR Content Delivery

• Examples: • Chronic Disease Management • Panel Management • EMR Security • Physician Workdesk for Staff (P4S)

10 Confidential

Billing Optimization


• High Return on Investment

• Supporting Provincial Billing Requirements • Incentive Billings

• Third Party and Private

• Reporting

11 Confidential

Site Technical Consulting

• Assessment and Hardware Review

• Hardware Qualification

• Network Performance

• Multi Location Enablement

• Speed Performance Benchmarking

12 Confidential

Onsite Change Management Activities

• Assessment of current environment

• Supporting EMR Adoption

• Coaching and Mentoring for Best Practices

• Go Live Support • EMR Troubleshooting • Technical Liaising

13 Confidential

All begins with the assessment

• Remote and Onsite availability

• Finalized Report • Clinical Drivers • Assessment • Recommendations • Highlights Return on Investment

14 Confidential

Overall Approach

• Understand the clinical drivers

• Analysis/Assessment (investigative)

• Recommendations

• Action plan

15 Confidential

Assessment Tools

• Case Analysis Tools

• Return on Investment (cost savings)

• Technical Performance

• Workflow Analysis

Current State 3

17 Confidential

Current State and Success with PCS

• Over 80+ projects across BC and AB

• Approval to build the program cross Platforms • MedAccess • PS Suite

18 Confidential

Practice Consulting Statistics

Category Results

Interaction with Health Business Consultant – Top 2 Box

100%

TELUS Health was successful at improving relationship with customer

95%

Customers indicated being able to use EMR more effectively

94%

Likelihood to Recommend 82%

Clinics wanting additional consulting services in the future.

95%

19 Confidential

Practice Consulting Projects/Comments

“Visits like these keep us focused on full EMR utilization”

“Support for Billing Optimization Please”

“I Just wanted to say how helpful it was to have a Health Business Consultant stop by

the office yesterday – we really appreciated picking their brains about some of the questions/issues we have had about the software. I think it is a great service.”

20 Confidential

Introduction of South Calgary PCN

• SCPCN has been with TELUS since: 2010

• 3 Managed Clinics (4 main services)

• 3 x onsite Practice Consulting visits

• Workflow Analysis and Change management

• Custom Training Plan for super users

Oliver Schmid (PhD) South Calgary PCN Director of Evaluation and IM&T

SCPCN experience with Practice Consulting

22 Public

The Need: Clinic Consolidation 1 The Approach: TELUS Health PCS Engagement 2 The Current State: Where are we now? 3 The Future State: Where do we want to be? 4 The Benefit: What did the PCS Team bring? 5

The Need: Clinic Consolidation 1

The Need: South Calgary Primary Care Network

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• SCPCN is a growing PCN with (currently) 220 member physicians

• 4 managed clinics

• Multiple centralized services and service models within 3 EMR databases • Family practice • Low Risk Maternity • Diabetes Management • Chronic Disease Management • Counselling • Pediatric Weight Management • Nutrition Counselling • Others

• Ave. 380 incoming referrals and 1,700 visits per month

The Need: What is the Issue

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• No room to expand

The Need: What is the Resolution

26 Public

• Consolidate all clinics into 1 large space

The Need: Resource Optimization

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• Going from ALL things for 1 clinic

• To 1 thing for ALL clinics

The Need: What to do with the 3 EMRs

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Option 2: Start entering into 1 EMRs

Option 3: Engage TELUS for Feasibility

Study of 1 EMR

Option 1: Keep 3 EMRs

The Need: Project Roadmap

29 Public

EMR Clinical

Processes

Buildt Clinic Process

Redesign

Training

Database Merge

Goal

Vision

The Need: Project Overview

30 Public

• Consolidate 3 Wolf EMR databases into 1

• Setup Clinical & Corporate Network at new clinic

• Equipment and connection to TELUS data centre

The Approach: TELUS Health PCS Engagement

2

The Approach: TELUS Consultancy Team

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• Sonny Sull – EMR Consolidation Program Manager • Rob Harris – Senior Project Manager • Karen Loukota – Systems Engineer Specialist • Ryan Everitt – EMR Trainer • Erik Christensen – Merge Tool Developer • Shannon Cotter –Networking Project Manager • Rod Taylor – Account Manager

The Approach: SCPCN Project Team

33 Public

• Lonnie Ellis – Project Manager • Vinh Huynh – IT Manager • Valerie Moldowin – EMR Trainer • Sarah-Joy Haggstrom – EMR Optimization Lead • Bekki Tagg – EMR Analyst • Theresa Cooke – Assistant Clinic Manager • Oliver Schmid – Director IM&T

The Approach: Current State Assessment

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3 9

2 8

7 5

4 6

Current State Assessment

The Approach: Current State Assessment

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• Karen Loukota (TELUS Systems Engineer Specialist)

• Interview cross section of staff, providers and physicians covering all roles and responsibilities

• Mapping out all EMR workflows across all clinics

• 25 different workflows

• Performed June/July 2015

The Approach: Feasibility Study

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3 9 1

Feasibility Study

8

7 5

4 6


The Approach: Multiple Clinical Business Models

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• SCPCN has a two state business model

• Family Care Clinic

• Family practice with physicians

• Standard ‘stable’ patient panel

The Approach: Multiple Clinical Business Models

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Intake Appointment

Appointment 2

Appointment x

Discharge Appointment

• Low Risk Maternity Clinic

• Health Management Clinic

• Time 2 Talk

• Specific care pathways with transient panels

• 12 months • 6 – 7 months • 6 weeks

The Approach: Frequent Patient Panel Changes

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Family Care Clinic Low Risk Maternity Clinic

Time 2 Talk

The Approach: Patients in Multiple Panels

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Family Care Clinic Low Risk Maternity Clinic

Time 2 Talk

The Approach: TELUS Future State Suggestions

41 Public

TELUS Future State Suggestions

9

Feasibility Study

2 8

7 5

4 6

1


The Approach: TELUS Future State Proposals

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The Approach: Review & Select Future State

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3 9

Feasibility Study

2 8

7 5

6

1

Review & Select Future State



The Approach: Review & Select Future State

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• Not all Workflow Recommendations could be adopted • Move to 100% e-referral is not yet possible due to physicians in network

being on non-Wolf EMRs • Do not print day sheets /referrals not possible due to secondary data

capture for Business Intelligence work

The Approach: Re-Design EMR Workflows

45 Public

3 9

Feasibility Study

2 8

7

4 6

1

Review & Select FutureState


Re-Design EMR Workflows


The Approach: Re-Design EMR Workflows

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Current State Future State

The Approach: Define Data Standards

47 Public

3 9

Feasibility Study

2 8

7 5

4

1




Define Data Standards



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SCHMC SCFCC SCLRM HMC New Patient New Patient new pat

HMC Office Patient Office Patient Office Patient HMC Left Practice Acute Care Patient Acute Care Patient

Deceased Long Term Care Patient Long Term Care Patient RR- HMC Re-Referred Left Practice Left Practice

PR- HMC Discharged- Patient Request Housebound Housebound NC- HMC Discharged- Non Compliant Deceased Deceased

NI- HMC Discharged- No Initial Member Discharged PC- HMC Discharged- Program Complete Eagles Med Pts Unattached-Now Attached

GI Patient Dr 1 Previous Pt Refer to OB GI Discharge Inactive Patient Not Accepted

Nutritional Services Patient Dr. 1 PT Found FP Discharge Nutritional Services Dr. 2 PT Not Our Patient Pediatric Wellness Program Dr. 3 PT Never Seen

Discharge - Pediatric Wellness Program Pediatric Kids in Care Transferred to OB Inactive Patient Home Safe South Miscarried

COST RD Dr. 4 PT Before EMR Time To Talk new Patient Never Seen Hearing Impaired

T2T Discharged Path To Home Pelvic Floor T2T Lost to Follow Up Dr. 5 PT

T2T Never Seen HSS Never Seen T2T Discharged-Provider Left PTH Discharged

T2T Discharged- patient request HSS Discharged Nutrition Services NEVER SEEN

PWP Never Seen Pharmacy

Pharmacy Discharged Pharmacy Never Seen


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SCHMC SCFCC SCLRM HMC New Patient New Patient new pat

Time To Talk new Patient

The Approach: Develop EMR Merge Strategy

50 Public

3 9

Feasibility Study

2 8

5

4 6

1





Develop EMR Merge Strategy


The Approach: EMR Merge Strategy

51 Public

• Erik Christensen (Merge Tool Developer)

• Select target system

• Define what to do with historical referential data

• Leave as is • Override with future data standards

• Merge instances 1 by 1 or all together

• Log what requires manual migration

• Document all decisions and sign-off

The Approach: Develop Training Strategy

52 Public

3 9

Feasibility Study

2

7 5

4 6

1






Develop Training Strategy


The Approach: Train the Trainer

53 Public

• Ryan Everitt (TELUS EMR Trainer)

• TELUS designed comprehensive custom training plan for local EMR trainer and EMR Improvement Lead

• 3 sessions of 2 days split over 6 weeks

• SCPCN sandbox environment for testing and familiarization

The Approach: Internal Expertise Development

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Before After

The Approach: Training Plan

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• 61 total SCPCN staff to be trained • 4 Managers • 9 Nurses • 11 MOAs • 21 Allied Health Providers • 17 physicians

• Most have no previous formal EMR training

• Customized training sessions by staff type

• Group sessions and on-on-one

The Approach: Test Merge Tool

56 Public

3


Feasibility Study

2 8

7 5

4 6

1






Develop Training Strategy

Merge Testing

The Approach: Same Patient in Multiple EMRs

57 Public

EMR2 EMR1

The Approach: Same Patient in Multiple EMRs

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The Approach: Similar Patient in EMR

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81.3% Match Do you want to merge this patient?

The Approach: EMR Merge

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The Approach: What’s in the Box

• 6,947 active patients • 1,306 Low Risk Maternity • 2,535 Chronic Disease Management & Mental Health • 3,106 Family Practice

• 34,508 inactive patients • 12,663 Low Risk Maternity • 7,010 Chronic Disease & Mental Health • 14,835 Family Practice

• 494 SMART Forms

The Current State: Where are we now? 3

The current State: Where are we now?

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• EMR team has been trained (Oct 2015)

• Merge strategy has been defined (Sep 2015)

• First test merge executed (Nov 2015)

• Workflows have been re-designed - awaiting sign-off

• Data standards have been developed – awaiting sign-off

• Training schedule has been developed (Jan 2016)

• TELUS onsite support has been scheduled

• Go-live has been set (Feb 2016)

The Future State: Where do we want to be?

4

Mar 2016

The Future State: Where do we want to be?

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Train EMR Team

Test Merge (test environment)

Data Cleansing & Manual Migration

Sign-Off Future State


Future State Development

Physical Clinic Move

Train Staff & Providers

EMR Merge (live)

Feb 2016 Jan 2016 Dec 2015 Nov 2015 2015

The Benefit: What did the PCS Team bring?

5

The Benefit: Team Work

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• Bi-weekly project calls with PMs

• Weekly EMR Merge calls and constant Q&A access to system developer (Erik)

• Expert Wolf capabilities/limitations knowledge

• Comprehensive custom made and flexible training plan from Ryan (the EMR team/girls loved this part)

• Constant access to Systems Engineer (Karen)

• Early start Network project kick-off

• Smooth behind the TELUS scenes coordination of projects

• Pro-active project input from TELUS team • Break training into multiple sessions` • How to handle different clinical business models • Onsite change management support during migration • Direct access to key staff to resolve project issues during go-live • Programmatic bulk data corrections • Training support • Etc.

TELUS Health PCS

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To learn more about PCS: [email protected] Feel Free to Connect with us at the conference this weekend Please take a PCS Brochure and Case Study

Documents

TELUS EMR Practice Consulting · Merge strategy has been defined (Sep 2015) • First test merge executed (Nov 2015) • Workflows have been re-designed - awaiting sign-off • Data