NGHN has assisted 3 California Planned Parenthood members in going live on EMR in the past 6 months: Planned Parenthood Los Angeles, Planned Parenthood MarMonte, and Planned Parenthood San Diego and Riverside Counties. Each one started at an initial clinic site and then began their rollout to their other clinic sites. These members plan to roll EMR out to a new clinic on average every 3 weeks.
NGHN continues to develop and enhance best practices surrounding EMR implementation in a Planned Parenthood setting that can be used by other affiliates to come. We facilitate a bi-weekly EHR Implementation meeting which serves as a “learning community” for our members to give and get updates on respective implementations, share lessons learned and best practices, and ask questions of each other. Some join just to listen in on things to come. We’ve been working closely with our vendor partner, NextGen, to provide seamless and integrated services to our mutual customers and this effort is starting to pay off with more timeline planning meetings with respective project managers and more closely aligned issues management. Some key representatives of NextGen have started to participate in our regular meetings such as this bi-weekly EHR meeting to gain more insights from their perspective.
One of the biggest challenges for our members has been lab interfaces (no surprise there). Our members have strived to have lab interfaces up and running prior to going live on EMR; however, in the cases where this has not happened in time, clinic staff are finding they must manually approve and data enter the results in EMR which is a time intensive process. Even though there is at least one member that has successfully implemented an interface with Quest and LabCorp, it is still proving to be a challenging and lengthy process for others. The move to national test codes by Quest has added some additional complications in working with them, such as their own staff needing to be trained on these new codes.
Another recent challenge is the current economic environment and uncertainty of the California state budget, which may end up impacting the rate at which our members can move forward in their EMR implementations.
An additional challenge our members have noted is in training their end users. There are challenges in: 1) training new staff in a timely manner who are hired to work at a clinic that is already using EMR; and 2) training per diem or very part-time staff who experience a learning curve every time they work because their time in the clinic is limited.
NGHN continues to refine and enhance the customized templates that we provide to our members as clinic staff use them and find bugs or provide ideas for improving the templates or need additional data to be collected. We continue to explore more effective ways to offer our own training including providing a web-based training each time we publish a template release in order to provide an overview of the changes and training on any new templates or features to our members.
We will be applying our lessons learned in our work in assisting three more customers to go live with electronic lab ordering and/or full EMR by the end of 2009. Our optimization efforts will be based on our approach of continuous quality improvements driven by data and best practices.
1 comment:
Tanya -
Thank you for the comprehensive update. We always learn so much from what you are doing. The lab issue does seem to surface again and again, everywhere. One of the recommendations from our first round of evaluation interviews was going to be to make sure the lab interface is working before going live, however, when faced with such extensive delays it could be a momentum killer entirely.
On the issue of very part time providers, have any of the affiliates resorted to assigning "scribes" or scanning in the note written by the part time provider?
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