KRAs for 2017

The group asked for more consideration about how ePrescribing might be deployed, including a focus on default pharmacies, a process to discontinue e-prescribed medications and enrolling everyone rather than selecting specific users based on discharge prescription utilization.

[ ] Interested directors should email Anupam for access to the copy-and-paste tool.

Process for approving change requests

The CareConnection is undergoing some restructuring with a new director to be hired in April. Information Technology has created an optimization team that will work on completing enhancement requests. It is up to the Clinical Informatics team to help prioritize the requests for Information Technology to complete. The rank order of work for the team is:

1. Revenue Cycle
2. Sherman integration
3. Nursing optimization
4. Other requests

The other requests from physicians are ranked with other end-user requests using a scoring algorithm that includes number of users affected, number of patients affected, safety, cost-effectiveness and KRA alignment. In general, system change requests are prioritized over site-specific requests.

Moving PowerPlans forward

In preparation for the Sherman integration, scheduled for April 2018, Advocate is looking to consolidate the number of PowerPlans and order sets to help reduce the Information Technology team's maintenance work and increase standardization of care delivery. In reviewing Sherman's list of existing PowerPlans, there may be an additional 60 PowerPlans to match the hospital's existing functionality.

There have been some concerns about about the PowerPlans' complexity and different display formats. In an effort to be more consistent in what our end-users see, the following suggestions were made:

In general, the directors supported the recommendations. In addition, the group asked for

• A new category "Discharge Planning,"
• Pre-checking those orders that are evidence-based instead of what is ordered most frequently.

[ ] Anupam to continue to refine the PowerPlan style guide and update PowerPlans as they are refreshed.

Opening two charts at once

At least two sites have observed documentation and order entry near misses and errors after implementing this change. Other sites have not seen errors with this functionality change. In fact, some physicians are asking for a third and fourth chart to be opened. The group agreed to keep the functionality for PowerChart users and reinforce the need to verify the correct patient before entering orders and documentation.

[ ] Anupam to investigate if an alert can notify end-users when a second chart can be opened.
[ ] Anupam to investigate if a third chart is opened, close the first chart by default

Highlighting abnormal test results when pulled from a flowsheet through a PowerNote

One site was requesting the CareConnection team highlight abnormal lab values when identified from a results flowsheet within a PowerNote.

Unlike other documentation templates where the lab result is highlighted in red, the flowsheet information is marked as abnormal (HI or LOW), but does not show up in a red font.

The group agreed that abnormal lab tests should be highlighted regardless of the method that is used to pull those laboratory results into the physician's documentation.

[ ] Anupam to submit the request to the change management queue.

Dragon update

The directors were very interested in knowing the Dragon Nuance roll-out plan. Since the meeting, Anupam has learned that the Information Technology Field Services team has signed a Dragon training contract for Illinois Masonic. Addition site training contracts are being negotiated. The Dragon training contracts will determine the roll-out schedule. Anupam will provide additional information when it becomes available.

Issues from prior meetings

[] If the signature + specialty request (with changing the resident's specialty with each rotation) and SmartTemplate work are performed by separate teams, then we will proceed down both paths simultaneously. Otherwise, we will work on the SmartTemplate request first before adding troponin in the daily labs SmartTemplate.
[] Anupam is still waiting to hear back from the Advance Care Planning Council about changing the requirement for a physical signature for LET orders.
[ ] Anupam to present electrolyte management to the ED Clinical Excellence Council to determine if this protocol could be applied in that setting.

Next meeting March 9th 0730-0830 hours CST.

Click here to see minutes from earlier meetings.