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Using an EMR to Support Screening Processes

Session 2

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Objectives

• To identify the difference between standardized and non-standardized data

• To identify how the EMR supports screening processes

• To identify how EMR practices support screening processes

• Where to start with our teams

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Question:

• What health data is most encoded from physician offices across Alberta?

Answer:

Billing data

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Types of Data Recorded in an EMR

At the clinic level data can be classified as:

– Structured data• May be standardized at the clinic level• Searchable

– Unstructured data• Usually unstandardized• Challenging to search for, or,• Non-searchable

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Examples of Structured Data

• Radio Buttons• Tick Boxes• Drop Down Boxes• Pick Lists• Discrete fields

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Examples of Unstructured Data

• Fields where notes can be written• Includes drawings and sentences

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Templates

Text Field amongst many discrete data fields

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EMR Capabilities Relevant to Screening• Track data over time

• Identify and sort patients

• Identify patients who are due/overdue for

screening

• Monitor parameters, such as vaccinations and

BP readings

• Messaging between team members

• Create reports

• Generate, print and store requisitions

• Fax from within EMR to lab or diagnostic

imaging sites

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Blue Meadow Case Study

Engaging the whole team in this discussion

makes decisions and priorities

transparent for all and builds shared

commitment

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Current State Assessment

• Determine what is currently being recorded in a standardized way

– By individual providers/staff

– Amongst all providers/staff

– By the system

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Data Relevant for ASaP

How are the ASaP maneuvers documented?

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Screening Offer Documentation

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Consider Dr. Doe and Dr. Green’s patterns of screening documentation

• Many offers occur during a Complete Physical eXamination (CPx)

• Mixed use of standard fields and notes – which may not be searched or

reported• Investigation requisitions are created

and results received in the EMR (not scans)

• Influenza is offered seasonally

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Moving Forward: Gain Agreement on Standardization

1) What does Blue Meadow want to get out of the EMR?• Agree on desired outputs

2) What needs to go in to make this happen?• Determine which fields in EMR need to be

filled to generate the desired reports• Agree on data entry• Identify skill gaps and train• Monitor regularly and reinforce

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Getting Help

• EMR Help Files

• Vendor

• POSP funded VCUR 08 clinics

• Share with another clinic using the same system

• TOP resources

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Key Concepts

• Foundationally: EMRs can– Identify target populations for

screening– Remind that the screening is due– Record that screening has been

offered– Fax requisitions

• Understand where you are in order to conduct chart review and prepare for screening process redesign

• Screening is not a one-time event but a process

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Summary

• EMR will contain both structured and standardized data as well as unstructured and non-standardized data

• EMR for Screening Processes– Capabilities: sort, fax, search, report– Practices: standardize where possible

• The Chart Review will help to understand the current state and inform screening process redesign