CLINICAL INFORMATICS

FROM THE NACHC LENS  As of 2018, nearly every Federally Qualified Health Center (FQHC) (99%) reported using Electronic Health Records (EHR). There is no question that the use of EHRs has greatly strengthened the way care teams function and provide, monitor, assess, and report patient care.  But no EHR is perfect. Using the software correctly, consistently, and efficiently as well as adapting to system updates does take time and effort for care teams. The additional work needed to enter and manage patient data can be significantly challenging and can lead to staff burnout, stress, frustration, and longer workdays.

IT Clinical Champions–Helping Health Centers Use EHRs to Provide High Quality Care "IT Clinical Champions are change agents,” says Lisa Masinter, MD, MPH, MS, Senior Director of Research, AllianceChicago, a health center-controlled network and practice-based research network linking more than 50 organizations serving FQHC patients across Illinois and 19 other states. “They can help create change in the EHR that can support the care teams, and they also inform changes and updates for the health center and EHR vendor. Their communication to care team members not only helps disseminate new information about the EHR, but also helps to generate buy-in for implementation.”   Helping care teams more fully optimize their use of the EHR is another important role IT Clinical Champions play. “I try to help to make our EHR less cumbersome for providers, meaning less clicks and time to get to an outcome,” says Carolina Saldarriaga Perez, MD, FAAP, a pediatrician at Neighborhood Health, Alexandria, VA who also serves as the health center’s IT Clinical Champion.

IT Clinical Champions Support Care Teams By:

creating short cuts for using the EHR and developing dot-phrases (commonly used medical terms) and instructions staying on top of new EHR updates while sharing updates with clear and simple guidance

working with EHR client support teams to address provider questions, request new templates, or follow-up on help tickets troubleshooting provider challenges and helping to find solutions

“Nothing can be improved upon unless you measure it in the health center,” explains Tiffany White, MPH, Director of Quality Improvement, Ohio Association of Community Health Centers (OACHC). OACHC works with health centers throughout Ohio to improve patient care services and quality of care that Ohioans receive.  As a bridge between care teams and the quality team, IT Clinical Champions understand each team’s needs and when there is a break down in a process or gap in data that needs to be addressed. They work with both teams to figure out a solution, whether it is clearer instructions for the care team on how and where to enter data, the need for a new EHR template, or a change in the process for gathering certain patient information more efficiently.  For example, at Neighborhood Health, Dr. Perez learned that many of the providers regularly spent several minutes trying to send e-prescriptions, which should only require a few clicks. Providers often had to locate the correct pharmacy because the information was not already in the EHR, and patients were not always sure which pharmacy they used. Dr. Perez identified the break in the process and worked with the front desk staff to make sure pharmacy information was entered during check-in and registration, well before the provider would see the patient. The result: providers had more time to focus on their patients and spent less time on sending electronic prescriptions, and patients were happy because they received their medications more quickly.

Qualities of an IT Clinical Champion

IT Clinical Champions possess skills and abilities that enable them to be problem solvers and can easily work within and between care teams and the quality team. Looking to add an IT Clinical Champion to your health center team? Here are a few professional and personal assets to look for: A clinician or quality team member who intimately understands care team needs and approach to patient care A super user (or wants to be) of the health center’s EHR who likes detailed information; understands how HIT helps close care gaps Curious with a desire to change things that would benefit from improvement and not satisfied with the status quo Strong desire to stay current on the health center’s EHR and how updates will affect workflow changes Good communication skills to deliver information to clinicians that is very clear, easy-to-understand, and inviting Self-starter who is proactive about the EHR and helping care teams document needed data rather than reactive to issues as they arise Persistent, yet patient Collaborative

CARE TEAMS SPOTLIGHT

IT Clinical Champion Carolina Saldarriaga Perez, MD, FAAP Pediatrician Neighborhood Health, Alexandria, VA

“IT Clinical Champions are curious and never satisfied with the status quo. We find solutions to the challenges our fellow providers experience with the EHR so everyone can focus more time on caring for our patients. I was the number one complainer about our EHR, and if I am complaining, I should be looking for solutions,” says Dr. Carolina Saldarriaga Perez when sharing why, in addition to her responsibilities as a pediatrician, she took on the role of IT Clinical Champion at Neighborhood Health. This new role was created in response to physician burnout, frustration, and fatigue from trying to correctly and quickly use the health center’s EHR to capture, manage, and/or retrieve patient related information while also providing high quality medical care during each patient visit. Keeping up with the inputs and outputs of their EHR made for longer workdays and more stress and pressure to complete patient visits in a timely fashion. As an IT Clinical Champion, Dr. Perez helps Neighborhood Health’s 60 providers and 200 clinical staff optimize their use of their health center’s EHR. She finds solutions for making the EHR less cumbersome—often by reducing the number of “clicks” physicians need to make to get to an outcome. Every two weeks, Dr. Perez sets aside a half day to assume her IT Clinical Champion role. Her duties vary from liaising with the EHR vendor about a problem or new update to finding shortcuts and time-saving tips and tricks (i.e., using more common phrases) to learning new program updates and determining how physicians can most easily apply them. Dr. Perez has become the resident physician “EHR Super User” who then shares all she learns with the other physicians during staff meetings, bi-weekly emails featuring simple, clear guidance, and one-on-one individual support.   The impact is a win-win all around:  Improved and more efficient use of the EHR Physicians are less stressed and can put more focus on their patient’s medical care and counsel Patients receive higher quality health care and have a better patient experience such as reduced wait times for services and test results and more clear and complete home care instructions Health center leadership have clinical informatics data needed to track cost, patient trends, population health trends, quality assurance, and much more.

EVENTS AND RESOURCES

Clinical Informatics Section on NACHC Website New web page showing how NACHC helps health centers expand the use of data and technology   Sample IT Clinical Champion EHR Tips of the Week Example of one health center's strategies to improve workflow

THE 5-4-3-2-1 MINDFUL EXERCISE

Anxious and stressful thoughts can sometimes get in the way of living in the moment. This five-step mindfulness tool can help keep you in the present when your mind is circulating one or more anxious thoughts. Take a deep breath and bring your attention to the current moment. Then begin to focus your thoughts on the following, one thought at a time.  5 things you can see 4 things you can feel  3 things you can hear 2 things you can smell 1 thing you can taste

Source: The 5-4-3-2-1 exercise is the copyright of SOAR Inc. Fear of Flying program.

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