WHATCOM COUNTY, WA a Case Study WITH UNANSWERED QUESTIONS - PowerPoint PPT Presentation

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WHATCOM COUNTY, WA a Case Study WITH UNANSWERED QUESTIONS

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WHATCOM COUNTY, WA a Case Study WITH UNANSWERED QUESTIONS Marc Pierson My community PeaceHealth / HInet / CHIC / Pursuing Perfection PEOPLE & PLACE Who is we ? – PowerPoint PPT presentation

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Title: WHATCOM COUNTY, WA a Case Study WITH UNANSWERED QUESTIONS


1
WHATCOM COUNTY, WAaCase StudyWITH UNANSWERED
QUESTIONS
  • Marc Pierson
  • My community
  • PeaceHealth / HInet / CHIC / Pursuing Perfection

2
PEOPLE PLACE
  • Who is we?Where is home?

3
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4
"Never doubt that a small group of thoughtful,
committed citizens can change the world indeed,
it's the only thing that ever has." - Margaret
Mead

5
It Takes a Community
6
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7
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8
HISTORY
  • Sense making

9
Healthcare Collaboration in Whatcom County
  • 1990 Vision of Seamless Care
  • 1994 Whatcom Integrated Delivery System
    Community Health Improvement Consortium (CHIC)
  • 1995 SJH/PH goes live with Community Health
    Record
  • 1996 Whatcom Health Information Network (Hinet)
  • 1998 HInet becomes LLC charges for first time
  • 2001 Diabetes registries, IOM report, continued
    growth
  • 2002 Pursuing Perfection Project
  • 2003 Patient Health Record (Shared Care Plan)
  • 2003 Community-based Care Coordination

10
WHY DO IT?
  • Community Information Technology

11
Values and Beliefs
  • Seamless care
  • Best outcomes
  • Community collaboration
  • Systems thinking
  • We are all in this together
  • Individuality is over-rated, and misconceived
    all that is uniquely human is social
  • Sociology is the missing medical science

12
WHO DID IT?
13
No One Individual or Organization
  • The initial vision came from the IOM
  • The Catholic tradition of service influenced the
    Sisters of St. Joseph of Peace
  • Don Berwick influenced the CEO
  • 84 doctors and a hosp. exec team created a vision
    of seamless care
  • A hospital and a payer funded the creation of the
    WAN / CHIN--then all users paid
  • Malcolm Gleser wrote EMR code hoping for users
  • Everyone let holes be drilled in their walls and
    they all purchased computers and printers
  • Patients found their voice and created their PHR

14
CONVERSING more than installing systems
  • We all worried, thought, planned, stalled,
    fought, agreed (not all at once, never
    completely), and found our way forward toward our
    hopes.
  • It was and is mostly talk, conversations--understa
    nding each other, technology, timing, capability
  • Who is we? Who is talking? Why? How?

15
In my opinionThe most essential person in our
community is a PhD Sociologist
  • Injured by our system of healthcare.
  • Compassionate and deeply understanding of the
    people.
  • Aware that an organization is its people.
  • Fully engaged (and employed) by the system

16
WHAT HAS BEEN DONE?
17
Current State of IT
  • Private self sustaining Health Information
    Intranet serving community
  • 1 hospital
  • 300 physicians (99)
  • 8 of 9 Skilled nursing facilities
  • 90 locations
  • Over 1800 pcs
  • 1800 network users
  • 170,000 inhabitants

18
Current State of IT
  • Hospital online with robust installation of IDX
    LastWord EMR, accessible to all physicians and
    their staff in their offices and homes
  • Labs and images online
  • Several specialty practices importing notes GI,
    vascular lab, nephrology, echo, surgery centers
  • E-mail - internet access antivirus protection
  • Helpdesk phone and onsite service
  • LAN consulting and implementation

19
Current State of IT
  • Medical reference resources on line
  • Up To Date
  • Micromedex
  • MD Consult
  • Medical Journals, databases, etc in electronic
    library
  • 40 doc family practice on Logician EMR
  • 60 doc multi-specialty group implementing Better
    Health Record EMR
  • 575 Patient Health Records in use, rollout to
    broader community started
  • Pilot e-prescribing project beginning
  • Designing integrated display of Patient Data from
    disparate systems

20
WHATS NEXT
21
Depending on the Conversations
  • Medication reconciliation between patients and
    clinics (in pilot)
  • eRx community-wide
  • eRx state-wide?
  • Interfacing / connecting existing EMRs including
    the PHR
  • State-wide PHR?
  • HIPAA compliant community-wide clinical
    analytical database for health quality improvement

22
QUESTIONS
  • LOOKING FOR
  • YOUR ANSWERS

23
Who are the legitimate stakeholders for clinical
/ health information technology?Who is we?
24
How do we meaningfully engage our communities,
states, nation in something that resembles a
public utility model for health information
technology?
  • vs. privately owned and competing toll roads?

25
What is the ultimate role for Patient Health
Records in an individuals health? In a
communitys public health?
  • Who is we?
  • Enforce the continued professionalization of
    health?

26
  • How might community members involvement in
    health information technology initiatives impact
    the process and outcomes?
  • Enthusiasm
  • Design
  • Governance
  • Scope
  • Funding,
  • Implementation

27
Social Networks Multiple Identities
  • If physician adoption follows the average 17 year
    delay (a dense social network) and if it is
    compounded by financial barriers, what can be
    done to overcome the social-structural delay and
    financial barriers?

28
THANK YOU
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