Enhanced View Prologue

The training team is now half-way through the physician/provider introductory training sessions and I have learned a tremendous amount. First, I realize we chose a misnomer in initially calling these sessions "superuser" training sessions. This was confusing since the term superuser generally refers to non-physician/NP/PA folks who have stepped up to take a lead role in their respective practice sites and learn some of the intricacies of CIS. The providers, on the other hand, are taking these classes in order to familiarize themselves with the new interface and be exposed to new functions/features.

Second, I have learned how talented and patient the trainers are: Jeri Baker, Sally Cooper, Sandy Gagnon, Eileen Giardina, Cathy Weldon, and Dave Lapierre. I have watched them stay on topic, answer questions, maintain focus, and navigate through a complex curriculum in just two hours time. While no one walks out a pro, attendees leave with an excellent sense of what lies ahead. Great team!

Third, there is a lot that I still have to learn about the Enhanced View. There is a lot that is changing with this upgrade and a good deal of it may not seem so much for the better at the outset. Up til now, physicians have striven to achieve a measure of mastery with CIS and CIS-Office; suddenly, we are being asked to relearn many of the tasks, rework many of the processes, and rewire how we think of electronically-based patient care.

My goal is to try to address all issues and questions that arise from this potential shock to the system. The following is a list of issues that have come up since the physician training sessions began yesterday morning and, in the coming days, I will make every attempt to tackle each one of them:

• Family History [please see recent prior blog posts]
• Ambulatory divided screen to view Message Center and Schedule [this will be done prior to go-live for all BAPO and BMERF primary care physicians/PAs/NPs and any other providers who make the explicit request]
• "Stick pin" not holding [this will hold upon logging of and logging in again, as opposed to closing the patient chart and opening it again.]
• Medication List/Prescription Writer vs. Medication Profile/EasyScript: I will do an in-depth study of this major re-design and post an equally thorough review over the next couple of days
• the future of ePrescribing
• Best practices for tracking narcotics
• Banner bar changes
• Problem/Diagnosis list building and viewing
• Correct & Modify
• Edit
• Procedures/Surgery History

I know the list will get longer, but I thought to iterate what I've been asked in conversation and email.

Please post or email me your concerns, questions and suggestions.

Medical Grand Rounds Preview

Tom Higgins and I will be presenting at Medical Grand Rounds tomorrow and I thought to post our slide set to give you an idea of what we will be covering in the event you are not able to attend. The gist of the talk will be focused on changes in form and function of CIS with the rollout of the Enhanced View. As always, I'd be glad to field questions on- or offline.


Uploaded on authorSTREAM by nrk99

EV Peek: Reminders

While I've had reasonable exposure to the Enhanced View interface, I had a chance to really get into the Message Center this morning. I've been touting the new look and tools, but not until today did I really get a good feel for how it drives. I can't tell you much about Pools since they are yet to be built, but Proxies are very cool. The proxy tool is highly customizable such that you can select from a long laundry list of chart elements to proxy to others. This can be useful for managing messages, labs, documents, etc., and can improve clinic/office workflow depending on how responsibilities are shared. It's design is much simpler than the current one.

Reminders can be set to display instantly or at some later date/time and remain in your Message Center Inbox until cleared. It can also be set up to return at a later date. For example, you've got a patient that needs a follow-up imaging study in 6 months. You might post a reminder to yourself and forward it to your staff assistant to have the test scheduled 6 months from now. That "shared" reminder can serve as a message to staff and can then be cleared from your inbox once the necessary deeds are done. At the same time that this reminder message is generated, you can also set a due date for the reminder to return to your inbox to again alert you to the need for the follow-up test. This type of reminder is saved to the "Recipient's Inbox", as seen in the slide below.


Uploaded on authorSTREAM by nrk99

A reminder can also be saved to the patient's chart rather than to your inbox. A typical situation when this would be useful is in posting a note to yourself to do something, say a comprehensive diabetic foot exam, on the patient's next visit. This functions like a sticky note should and, while it hangs in the chart as a reminder, does not clutter your Message Center inbox with less crucial cues.

More feature reports to come

Thank you, Patti & Yvette!

Today's entry is an easy one for me. The work has been taken care of by two terrific members of our IS team.

Patti McConnell of our supreme training team has redesigned the CIS Enhanced View Info site that you can access by clicking on the link here or on eWorkplace. It now has the look and feel we've been working towards and is only the beginning of what will become an advanced web-based learning center for CIS.

Yvette Carter of our equally outrageous technical team whipped off a quick slide set earlier today that summarizes most of the new features found in the Enhanced View. Given its comprehensive simplicity, I thought to heist it for posting here today. I think it offers more food for thought as we get ready to roll with EV.


Uploaded on authorSTREAM by nrk99

More on CIS Enhanced View

Phew... I just came home from a day-long synagogue board retreat. In an effort to prevent my wife from saying yes to another community responsibility, I stepped up last summer when things were looking pretty bright for the coming year. Well, what a difference an economic crash makes. Suddenly, I find myself in the mix of change management in all corners of my life. (I don't think I need to give the gory details of "managing" two teenagers.)

While I can't say that change is always easy, there's no doubt that it can be good. And the IS and informatics teams are doing all we can to make the change to CIS Enhanced View better than good. With time and attention, I think you will find yourself with an EMR that truly is enhanced. The training sessions that the team is currently holding for staff superusers are going extremely well. Each and every clinical site will have at least one person who will have an in-depth introduction and understanding of the Enhanced View and will be the first line of response when we rollout on March 24. And as you've heard here and elsewhere, physician superuser classes will be held in early March. Get to a session if you can.

Yesterday, I posted a brief intro to the Message Center. In the coming days, I'll get a little deeper into the tools. Messages, reminders and consults will foster communication not previously practical via CIS. Take advantage of the new Pools feature and foster new ways to manage messages and results by all members of the clinical team.

As for documentation, we continue to create PowerNote templates to meet the needs of primary and specialty care clinicians. Two new features that we will be introducing are Free Text and Auto Text. Free Text allows for text entry directly into the "final version" view of a document. Simply click into the note and type. No more need to scroll back and forth or stretch open the text box. Auto Text is similar to using macros, using abbreviations to populate the note with text. For example, "The patient is brought in by ambulance" could be entered into the note by typing BIBA or by selecting from a list as is done with macros. More to come in future posts.

Message Center

So here's my first attempt at a new technology: an animated (well, that seems a bit of a stretch, but not my term!) Power Point presentation. What I've tried to do is give a quick taste of what the Enhanced View looks like. This presents a brief tour of the Message Center, the updated version of what has been called the Inbox. Check it out to find out what's new.

The IS training team is doing a tremendous job of turning over a vast library of dated tools in order to populate our new CIS Enhanced View Info site with a compendium of training and reference materials. We hope to be able to catalog of slide sets, text aids, and short single-content videos to help you pick up tips and tricks with the click of the mouse.


Uploaded on authorSTREAM by nrk99

With this slides below, I suggest opening the view to full screen by clicking on the box-inside-a-box icon at the right side of the lower banner and then pointing the mouse at the arrow in the left lower hand corner to advance to next image. Give it a look and let me know what you think.

Become a Physician Superuser - Sign Up Now!

If you've made it to this site, you are probably aware of the CIS Enhanced View Info site and the opportunity to sign up for an Enhanced View physician superuser class. These 2 hour sessions will be directed towards physicians, nurse practitioners and physician assistants who have relative facility with CIS. No need to be an expert. We're hoping to turn into one.

Classes will be offered mornings and evening on March 3-5 and again on March 10. These classes are being held in the Baystate Health Sciences Library computer training room with simulcasting via the internet and conference call at BFMC with a trainer onsite. Classes will focus on features analogous to the current state and new features that truly enhance the clinician's experience with the EMR.

• Message Center: slick new appearance that serves as a great new CIS homepage
  
• Inbox, Proxies & Pools: manage your work on your own and with your clinical team
  
• Results, Documents & Reminders: ready access to the information you need
  
• New Family History tool: import into PowerNotes and carry across the patient record
  
• New Procedures History tool: enter accurate terminology and details
  

So make sure to sign up and join us for this instructional session. And keep an eye on the the Info site for a growing catalog of tips and tricks.

Enhanced View is Coming!

Come one, Come all. The new and improved CIS Enhanced View will arrive in a big bang rollout across Baystate Health on Tuesday morning March 24. Three hospitals, three community health centers and over 50 BMP ambulatory care practices will be introduced to this new interface and find the look and feel of the web and new tools that will serve clinicians and patients alike.

The Enhanced View not only provides advances in efficiency and function, but also serves up what its moniker promises. This new design unifies CIS Office and Hospital into a single interface making chart navigation more fluid and intuitive. A single point of entry allows for easy retrieval of results, schedules and patient lists. And, with design and development close at hand, computerized provider order entry (CPOE) will soon be available for the ambulatory setting.

Another exciting feature is the Message Center. This replaces the Inbox and is much cleaner and better designed for communication between users, be they physicians, nurses or support staff. Proxies and Pools will facilitate new, more efficient workflows for all clinical sites. One of my favorite features is the new Reminders tool. Here, we'll be able to create patient-specific reminders that will pop up when you need them where you need them. Reminders do everything that Sticky Notes couldn't.

Most important, though, is for folks to get trained and ready for this new view. While we are very excited to introduce the Enhanced View, it will take some work and investment of time to get accustomed to the change. Click on the CIS Enhanced View Info Site banner on eworkplace to follow developments and sign up for Physician Superuser classes. And follow along as we provide sneak previews and instructional tips.