ePrescribing

1
ePrescribing

• Grace Terrell, MD, MMM, CPE, FACPE, FACP

2
Cornerstone Health Care, P.A.

• Cornerstone Health Care, P.A. is a
  multi-specialty group practice formed in
• High Point, N.C. from the merger of 16
  separate medical practices in 1995.
• Since its inception it has grown from the
  original 42 shareholder physicians
• to more than 225 providers practicing
  throughout the Piedmont Triad area
• at five hospitals and 55 separate outpatient
  locations.
• Cornerstone has a fully implemented electronic
  health record, complete
• NCQA certification in diabetes and
  heart/stroke for its internists, family
• practice physicians, and endocrinologists,
  heart/stroke certification for its
• cardiologists, and back pain certification
  for its neurologists.
• The organization is currently building two
  100,000 square foot facilities
• designed to delivery 21st century
  patient-centered health care.
• Cornerstone physicians practice in 25 separate
  specialties in 55 locations,
• providing a comprehensive medical home to our
  patients in the Piedmont
• Triad.

3
Institute of Medicine
In 2001 the Institute of Medicine published
Crossing the Quality Chasm calling for
fundamental change in the American health care
delivery system, emphasizing six aims for
improvement. The Institute called for health
care that is safe, effective, patient-centered,
timely, efficient, and equitable. The redesign
of health care processes was proposed to be based
up ten rules

• Care based on continuous healing
  relationships
• Customization based on patient needs and
  values
• The patient as the source of control
• Shared knowledge and the free flow of
  information
• Evidence-based decision making
• Safety as a system property
• The need for transparency
• Anticipation of needs
• Continuous decrease in waste
• Cooperation among clinicians

4
EMR

• Survey of Physicians 2001
• EMR Physicians search committee 2001
• Electronic Medical Record (EMR Task Force
• Employees and MD Champion) formed in 2004
• Consisted of 4 members
• Began building the system in November 2004
• Brought 1st office LIVE January 2005

5
EMR Implementation

• Each office received a presentation of EMR
• Explanations of what changes would occur
• EMR Team presented LIVE demonstration
• Offices began scanning charts prior to
• patients appointment
• EMR was implemented in 2 phases

6
EMR Phase I

• NO paper charts were used on day of Go Live
• Providers automatically began using
• tasking
• prescribing
• viewing
• adding/maintaining patient history
• entering vitals
• allergies and active problems

7
EMR Phase 2

• After 2-4 weeks of Phase 1 Phase 2 was
  implemented
• Documenting electronic notes
• Ordering
• Resulting

8
ePrescribing
A process that takes place of todays written
prescriptions. This comprehensive approach
involves

• Active electronic list of patient medications
  that
• interface with allergies, links to diagnoses,
• formulary tiers and insurance information
• At office visit nurse updates, confirms
  accuracy of
• list
• Provider prescribes medication electronically
  with
• alerts popping up to indicate allergies and
  potential
• drug interactions

9
ePrescribing

• Prescription is electronically sent directly to
  pharmacy or mail order can set defaults to
  automatically defer to generics
• Medication is instantaneously accessible by
  pharmacist at time of office visit

10
ePrescribing
TouchScript Solution with Allscripts
11
ePrescribing
12
ePrescribing

• Grace Terrell, MD, MMM, CPE, FACPE, FACP