Provider Advisory Group January 9, 2018

0700-0800 hours CST

Attendees

Anupam Goel (corporate) Sakhie Hussain (Trinity)
Chris Jamerson (Children’s) Kris Kardasis (South Suburban)
Sudha Kumien (Advanced Practice Registered Nurse, Cardiology) Elliot Levine (Illinois Masonic)
Shilpan Patel (Good Shepherd) Doug Propp (Lutheran General)
Natalie Selk (Christ) Suneel Udani (Good Samaritan)

Old business

PowerPlan consolidation

Anupam outlined the plan to consolidate existing order sets into system PowerPlans over the next twelve months. The focus for each phase will be: February – STAAR, antibiotics, May – stress testing, non-STAAR surgical PowerPlans, DKA, August – admission and hemodialysis, November – ED orders, alcohol withdrawal.

Voice recognition

Advocate is still trying to negotiate for more licenses and mobile microphones. The negotiations have delayed the conversations with a new vendor. For now, physicians interested in obtaining a Nuance license for voice recognition can contact their site Health Information Technology Field Services to obtain a license. Users who do not utilize the license after 60 days will have the license revoked.

At least one site is interested in obtaining mobile microphone access to allow users to speak into their smartphones instead of looking for a tethered microphone. Anupam will update the group as more information becomes available.

Updating provider training content

Anupam reviewed the option of hiring physicians to work part-time with Health Information and Technology to help update the existing training and support content. Most attendees were interested in reviewing a job description before considering the position or asking colleagues to apply.

To do: Anupam to circulate a job description for the physician informaticist position.

New Business

Illinois Prescription Monitoring Program

Anupam updated the group about the new state statute to check the state’s controlled substances prescription database before prescribing any new controlled substances prescriptions. As of today, both CliniCare and CareConnection will have text macros to help users complete the necessary documentation within those medical record systems. Longer term, Advocate is investigating what work would be necessary to connect all of its EMR platforms to the state database for automated queries.

Bidirectional texting

Anupam reviewed a proposed policy with the group to enable bidirectional texting between providers and nurses. Medicare has issued a statement declaring that orders cannot be transmitted via secure text. The group agreed with the policy. The policy will be reviewed by Nursing Practice and forwarded to Bobbie Byrne to be implemented as a policy.

(update: The policy request has been withdrawn due to technology limitations.)

Anupam attending site Medical Staff meetings

Given the amount of change in our electronic medical record systems, Anupam asked the group if he could attend the site’s medical staff meetings twice a year. This would give him an opportunity to answer questions about the electronic medical record and help clinicians understand the vision of where the Health Information Technology team is headed as they work to optimize the medical record systems.

UpToDate

Wolters-Kluwer, the parent company for UpToDate, has increased its maintenance fees for Advocate. Given the company’s dominance in the medical electronic library market, Advocate will continue to pay these higher fees. UpToDate does allow for users to collect continuing medical education (CME) credits for searches. Internal Medicine physicians can also obtain Maintenance of Certification (MOC) points using the product. The group was open to requiring a login for users to access the CME and MOC if that helped increase adoption. Tracking logins would also help Advocate verify the vendor’s claim that all Advocate physicians use the service.

(update: Wolters-Kluwer will not adjust their pricing structure even if Advocate proves that a fraction of its provider community uses the software. Anupam will discuss next steps with Rick Scott.)

Miscellaneous

  • The group agreed that any specialty-specific change requests (e.g., anesthesia, emergency room, oncology) with no impact on the larger provider community should be forwarded to CISE for review and approval.
  • Merger update – Anupam spoke about how the conversations between Advocate and Aurora are continuing. From an informatics perspective, it is not clear:
    • Which EMR platform Advocate will use to consolidate its inpatient and outpatient electronic medical record systems
    • If Advocate does migrate to Epic, would Advocate use Aurora’s instance of Epic or its own instance
    • These decisions should be made in the next few weeks. The answers will determine how we best proceed.

  • Our medical leadership team requested permission to notify clinicians when the inpatient census was high through PerfectServe. The group agreed that notifying the hospitalists and “heavy admitters” might adjust rounding and discharge patterns. The request will be forwarded to the PerfectServe team for consideration.

Clinical Information System enhancements awaiting disposition

  • Simplifying the menu bar: Anupam to develop a mock-up to share with committee for review by next meeting.
  • Educational link within CareConnection: Anupam to submit request to CISE.
  • ED alerts about possible post-delivery pre-eclampsia: Anupam to connect Elliot with ED physicians requesting this change.
  • Auto-text to pull in influenza vaccination information: Anupam to submit request to CISE.
  • Blood product review: pending CISE review.
  • PTCA quality measures: the Illinois Masonic team agreed to limit the alert to those patients who underwent a PTCA as marked within a system PowerPlan. The primary team and cardiologists would receive the prompts to add more information if necessary. The request will be submitted to CISE.
  • Antimicrobial stewardship: the group developed an alert that drives the user to the Medication Management mPage for those patients whose antibiotics are expiring within 24 hours. The request will be submitted to CISE.
  • Safer process to administer contrast dye for patients undergoing radiology and cardiology procedures: await South Suburban pilot including Cardiology implementation timeline from CareConnection team.
  • Next meeting: February 8, 2018 at 0700 hours CST