Tag: EHR

EPCS: Morphine (ukulele video)

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This guy thinks he can sing. How unfortunate.

Has your organization adopted technology to electronically prescribe controlled substances (EPCS)? If so, good for you! If not, what are you waiting for? UCHealth is kicking off this project on April 9, 2018, a “big bang” for all providers who have a DEA number to be able to e-prescribe and avoid that horrible, bifurcated workflow of “electronically transmit all the regular prescriptions directly to pharmacy, but remember 1) keep your tamper-proof prescription paper stocked in the correct drawer of the printer, 2) to go get that narcotic prescription off the printer, 3) sign it with pen-and-ink, 4) then tell your staff to track down the patient to come pick it up or remember to put it in certified mail to the patient, especially if the patient called to request, or worse, you forgot to get it off the printer before the patient left clinic.

After the DEA ruling to permit EPCS a few years ago, our EHR vendor developed the 2-factor authentication tool to meet the regulation, and now we have finally contracted with a company to provide that service, link our physician identities to their smartphones via an encrypted app, and now a smartphone alert and a password (something you have and something you know) are our two factors that permit EPCS.

Here’s a little something I wrote to commemorate our EPCS go live:

CT on ukulele singing “Morphine” inspired by Eric Clapton’s classic song “Cocaine.” https://youtu.be/EC6yXXYl1vY
(Part of my YouTube channel)

I also created an internal-only training video for Duo Mobile as second factor for EPCS.

I learned the structure of a well-told instruction video from the original “Apple Business” video tips back in the early zips (2000’s). You’ll see a human, then a quick screen video, then close with a human. Perfect format:

https://www.youtube.com/watch?v=oswqRHFJqH4

CMIO’s take? Sometimes a video tip (or video musical tribute) is what gets an audience’s attention.

NYT: Talk to your doctor about your Bucket List.

I love this idea. So often I struggle with setting treatment goals for patients, and equally difficult, how to bring it up, make it relevant to their lives, and make their treatment consistent with their life goals. This is a wonderful, succinct way to think about it and ask about it. I’m going to start doing this.

Our EHR already has a great place to put “Patient Goals.” Why not make that the patient’s Bucket List? Seems right to me.

CMIO’s take? Sometimes the non-medical literature is where we learn the most about humane health care. What are you doing to help your patients reach their goals?

Advance Care Planning video at UCHealth

 

It is always a joy to realize that one works with amazing colleagues. Here is a video (in which I participated), on the emphasis UCHealth is placing on Advance Care Planning, specifically of Durable Power of Attorney for Health care, a Living will, the 5 wishes documents. It is a way for our patients to indicate to us their wishes for end-of-life care.

Equally important, we have made it much easier for patients to submit their own documents and statements directly into their electronic health record through their patient-portal, that we call My Health Connection.

Thank to to our team, and to teams worldwide, who are raising awareness and assisting patients with expressing these very important wishes, and making them known to their healthcare providers.

CMIO’s take? Thank you to our team, and to teams worldwide, who are raising awareness and assisting patients with expressing these very important wishes, and making them known to their healthcare providers.

Date night with the EHR (from the VP of Joy)

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This is both impressive work and incredibly depressing, and is a clarion call for those in physician informatics. Dr. Christine Sinsky’s piece in the NEJM catalyst is called “Date night with the EHR” and very clearly delineates physician time spent charting in electronic health records. Particularly appalling is the time spent on WEEKEND evenings (red circle) reliving the past week’s worth of left-over work. It is a clear dagger into the heart of physician wellness and key manifestation of physician burnout.

It is for this reason, that Practice Efficiency efforts with EHR optimization Sprints as well as Care Redesign by re-configuring clinical teams in clinics are gaining traction. It is for this reason that hospitals and clinics are taking a hard look at improving their Culture of Wellness. It is for this reason that organizations are investing in Physician Resilience programs.

And, the American Medical Association now has a Vice President, Professional Satisfaction, or as Dr. Sinsky calls herself: “The VP of Joy.” what an awesome title.

CMIO’s take? It is about time. Could this be the inflection point where silently suffering physicians begin to see hopefulness on the horizon? Physician Informaticists have long been at the bleeding edge of this work and the cultural traction is gratifying. March on, colleagues!