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RAVEN Records And Verifica1on
Electronic Network
Karl Powers, Chief Informa1on Officer Patricia Smith, Pa1ent Care Services Administrator
Ellen Hodges, MD, Chief of Staff
What is RAVEN?
• RAVEN is YKHC’s new electronic health record
• The RAVEN “Go Live” was January 28, 2013
• It is in use at every village clinic and SRC
How did it go?
• Staff are adap1ng to RAVEN and becoming more proficient
• Addi1onal training as needed
• Improvements to RAVEN as needed
Go-‐Live Bethel Outpa1ent Clinic
• Increased outpa1ent clinic appointments from 20 minutes to 40 minutes from 1/28/13 – 2/28/13
• Extended Clinic hours to 8pm • Held Saturday clinic each Saturday for first month also opened clinic on President’s Day 2/18/13
• Maintained adequate number of providers in outpa1ent clinic each day
• Maintained 1 provider for RMT in the morning and 3 providers for RMT each adernoon
Go-‐Live Pa1ent Care Services
• Added full service for extended clinic hours and Saturday clinics – Imaging
• Mammography and Ultrasound
– Pharmacy • Full service for prescrip1ons
– Laboratory • Full services for specimen collec1on and processing
Go-‐Live ER/ Inpa1ent
• Added a Pediatrician to the ER from 3pm – 11pm each day
• Added an addi1onal Physician to the Inpa1ent services for the week of go-‐live
• Bumped up Fast Track to open at 3pm instead of 5pm
• Added an extra RN to each shid temporarily to assist
Go-‐Live Sub-‐Regional Clinics
• Increased clinic appointment from 30 to 60 minutes from 1/28 -‐3/4
• Increased providers that were available at each site to see pa1ents
• Started village travel and specialty travel week of 2/4
• Ensured pa1ents were seen within 3 days of request
Go-‐Live Village Clinics
• Video Teleconferences held the week prior to Go-‐Live with each clinic advising staff to – Explain the new process to community – Prepare for backlog of pa1ents, handling difficult situa1ons
– Review support available – Encourage using all resources
Go-‐Live Village Clinics • 8 Float CHA/Ps in field + all Back Up Health Aides and Office Assistants approved to work
• 16 Super Users trained from larger, busier clinics for onsite help
• Increased individual pa1ent appointment 1mes to up to 2 hours for first day of Go-‐Live
• Some clinic hours extended
Go-‐Live Village Clinics • Call Center implemented at the Health Aide Training Center: – 10 Instructor-‐experts assis1ng Health Aides over phone and via computer
– Staffed 8am-‐7pm first two weeks – Aderhours On-‐Call phone support (on-‐going)
• VO Registra1on Call Center helped Office Assistants w/registra1on
RAVEN Data
• When a pa1ent is seen in a village clinic or SRC, the Health Aide enters the informa1on into RAVEN.
• This informa1on is then reviewed by Bethel or SRC providers for RMT (Radio Medical Traffic)
• The visit informa1on is immediately available for anyone with access to that pa1ent’s chart
RAVEN Data
• The notes are complete and readable • The Health Aides also have access to all the things that happened in Bethel or in an SRC
• Complete record of all things that happened to the pa1ent in one place
• Mul1ple providers can view chart at the same 1me.
RAVEN Data
• Pa1ents presen1ng to the ER with complete history – Village Clinic Notes – All previous visit notes
• This allows a complete evalua1on of the pa1ent without any missing visit informa1on.
RAVEN Data
• Meaningful use indicators • Not enough just to buy and implement an electronic health record
• Also must prove that you are using it in a way that improves the pa1ent experience in the hospital system
RAVEN Data
• The Affordable Care Act required implementa1on of an electronic health record in order to maintain funding from Medicare and Medicaid
RAVEN Data
• The board of directors directed us to explore all op1ons for an electronic health record
• RPMS was “free” but clinical staff felt strongly that this would not meet our clinical needs
• A process that took over 2 years was undertaken
RAVEN Data
• Cerner was the company chosen – High quality product – Excellent support
• Gives our pa;ents the high quality product that could be implemented safely in all villages
Meaningful Use Summary
03 28 2013 YKHC MU Summary 26
14 Hospital Core Requirements Name Target
CPOE for Medication Orders >30% Drug Interaction Checks Y/N Maintain Problem List >80% Active Medication List >80% Medication Allergy List >80% Record Demographics >50% Record Vital Signs >50% Record Smoking Status >50%
Clinical Decision Support Rule Y/N Electronic Copy of Health Information >50% Electronic Copy of Discharge Instructions >50% Electronic Exchange of Clinical Information Y/N Protect Electronic Health Information Y/N
Meaningful Use Summary
03 28 2013 YKHC MU Summary 27
• Where we are now • Hospital Status as of 03 21 13
Current Percentage Target
CPOE for medica1on orders 93 30
Maintain ac1ve medica1on allergy list 97.6 80
Maintain ac1ve medica1on list 90.9 80
Perform medica1on reconcilia1on 83.5 50
RAVEN Data
• All of the pa;ents medica;ons are in one place accessible to everyone who needs to review the list
• Also a complete list of the medica;ons that were given to the pa;ent during a course of treatment