Transforming Education: EMR Pathology Interface

Helen Connors, RN, PhD, FAANAssociate Dean/Academic Affairs

University of Kansas School of NursingExecutive Director

KU Center for Health Informatics

Academic-Business Partnership

Cerner CorporationKansas City, MO

Neal PattersonChairman of the Board Chief Executive OfficerCerner Corporation

Dean Karen Miller, RN, PhD, FAANSenior Vice Chancellor KUMC

University of Kansas School of Nursingshowing the world what nurses can doFall 1999

Driving Forces for Technology• IOM Reports on Quality and Safety• Automated work environments• Commitment to use technology to

transform healthcare system• National Healthcare Information

Infrastructure and other Government efforts

• Cultural change starts in the classroom

SEEDSSimulated E-hEalth Delivery System

Academic Education Solution

Problem based Learning

Designed to provide teaching and learning tools to assist health professional students to develop competencies to harness the power of information technology, thus improving the quality, efficiency and effectiveness of healthcare.

SEEDS Objectives

• Enhance development of critical thinking and problem solving.

• Integrate online patient assessment, problem identification, treatment and evaluation.

• Demonstrate the impact that structured data and information have on patient care.

• Provide the information infrastructure for evidence-based clinical practice.

• Promote the dissemination and evaluation of knowledge and research.

• Foster inter professional education

Miller Memorial Medical Center

Florence Nightingale Mental

Health Center

Bleich Outpatient Clinic

JayHawk Public Health Dept.

Clifford Home Care

Connors School Clinic

JayDoc Clinic

SEEDS Program

One-On-One

Standardized Patient

Encounters

Seminar Group

Simulations

Independent Study

Skills Lab

SEEDS Usage

School of Medicine

• Leverage the success of the SON• Negotiated access to PCO (“PowerChart Office” out-

patient application) fall 2004– Tool to automate office practice– Includes “view” into in-patient environment

(PowerChart)– Provides tools for:

• Structured Clinical Documentation• Prescription Writing• E&M Coding/Automated Note Review• Lab, Rad, PT, OT, Nursing Services, etc…• Links to Outside Resources

EMR Roll Out—SOM • Introduction to Clinical Skills

– Overview of EHR/HIT—2nd day of medical school– Hands-on experiences in the first week– First “full H&P” documented with EHR

• Skills Lab– Teaching labs and patients

• i.e. dermatology examination, CV exam, etc…• other specific topics for history of PE

– Group-based standardized patient experience– Individual year-end standardized patient experience

EMR Roll Out—SOM • Cell and Tissue Biology

– Large Lecture-Hall Clinical Correlation—Pancreatic CA (where case history is presented through the EHR) with 5 faculty members participating

– Large Lecture-Hall Clinical Correlation—Colon CA (presented through EMR—data about case returned to students sequentially over time)

• Medical Microbiology– Multi-part, small-group, PBL (problem-based

learning) on community acquired pneumonia (diagnosis and treatment)

University of Kansas School of Medicine Phase I (Pre-clinical Phase)

• Modules versus semester-long courses• Interdisciplinary versus departmental• Normal and abnormal structure and function

throughout the first two years• Active and collaborative learning – PBL, small

groups, histopathology groups• Technology-based – Tablet PC, virtual

microscopy, Angel• Enhanced student assessment – computer

testing, tracking of student performance

Modules

• Year 1– Foundations of Medicine (8 wks)– Genetics and Neoplasia (4 wks)– Inflammation and Immunity (4 wks)– Cardiopulmonary (8 wks)– Gastrointestinal Tract and Nutrition (4 wks)– Renal and Endocrine (4 wks)– Sexuality and Reproductive Medicine (4 wks)

Modules

• Year 2 – Musculoskeletal, Skin, and Soft Tissue (4

wks)– Brain, Mind, and Behavior (8 wks)– Blood and Lymphoid (4 wks)– Infectious Diseases (6 wks)– Medicine Across the Lifespan (4 wks)– Integration & Consolidation (7 wks)

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Cell and Tissue Biology

Students

• “I think familiarity with this type of technology is no longer optional but mandatory for people entering the healthcare profession.” (S. Oberhelman – Med Student)

• The health care environment is quickly moving toward EHR and electronic documentation, I’m glad I’m learning in the same manner I will someday be working.” (J. Gray – Nursing Student)

Faculty

• “I become more of a facilitator of their learning, not just a talking head.” (K. Fletcher)

• “The technology engages the students on a whole different level- one that they don’t get in any other classroom.” (M. LeBlanc)

• “Providing the nursing students with the EHR along with the human patient simulator gives the students more than an episodic patient care event.” (C. Zimmerman)