IHS EHR Indian Health Service Record Electronic Health

IHS EHR Indian Health Service Record Electronic Health COMMUNITY HEALTH PROGRAMS Their Experience with EHR Marge Koepping, RN, MN, FNP IHS Model Diabetes Education Program

Community Health Programs Ø Diabetes Program Ø Public Health Nursing Ø Nutrition Program/WIC Ø Community Health Representatives Ø Maternal Child Health Ø Community Wellness Team Ø Behavioral Health / Social Worker

EHR & Community Health Ø Community Health visits may be different: l l Field /Home visits vs clinic visits Group Visits: in clinic and in community Case management / chart review/preventative care. “Safety net” functions. Drop in visits vs scheduled encounters.

Process Changes: Ø All programs/providers needed computer access and needed to integrate Ø Field visits sometimes required portability Ø Documenting group education/visits Ø Use of additional signer of notes increases communication Ø Consideration of scheduled visits vs drop in visits

Process Changes (cont. ): Ø Case Management - Chart Reviews • Registries still function as before in RPMS Ø Flow Sheets – finding creative solutions to tracking care • Addendums to notes or consults • Templates for periodic reviews of care, education visits or complicated protocols • Worksheet function on labs tab

Worksheet function on lab tab:

Ø Consult/Referral process l l l Prepare for increased # of referrals Prepare for temporary increased avenues of referrals. It helps to keep a paper log of referrals to make sure things get completed.

What we discovered with EHR… Ø Faster entry of case management chart reviews…. Ø Increased visit documentation… Ø Increased communication… Ø More consults between departments…

Some challenges… Ø How to call attention to a special needs patient ? …. Ø Drop in visit vs scheduled visit