Compass Clinical Accreditation and Compliance expert Sena Blickenstaff, BSN, MBA, was interviewed by editor Matt Phillion of HCPRO, for the Briefings on the Joint Commission report. This is part 3 of a 4-part series.
No conversation about process improvement is complete without bringing up the electronic medical record (EMR) and its lack of consistency across the country.
As the saying goes, thou shalt have an electronic medical record—so why hasn’t the industry found a way to make the EMR more pervasive and consistent?
“During an accreditation survey, The Joint Commission will ask staff ‘Where is your patient’s last pain assessment or history and physical prior to a surgical procedure?’” says Sena Blickenstaff, BSN, MBA, and principal with Compass Clinical in Cincinnati. “The expectation is that if you’re putting relevant, pertinent information in the patient’s medical record, you should be able to get it out to ensure that information is used to coordinate safe, quality patient care amongst all involved in the patient’s care.”
And yet healthcare organizations are struggling with this process.
“This goes up to the leadership level as well,” says Blickenstaff. “It’s pervasive and a bit unnerving to watch healthcare professionals struggle to access basic patient information needed to safely coordinate ongoing care activities. Physicians and staff often do not easily have access to the information they need, and we are hearing reports of where this is being scored during accreditation surveys under a Record of Care standard.”
It requires a hard look at your own processes to determine where the hitches and glitches in your EMR process stand. Is it a leadership issue? Do you need to hold your vendor’s feet to the fire for a more useable record?
One solution might lie in an unexpected place: the VA.
“As a former Joint Commission surveyor, I surveyed VA hospitals which were essentially paperless and used an impressive EMR that translated almost everywhere,” says Blickenstaff. “I remember thinking, ‘That technology is there, why don’t we take it and translate it to other hospitals, why are there so many different EMRs across the country that do not connect or smoothly transition patient information from one location to another as people travel or move around, such as can be done with the VA EMR?’”
She surveyed one non-VA hospital that reached out to the VA for that system and had it embedded in the system’s hospitals and ambulatory sites.
“They had clinics in schools, dental clinics, mother/baby clinics,” says Blickenstaff. “They were able to take that system and put it in place with a few modifications and more importantly, use the system and access patient information to coordinate care as it’s meant to be coordinated.”
Blickenstaff was able to sit down and navigate the EMR with very little training.
“It was so intuitive,” says Blickenstaff.
With so much of the healthcare world going global and becoming more interwoven, it only makes sense to build toward a better flow of information, she says.
“If something happens to me in New York and I’m from Idaho, who can have access to my medical records and ensure that I am getting appropriate care, based on my unique medical history?” she says.
Unfortunately, the healthcare world has to find a better balance of collaboration and competition for this to truly happen.
“We like to say we are collaborative, but even healthcare is a highly competitive industry,” says Blickenstaff. “I think that’s one of the opportunities we have in healthcare.”
