Pre-Visit Planning

Posted on 3 April 2013 by ImproveCareNow

Imagine being a patient who arrives at the clinic and can really sense that the providers are ready to meet your needs!

Imagine knowing that your whole care team sat down a week in advance to review your disease course over the last six months, track down any missing lab results, and troubleshoot with colleagues to figure out why it’s been so tough to keep your disease in remission. Imagine getting a call from the nurse a full week before clinic to ask what has been going on since your last visit and, as a result, the social worker is in clinic and ready to discuss solutions to the issues you are having at school. Imagine the lab having your orders well in advance so that the collection tube that they have to use, but don’t keep stocked, is ready and waiting. This time you don’t have to wait while they run down to the supply room, making you late for school and your parents late for work.

The automated pre-visit planning tools that ImproveCareNow centers are now able to use will help make scenarios just like these a reality. Providers will have detailed summary information about their patients available at their fingertips when they need it…before the visit. They will have a concise, printable tool that can be easily shared with the rest of the care team. Ideally, this tool will be used to guide conversations with parents and patients before they come to clinic so that they can be a part of planning their visit, not just passive participants in it.

The result will be more reliable, proactive and individualized pediatric IBD care.

[editor's note: submitted by Sarah Myers, MPH, RN | Lead Quality Improvement Consultant for the ImproveCareNow Network]

Emma: Your Waiting Room Ally

Posted on 3 December 2012 by samisophia

Today is the second day of Crohn’s and Colitis Awareness Week. Throughout the week, Jill, Jennie, and I will be taking turns profiling some ImproveCareNow innovations we are incredibly excited to share with the community. I have the honor of introducing Emma, a promising initiative out of Oklahoma University (OU) Children’s Hospital to bridge the gap between tech-savvy adolescent patients and their gastroenterologists.

Who is Emma? Emma is the main character in a captivating iPad game of the same name, developed by OU students in collaboration with Dr. John Grunow. The Emma iPad app is designed to engage young patients in the waiting room, educate them on how to better manage their IBD, and give clinicians a preview into their patients’ health and needs. Each session is customizable to a young patient’s diagnosis and history.

Put an iPad with the Emma app in the hands of a young patient; she’s a little bit anxious about her upcoming clinic visit, but is tech-savvy and somewhat disengaged in the waiting room. Emma transports her into a colorful, interactive four-realm world. It reads like a storybook at first, but soon launches into a variant on Angry Birds. The adventure begins in Port Vanguard, the portal to all four worlds. Soon, our patient is swiping her fingers across the touch screen, navigating Emma’s rocket ship through hazardous terrain and “boosting” it when it starts to fall. It’s familiar, it’s engaging, it’s competitive….and it’s educational!

Emma App Screen Shot Welcome to Port Vanguard

Screenshots from Emma app courtesy of Robert Free (co-developer)

As our patient plays, Emma slips in multiple choice questions that test her comprehension on topics like nutrition and self-management, questions customized to her diagnosis. Emma also asks the patient to rank her quality of life and emotional health. Emma sends our patient’s responses and a summary of specific target areas of patient education which need work to her gastroenterologist. Her GI can then tailor her subsequent visit to address gaps in her understanding of her diagnosis and specific areas of concern. Emma is all about streamlining the clinic visit to make effective use of everyone’s time. The app is currently being beta tested at OU Children’s Hospital, where a select group of patients are helping Emma reach her full potential before hitting ImproveCareNow centers nationwide.

Why do I think Emma is so brilliant? Emma is an effective and clever use of technology, which has been designed especially for a tech-savvy generation. Emma engages patients in the waiting room while giving physicians a quick pre-visit snapshot of their condition. She turns waiting room downtime into a productive use of patient energy (and maybe even jitters!) to better the patient-physician dynamic. I met Emma this past summer during a Patient Advisory Council beta test opportunity and was immediately impressed. As I transition into adult care, it’s exciting to watch technology improve the pediatric clinic environment I lovingly leave behind. Emma is innovating the clinical experience, starting right in the waiting room. That’s a real game-changer.

Incorporating Patient-generated Information to Manage Health

Posted on 23 August 2012 by ImproveCareNow

e-Patient Nikolai (Kolya) Kirienko’s White House testimony is a must read if you feel it’s essential to have a voice and visibility into your own healthcare.

Testimony of Nikolai Kirienko
Project Director, Crohnology.MD
University of California, Berkeley
www.crohnology.md

Incorporating Patient-generated Information to Manage Health
HIT Policy Committee Hearing
June 8, 2012

Health IT at the White House

Posted on 26 June 2012 by Peter Margolis

On June 19^th, I was honored to represent the ImproveCareNow network and other learning networks at a White House meeting on how Health Information Technology (health IT or HIT) can improve health outcomes.

Present were about 75 leaders from institutions and practices that have advanced the use of health IT to improve care and outcomes. In his opening remarks, Farzad Mostashari, MD, Director of the Office of the National Coordinator for Health (ONC) IT made a number of important points:

The number of offices using electronic medical records (EMRs) has doubled and about half (2,400) hospitals in the US now have EMRs
Increasing the use of health IT faces many challenges: workforce training, data sharing, privacy and security. The opportunity is to move beyond simply implementing new technology to using health IT to improve care and outcomes. ONC is particularly interested in how to turn data collection through electronic health records into a quality improvement program and so invited groups like ours.
What’s unique about HIT is how fast it can adapt and change in response to needs and feedback
And it’s important to harness the knowledge within the field. For me, this was the most important message of the day and one that’s right in line with what we’re doing in the ImproveCareNow Network and C3N Project. It’s our responsibility to share the knowledge of all – patients, clinicians, and researchers to make health care better. If patients and clinicians don’t speak up and share what they know, patients will suffer by not getting the best care

During the conference participants shared numerous examples of how HIT and the Affordable Care Act are working to make care better, more efficient and cheaper

HIT helps to engage patients in collaboration in addressing their problems. “You use it in collaboration with patients to guide their care.” Mike Zeroukian, MD
Charles Kennedy, MD Aetna. “We will increasingly see health insurers pay for health information exchange and better use of data.”

Participants also noted the many limitations of current technologies including:

Ways for patients to share information among providers
The need for greater public awareness about individual vendors’ willingness and action in making data sharing possible across systems
The need for public usability ratings for EMRs (like Consumer Reports) to spawn greater competition in meeting the needs of practicing clinicians
The need for EMR vendors need to learn about how to support QI

Overall, it was clear that administration officials were listening and that much excellent work is taking place in the field. It’s a pleasure to be able to represent the work of ImproveCareNow and the C3N Project, which is one of several data and knowledge sharing networks for kids with chronic illness. Networks such as ours will be the way of the HIT future.