Children's Minnesota and Cerner recently began a journey for primary care optimization focused on improving the areas of care coordination and clinic operations. This work effort spanned across three primary care visit types which include well child, complex care management and Ready Care (walk-in), in conjunction with the roll out of PowerChart TouchTM. Staff at the Minneapolis-based pediatric health system aimed to improve care for its patients by returning provider time back to the patients and away from their charts.
“We undertook the Cerner clinical blueprint evaluation process and identified several areas for improving work around and within the electronic health record (EHR),” said Chase Shutak, MD, MPH, clinical informaticist and primary care pediatrician. “Specifically, we looked at our care team model and assigned roles, chart prep and review, documentation standardization, and rooming inconsistencies.”
In addition to improving care experiences for children and their families, staff hoped to enhance quality, help provide insights into healthcare disparities and clinic financials.
“After Cerner completed an evaluation of our processes, they identified high-yield areas for improvement in our pre-visit planning, the check-in process, rooming and intake, assessment documentation and population health coordination,” said Shutak.
After the optimization, new workflow efficiencies helped eliminate approximately 66 hours of clinicians’ EHR time per month1 and reduce clinicians' after-hours time in EHR by 16%.2
“For me, the number of clicks felt significantly reduced,” said Razaan Byrne, MD, pediatrician. “I was able to get a lot more done in the room when I was with the family, instead of having to do it outside of the room. This made it easier to finish clinic visits and notes at the end of the day.”
Clinicians improved chart navigation efficiency, reducing the number of times they switch between tabs within patient charts by 8.7%.3 Same-day encounter closures increased 10.1%4, which can contribute to an improvement in discharged not final billed (DNFB) and healthier cash flow.
Furthermore, Children’s Minnesota was able to streamline their Ready Care service, by leveraging their new Cerner ED LaunchPoint™ product. This allowed them to have direct visibility to current visit status and actions, as well as a patient summary view with face-up one-click-order favorites.
“ED LaunchPoint was revelatory for our urgent care providers. It is refreshingly easy to use and provides immediate feedback on time-to-doctor or overall length-of-stay,” said Shutak. “It was designed for efficient chart review and quicker evaluations.”
In order to further support mobility across all visit types, PowerChart Touch was rolled out while Children’s Minnesota primary care optimization occurred. PowerChart Touch supports provider mobility on smartphones or tablets, allowing providers to document with built-in dictation software, review charts or take photos for easy import to patient charts.
“I personally find PowerChart Touch incredibly useful for on-call pages and after-hours results follow-up, because I don’t have to tote my laptop around everywhere,” said Shutak. “One of my colleagues now documents almost exclusively via the built-in dictation software moving between rooms. He essentially finishes almost all his notes outside of the room after leaving.”
Overall, the optimization project has been successful. Children’s Minnesota has plans to continue leveraging the operations, efficiency and quality dashboards that they partnered with Cerner to develop. These dashboards will give them insights into evaluating workflow and process for continuous optimization.
“We are excited to continue our relationship with Cerner as we further optimize our ambulatory experience, by taking advantage of Cerner-developed clinic enhancements that are on the horizon.”
Some data for this story was sourced from Cerner Lights On Network® and Cerner Advance.
1Comparing adjusted time per patient from July 2021 to September 2021 to November 2021 to January 2022, after completing the primary care optimization across 24 providers, as this allowed for a 5% decreased which is on average 66 hours per month.
2Comparing after-hours time in the EHR from July 2021 to September 2021 to November 2021 to January 2022, after completing the primary care optimization across 24 providers.
3Comparing tab hops per patient from July 2021 to September 2021 to November 2021 to January 2022 after completing the primary care optimization across 24 providers.
4Comparing same-day encounter closures per patient from July 2021 to September 2021 to November 2021 to January 2022 after completing the primary care optimization across 24 providers.