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Download CPRS - National Association of State Veterans Homes
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CPRS at CHVH Louis V. Kaufman, MD, MS, CMD Medical Director Charlotte Hall Veterans Home Charlotte Hall, Maryland NASVH Conference Burlington Vermont July 2011 Who Are We? Medical Director Certified Network Engineer Programming Staff Why VISTA/CPRS? Current Order Process Interim Physician Order Paper People Physician Resident Chart Physician Medication Treatment Order Order Admin Admin Requisitions Sheet Record Record Courier Bin W T C Nurse C F T R R T O D P Pharmacy T C H M Ancillary Services P Print T F Fax C Copy Transcribe O Courier M Mail W Write H Hand Carry D Data Entry R Proofread Order Volume at CHVH 280,000 Orders Per Year…. Which is a lot of transcribing, writing, copying, faxing,….. Current Order Process Interim Physician Order Paper People Physician Resident Chart Physician Medication Treatment Order Order Admin Admin Requisitions Sheet Record Record Courier Bin W T C Nurse C F CPRS O D P Pharmacy T T R R T C H M Ancillary Services P Print T F Fax C Copy Transcribe O Courier M Mail W Write H Hand Carry D Data Entry R Proofread Reengineered Current Order Process • Order Sheets • Requisitions • MARs • TARs Order • Order Labels • Prescriptions CPRS/VISTA Advantages Improves Quality of Care Increased nurse-patient hands-on interaction Reduced medication errors Reduced transcription errors Increased Quality Improvement process Reduced nurse-clinical provider communication error Increased Efficiency of Quality Improvement process CPRS/VISTA Advantages CPRS is 4 times less expensive to install than commercial electronic health record systems And costs 2/3 less to maintain over the long term Sharing Agreement Between Washington, DC VA Medical Center and Charlotte Hall Veterans Home Concept Initially Discussed at WVAMC in 2005 3-1/2 Years of Negotiation Memorandum of Understanding Signed In Late 2008 Between Federal Veterans Administration and the Maryland Department of Veterans Affairs Implementation “Nuts and Bolts” Certified Network Engineer (CNE) Hired Required by VA Information Technology and Security Departments Found existing CHVH computer network to be inadequate for CPRS Designed a new wired and wireless computer network “from the ground up” to comply with the VA’s computer hardware and IT security specifications Implementation “Nuts and Bolts” Certified Network Engineer Worked closely with WVAMC telecommunications department to install redundant high speed Point To Point data lines between CHVH and WVAMC Supervised the CPRS server move from WVAMC to CHVH for programming (Required by the VA Central Office legal team) Implementation “Nuts and Bolts” Certified Network Engineer After programming completed, supervised the physical move of the CPRS server from CHVH back to the WVAMC CPRS server will be physically located at the WVAMC and managed by WVAMC personnel with management and personnel fees paid by the Maryland Department of Veterans Affairs Implementation in the CHVH ALF 180 bed Assisted Living facility Implementation began in April 2009 Adjustments required to use CPRS/VISTA in a non Federal VA facility Pharmacy Laboratory Implementation in the CHVH ALF Laboratory Adjustments LabCorp is the laboratory services provider LabCorp has direct access to CPRS through a national agreement with the Federal VA This agreement allows bidirectional electronic lab test ordering and reporting directly through CPRS CHVH lab tests are performed in both Virginia and North Carolina This led to miscommunication between the LabCorp programmers in both states and at CHVH Hmmmm! Implementation in the CHVH ALF Pharmacy Adjustments CHVH uses a commercial non-VA long-term care pharmacy This means that the VA programmer pharmacist needed to approve all medications and treatments in 6 month time intervals (“Real time” order checking is not currently available in a non-VA facility) Implementation in the CHVH ALF Staff Training Implementation in the CHVH ALF Staff Training Group training Individual “hands on” training among staff members Computer “Screen Shot” Tutorials Lab Order Entry Medication Order Entry Implementation in the CHVH ALF Staff Training Issues Started too soon prior to implementation of CPRS Staff forgot user names and passwords Tutorials need further development Training Database Currently being implemented to separate “test” patient files from the production database “real” patient files Future Implementations of CPRS at CHVH 278 bed Skilled Nursing Facility Staff training to begin in September 2011 Imaging VISTA/CPRS imaging being implemented now to scan in documents, reports, EKGs, etc., from outside providers Future: scan actual x-ray images into the patient chart Future Implementations of CPRS at CHVH Electronic Medication Administration Record (MAR) Electronic Treatment Administration Record (TAR) Bar Code Medication Administration (BCMA) Conclusions CPRS is 4 times less expensive to install than commercial electronic health record systems CPRS Costs 2/3 less to maintain over the long term CPRS Improves Quality of Care Conclusions CPRS is a great example of Federal/State Partnership Our Tax Dollars At Work! and Conclusions The Best Care Anywhere!
