SHARED CARE PLAN
Implementation Status, Successes, Learnings
Sites Start on Schedule
v Ferndale Family Medicine
o Primarily updating existing electronic plans
§ Using paper process at time of visit
§ Have process to identify Shared Care Plan on Charts, in Practice Mgmt System
§ Tested and timed creation of a Shared Care Plan
§ Medical student will work on plans during internship
v Center for Senior Health
o Multiple small tests of change
§ Group visit with 2 patients
§ Updating existing Shared Care Plan(s) during visit
§ Group visit with 6 patients - sent paper version in advance
§ Timing entry of data
v SeaMar
o Preparing for use now
§ Planning to pilot RxPad (prescription writer in LastWord Electronic Medical Record)
§ Need to identify their Heart Failure patients
v SJH
o Implementation meetings now happening
§ Have seem demo of Shared Care Plan and received operational definitions
§ Team to identify where Shared Care Plan would be of most benefit during hospitalization
§ Patient team members will complete Shared Care Plans on paper during meeting
v Operational Challenges
o Information Technology resources to make needed changes/maintenance
o List of application adjustments/maintenance issues ranging from small to larger scale
o Server Performance - Application Performance
o Time required for completion of a Shared Care Plan
· minimum 45-90 minutes each (5000 patients = 5000 hours - 2.4 Full Time Eqivalents working for one year)
o Patients who 'need Shared Care Plan most' are least computer savvy - have most info to enter - need 1:1 assistance HF patients not readily identfied in all sites
o Lack of Staff in clinics to register patients, enter Shared Care Plan data
o Need to identify reimbursement mechanism for Shared Care Plan visits
o PCs in exam rooms still not prevalent
v Strategies
o Prepopulate as much data from existing sources as possible
o Send paper plan out to patients in advance for completion and interim use
o Secure Community resources to assist in interview/data entry, i.e. Whatcom Community College Medical Assistant program students, nursing students, libraries
o Create Value added functionality to encourage Shared Care Plan use (i.e. Med Flow sheet for paper charts)
o Explore feasibility of donated Personcal Computers to expedite use
· Cost to upgrade and configure approaches cost of new pc
