Health Informatics Internship

By Jason PurcellHINF 4900 Summer 2014Host : Southeast Georgia Health System(Brunswick Campus)

1

Southeast Georgia Health System is a not-for-profit healthcare system with multiple locations and servicesServes the needs of residents fromsixcounties in Southeast Georgia - Brantley, Camden, Charlton, Glynn,McIntosh,and Wayne.

Overview:

Cooperative Healthcare Services Inc. Or CHSI.2

The Health System has servedresidents and visitors to the beautiful Golden Isles and surrounding areasof Southeast Georgia since 1888Over 2,000 employeesHas 27 specialty groups with over 300 physicians

Overview (cont.):

Cooperative Healthcare Services Inc. Or CHSI.3

Main Campus

Overview (cont.):Brunswick Brunswick Campus2445 Parkwood DriveBrunswick, GA 31520912-466-7000

SGHS has 27 physician practices, all different kinds of specialties. They are under Cooperative Healthcare Services Inc. The Brunswick campus has a little over 316 beds, ER has 5 intake rooms and 19 emergency care rooms. Camden has 40 beds with a 17 emergency care rooms.4

Camden CampusCamden Campus2000 Dan Proctor Dr.St. Marys, GA 31558912-576-6200

Overview (cont.):

SGHS has 27 physician practices, all different kinds of specialties. They are under Cooperative Healthcare Services Inc. The Brunswick campus has a little over 316 beds, ER has 5 intake rooms and 19 emergency care rooms. Camden has 40 beds with a 17 emergency care rooms.5

What types of services are offered? Breast CareCancer CareCardiopulmonary ServicesEducationEmergency ServicesOncologyOrthopaedic CarePediatricsRadiologyRehabilitation ServicesRobotic TechnologyWound Care

Overview (cont.):

SGHS is has one of the two Cyber Knife system in the state of Georgia. Cyber Knife is a robotic system that uses pinpoint accuracy to shrink and kill tumors. They also have the Da Vinci robotic arm used for minimally invasive robotic surgery.6

What types of services are offered? Hospital Medicine ProgramImaging ServicesLaboratory ServicesMaternity CareMobile Health Service VehicleNeurosciencesSenior CareSleep ManagementSpine CareSports MedicineSurgical ServicesWomens Health Services

Overview (cont.):

SGHS is has one of the two Cyber Knife system in the state of Georgia. Cyber Knife is a robotic system that uses pinpoint accuracy to shrink and kill tumors. They also have the Da Vinci robotic arm used for minimally invasive robotic surgery.7

Overview (cont.):

Nunnally House will be a one-story residential building with three wings. The cancer patient wing will include 16 one-bedroom units, the critical care family wing will consist of 12 two-bedroom units and the student/on-call unit will have 16 one-bedroom and 2 two-bedroom units.8

Overview (cont.):Nunnally House

Nunnally House is a one-story residential building with three wings. The cancer patient wing will include 16 one-bedroom units, the critical care family wing will consist of 12 two-bedroom units and the student/on-call unit will have 16 one-bedroom and 2 two-bedroom units.9

What is Health Informatics?

Electronic Healthcare Records (EHR), Citrix, Cintricity are examples of innovated applications. 10

Health Informatics is the interdisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning.

Electronic Healthcare Records (EHR), Citrix, Cintricity are examples of innovated applications. 11

Intern Tasks:Assist with Cerner support - physicians and staffReview and discuss upcoming changes Shadow Nurse Informatics Analyst Learn workflow processes

Assist with staff training / auditing Learn CernerCreate sample patients for physician trainingAttend Informatics and leadership meetings

Intern Tasks (cont.):

My Top 3 Projects!

Blood orderables(Original) ABORHABSCCROSSMATCHTRANSFUSION ORDER

Four separate orders needed:

Use to be completed by a clerk. Now doctors has to answer same redundant questions. ABORH= blood type match, ABSC= antibody secreting cells in blood could indicate infection, CROSSMATCH= match pt and donor blood, then TRANSFUSION order to nurse. 15

Multiple stepsIn one flow sheetBlood orderables(New flow)

Dialysis Electronic Orders

Eliminate paper chartingBring Dialysis onlineEase of orderingPatient tracking

Severe Sepsis Protocol

Identify at risk patientsEarly Intervention

Blood Orderables ongoing status not completedDialysis Electronic Orders still in live testing mostly completedSepsis Protocol went live on 6/10 competed!

Projects Status

Top 3 projects, blood ordering 19

Intern Host Supervisors

Laura Grantham, RN, MSN, APRNDirector, Patient Care Services

Ryan Kaylor, RN Nurse Informatics Analyst Registered Nurse

Responsibilities: are to continually assess nursing work flow 21

Business casualDress CodePunctualityDeadlines

Flexible SchedulePlanned weeklyInformal FlexibleWork in progress

Schedule was flexible, I could take off anytime I needed to, planned each week as we go.22

Formal CommunicationDepartmental Meaningful Use CommitteeHealth InformaticsCHSI outpatient

Both forms of communication where used. The most important was formal thats where we finalized most plans.23

Informal CommunicationOne on oneGroup discussionsEmailForum chat

Both forms of communication where used. The most important was formal thats where we finalized most plans.24

Qualifications / InterviewNo interview No tests No background checkImprovements:Current Process:Conduct interview / TourMeet preceptor before start date

New process @ SGHS we had to go through. It would benefit both student and host to be able to sit down and interview to talk about expectations, skills, and possible projects. Have preceptor present during interview.25

SurprisesMost ChallengingBest Experience

I was surprised to learn that the applications analysts did not program their applications but they are given a set of powerful tools and a environment to create applications, some fully functional, and others that are limited. The most challenging for me and my preceptor was to stay on task with just one project. We had to do as much as possible on multiple projects, while giving Cerner support and fixing EHR related issues that come up on a daily basis. My best experiences is when we finally did finish a project and got to see the finished product and helping with creating test patients for physician training. 26

Recommendations

Integrate Cerner into EHR class Use of Dragon software being used for dictation and notesLess programming classes more work flow design and change managementLonger internships Fall + Spring semesters

Teach Cerner EHR and build and prod domains, since most hospitals in the surrounding areas use Cerner. Introduction to Dragon software should be implemented into a technology class since both Cerner and Epic is using this software for physician dictation and and power notes. Less programming classes, and more emphasis on work flow design and change management. Internships should be at least 2 semesters long.27