CMI and EHR implementation

dvitalone1

I work at a facility which is the largest of a system of 3. The smallest facility has gone live with EPIC in Feb 2011 and their case mix index dropped dramatically and CEO has been all over the CDIS at that facility and she is really feeling the heat. The second facility will be going live in Aug 2011 and my facility (which is the largest) will be going live in Oct 2011.

I started the CDI dept here in Aug 2010 and the CMI has gradually been on the rise since CDI started and it now at it's highest it has ever been historically. The CNO, CEO and CFO are all conerned about our CMI dropping once EPIC is implemented.

My question to the group is....Did your case mix index drop when you implemented an EHR and how long before you saw an increase in it after implementation? Thanks!

dsmith12h@aol.com

Looking back at pre-epic live and post epic live data, we did not see a drop in CMI.

toni.stastny

I would like to know how are you doing your queries? We are going to go live with Epic at our facility in Nov. for the physicians.

I am not happy with the workflow they have proposed to us. There are to many flaws where I feel the physicians will miss answering the queries. I feel Epic needs to develop an improved communication tool, currently it is limited to how the coders will do their queries. We need to be able to query a pool of physicians as not one doctor is involved with the medical record. The hospitalist program has changing doctors that see the patient. The have a three color teams that are assigned to the patient load.

You can email me if you like.
toni.stastny@aspirus.org
Toni Stastny at Aspirus, Wausau, WI.

dsmith12h@aol.com

We have been live with epic for about a year. We also have multiple physicians/residents who need to view the queries being posed. We started out using the "in basket feature" and general e-mail and found the response rate dropped significantly. It was also lobor intensive. We soon moved to using the "Sticky note feature" and have had much better success relative to responses. Our "sticky notes" are visible when a record is entered and can't be missed. There have been posts on this subject in the past and they can be found on the CDI Talk message board which may offer other options.