Front-line users oversee EMR developmentby Emerald Communications and Training CommitteeAmidst the rhetoric of the current presidential campaign, does it seem the politics of the day are missing those old refrains of “one voice, one vote” and “stand and be counted?” Not to worry, here's your chance to do just that, albeit for a different reason. The cause under consideration here is one that affects nearly every participant in MUSC's clinical endeavors—Emerald, the MUSC electronic medical record (EMR). Spend a few minutes next to one of the many computers around the medical center and you're likely to hear an opinion of the electronic medical record in its local form. Could be, you’ve even expressed a view yourself. No matter, whether you heard it or said it, hold that thought! There's a place for you to pass it on, to let your voice be heard—yes, to stand and be counted. That place is on one of the steering committees established to oversee the development and progress of various components of Emerald. Emerald has been making great progress lately, but “even greater developments are just around the corner,” said Larry Afrin, M.D., chairman of MUSC's Clinical Information Systems Steering Committee (CIS), the highest level steering committee overseeing work on the set of clinical systems collectively called Emerald. “Emerald increasingly is becoming as integral a tool in the MUSC clinician’s life as the paper medical record it intends ultimately to replace. We hope that clinicians and others who see the importance of Emerald will help shape its future by participating in the Emerald steering committees,” said Afrin, a hematologist/oncologist at MUSC's Hollings Cancer Center. “Since being established in 1989, CIS alone oversaw the development of MUSC's enterprisewide clinical information systems, including Oacis and others. In 1997 MUSC’s new Strategic Plan specifically called for the development of an enterprise-wide EMR, and the institution significantly boosted funding for the effort, charging CIS with guiding what has become known as the Emerald Project. CIS couldn't oversee all the work itself, so at the launch of the Emerald Project in the spring of 1997, CIS established several subcommittees to oversee the component projects. Each subcommittee generally has a chairman from the clinical community working closely with a project manager from the technical community, along with other committee members representing various interests from across the institution.” Victor Del Bene, M.D., of MUSC’s Division of Infectious Diseases and associate dean for Student Affairs in the College of Medicine, was founding chairman of CIS for its first 10 years and passed the baton to Afrin in the spring of 1999. CIS meets monthly to hear progress reports from each of the project committees as well as to discuss high-level matters including strategic adjustments to the overall project plan. CIS reports to the vice president for medical affairs and the dean of the College of Medicine. The Oacis Steering Committee focuses on all matters relating to Emerald’s “bedrock,” the Oacis system, a data repository used in both the inpatient and outpatient settings. The Practice Partner Steering Committee oversees enhancements and expansion of the Practice Partner ambulatory medical record system now used in all of MUSC’s primary care clinics and a growing number of subspecialty clinics. The Document Imaging Steering Committee is shepherding the development of the LanVision system that will make optically scanned paper medical records viewable on any workstation at MUSC. The LanVision system also will bring dramatic improvements to the chart completion process. The Enterprise Master Patient Index (EMPI) Steering Committee is working to provide a new system at MUSC that will promote accurate patient identification throughout the institution. Reducing the occurrence of such identification concerns as erroneous assignment of new medical record numbers to patients previously seen here should improve record quality and billing timeliness. The toughest job of all may well be that of the Emerald Security and Confidentiality (S&C) Steering Committee. The committee tackles difficult, controversial EMR S&C issues in the effort to develop policy and procedures that best balance our systems' technical capabilities with the S&C and clinical interests of patients, clinicians, administrators, regulators, and others. In contrast to that tough job, the Emerald Communications and Training (C&T) Committee probably has the most enjoyable job. C&T members put on their creative hats for monthly brainstorming sessions about how to keep the institution informed about Emerald progress and how to make effective use of Emerald. The newest committee to the Emerald Project, the Cognos Development Steering Committee is striving to understand how to use MUSC’s new, sophisticated clinical data mining software toolset (from Cognos) and how the Cognos tools should be set up for the institution to get as much out of them as possible. With so many resources being pumped into the Emerald Project, it's important that there be a good understanding of how the new technologies —and the new processes they make possible—are bringing about improvements at MUSC. The Emerald Outcomes Assessment Steering Committee, established last fall, considers a multitude of outcomes assessment projects, chooses the best ones, and oversees them through completion. Finally, the Workstation and Network Infrastructure Steering Committee ensures there are front-line computers and behind-the-walls networking technology to bring the power of Emerald to the people who need it. The progress on Emerald in the last three years is a direct result not only of the dozens of technical experts implementing the component systems but also the scores of people from every corner of the institution who are participating in the steering committees. “The steering committees,” Afrin said, “serve a crucial role by helping the technicians understand what functionality is needed by MUSC’s clinicians, researchers, educators, administrators, etc. It is these latter groups—the people who are using and will be using Emerald—who should direct, and indeed are directing, Emerald's development. If you want Emerald to work best for you, you need to be involved in overseeing the Emerald Project by participating in one or more of its steering committees. Committee membership is open to all at MUSC, including staff clinicians, housestaff, students, and other trainees, administrators, researchers, and educators.” Emerald committee minutes can be found on the Emerald Web site at <http://emerald.musc.edu>
Want a Say?The committees overseeing Emerald’s development are looking for “new blood.”Each committee is open for anybody at MUSC to join in and have a say. You can join as many committees as you would like. To get on the mailing list for Emerald committee announcements, just contact the chairman or project manager for the committee(s) you’re interested in. E-mail addresses and pager numbers are shown below. Clinical Information Systems Steering Committee
Meets fourth Friday, 7:30 - 9 a.m., room 211 HCC
Meets fourth Wednesday, 7:30 - 8:30 a.m., 136 Rutledge Ave.
Meets third Monday, 1 - 2 p.m., room 205C MUH
Meets biweekly, 10:30 - 11:30 a.m., room 525 CH
Meets fourth Wednesday, 3:30 - 4:30 p.m., IOP 3-North, Conference Room A.
Meets fourth Friday, 2 - 3 p.m.,room 209 NT
Meets first and third Thursday,10 - 11 a.m., room 201 HOT
Meets as indicated by current project
Major Accomplishments to date (April 1997 – June 2000)Infrastructure
Activated Oacis lab and dietary order entry on 10West; Completed design and development of the physician pharmacy order entry module; includes drug-drug and drug-allergy interaction checking. Practice Partner
Document Imaging/Scanning (LanVision)
Security and Confidentiality
Data Mining
Communications/Publications
Training
Priorities for 2000 - 01
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