One of the cornerstones of healthcare reform is the advent of electronic medical records (EMR). Virginia Garcia completed the conversion to EMR last year and everyone agrees that immediate access to a patient’s medical records improves care. But there are glitches. Sometimes when a patient is referred to Virginia Garcia from another health care system or hospital, their medical record is still in paper form and hasn’t been entered into the electronic record. “It’s been a conundrum,” said Lynn Baker, Lean Process Improvement Manager. This is where LEAN comes in.
LEAN, the continuous quality improvement model was developed by Toyota to tackle just this kind of problem. And LEAN is proving to be very applicable when addressing concerns in health care delivery. Last summer, Baker attended a Lean Health Care Summit in Seattle. In a breakout session participants were asked to submit a problem that they would like to use LEAN tools to help solve. Baker proposed using the gap in medical record recovery as an example.
“I presented the situation with EMR and we adopted it as our project,” said Baker. In the breakdown and brainstorming that occurs in LEAN, the group was able to identify simple ways to close the gap in EMR recovery. The solution: each team’s medical assistant would scan medical records into the patient’s EMR at the beginning of the day and send them on to the provider. The provider would have to mark the email ‘reviewed’ before he/she could exit their in-basket. “It is a fairly simple solution, “said Baker, “but the impact could be profound.” VG Hillsboro piloted this new system with great success and plans to implement it across all Virginia Garcia clinics.
On the broader scale, Baker is moving forward using the LEAN model to develop standardized training and practice for each role in the medical home team. In the process, a representative from each position in the team will give input into how their role fits into overall patient care. The goal is to have clear roles and responsibilities for each position. “Each team member‘s role will be defined and valued for what they bring to the team as we develop a more standardized practice,” according to Baker. “LEAN also provides great visual tools we can use to reinforce the team roles. This will be more and more important as we transition to being reimbursed for health outcomes under the alternative payment methodology.”
Baker is convinced that LEAN dovetails well with the continuous quality improvement implicit in the medical home model. “Virginia Garcia has a leg up in working as a team. The team-based solutions we introduce in LEAN will become part and parcel in improving patient care and outcomes. It’s where health care in this country is headed.”