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Health IT Success Stories

Nurse Bolton Helps Her Rural Clinic Achieve Meaningful Use and Improve Health Care Quality

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Kacey Bolton is a registered nurse and Clinical Director at London Women’s Care (LWC), a seventeen-provider rural clinic in London, Kentucky. In 2011, Nurse Bolton led the charge to update the electronic health record (EHR) system’s obstetrics flow sheets and achieve Stage 1 meaningful use. After achieving meaningful use, the clinic began using the EHR system improve health care quality.

Barrier on the Path to Meaningful Use

To achieve meaningful use, Nurse Bolton and her colleagues knew they needed to revise their EHR’s systems obstetrics flow sheets because the system’s built-in flow sheets were inadequate for high-quality obstetric care. “Flow sheets are intended to help providers track important patient information, like weight, blood pressure, and pregnancy problems,” explained Nurse Bolton. “When our providers see an obstetric patient, we want them to be able to easily identify any problems that could affect the pregnancy without digging through the patient chart.” LWC’s EHR vendor’s flow sheet functionality did not enable the clinic to track the information it needed for obstetrics patients, including complications of pregnancy such as preterm labor and diabetes. Without adequate flow sheets in the EHR system, LWC’s providers could not use the EHR system to collect the information they needed to manage obstetric patient care and achieve meaningful use. “We wanted the pregnancy record in the EHR system to mirror the critical data we previously collected in our paper charts,” explained Nurse Bolton.

To overcome this challenge, LWC’s EHR vendor helped Nurse Bolton and her colleagues connect with a practice in Louisville, Kentucky that had used the EHR system to build a custom flow sheet for obstetrics patients. After meeting with the Louisville practice and collecting design tips, Nurse Bolton went back to her practice’s providers and asked for their input. “We involved our providers in the flow sheet redesign process because we needed to ensure the new flow sheet would provide them with easy access to diagnosis codes, pregnancy records, and other important patient information,” explained Nurse Bolton. Using the Louisville practice’s recommendations and LWC provider input, Nurse Bolton built an obstetrics flow sheet and partnered with LWC’s EHR vendor to successfully integrate the flow sheet into the EHR system.

Improved Health Care Quality

After successfully integrating the new flow sheet into the EHR system, Nurse Bolton and her colleagues worked with Kentucky Regional Extension Center (REC) to achieve meaningful use. “Kentucky REC was wonderful,” said Nurse Bolton. “We could not have achieved meaningful use without the REC’s support.”

Now that Nurse Bolton and her colleagues are meaningfully using their EHR system, LWC is able to improve health care quality. Using patient lists, for example, LWC is able to quickly and efficiently identify patients who have abnormal test results or need preventive screenings. With the patient lists in hand, LWC can reach out to patients to schedule follow-up appointments. Among other health care quality improvement initiatives, Nurse Bolton and her colleagues use patient lists to identify smokers who have not received smoking cessation counseling so they can schedule counseling appointments for the patients. “We are encouraging our patients to live healthier lives,” said Nurse Bolton.