Columbia University Medical Center

Faculty Champion Goes the Extra Mile To Optimize CROWN For Peds Gastro

Norelle Reilly, MD, assistant professor of pediatrics, director of the Pediatric Celiac Disease Program for the Division of Gastroenterology, Hepatology and Nutrition, and the Celiac Disease Center.

With the help of a dedicated faculty member, one division in the Department of Pediatrics has taken an unusually hands-on role in shepherding a CROWN optimization project through to completion, with very satisfying results.

Since last August, ColumbiaDoctors chief medical informatics officer Timothy J. Crimmins, MD, RPVI, and health IT optimization specialist Kris Bhambhani have been working closely with Norelle Reilly, MD, assistant professor of pediatrics, director of the Pediatric Celiac Disease Program for the Division of Gastroenterology, Hepatology and Nutrition, and the Celiac Disease Center, as well as Jim Savage, Pediatrics’ director of operations.

As the designated champion, Dr. Reilly went the extra mile to conduct training for her colleagues on advanced features in CROWN, set up individualized sessions with other physicians in the sub-specialty to help them personalize the system and provide one-on-one support.

“We have focused on creating and sharing macros, creating diagnosis-specific order sets, updating their list of procedural CPT codes and creating a Z-score eCalculator to assign height and weight of children that fall above or below the typical curves,” Bhambhani said.

To move this initiative forward, becoming the resident expert on the latest in CROWN was job one for Dr. Reilly. To do so, she participated in the ColumbiaDoctors five-day EHR Training Specialist program, which focuses on advanced features in CROWN. Including both front-end and back-office functions as well as provider workflows, the training gives users a holistic view of CROWN workflows and a knowledge base that allows them to improve CROWN functionality within their practices.

After her training, Dr. Reilly gave an interactive presentation to providers in her division and department, including faculty, fellows, nurse practitioners, social workers, and dietitians. Attendees were able to follow along on their own laptops and try some of the strategies they were learning in the CROWN environment in real time.

“We are very subspecialized, so there was a lot of information to present,” Dr. Reilly said. “It’s difficult to change the way that people use CROWN. To reinforce the messages, I have been scheduling one-on-one meetings with colleagues to help them customize CROWN to suit their needs.”

So far, she has conducted hour-long sessions with eight clinical faculty members and is coordinating sessions with the remaining three faculty members within the division, guiding them through topics such as creating macros to be used in the discussion and plan section, creating order folders to expedite the ordering process, using the worklist to verify lab results, and using the tasking functionality.

Ali A. Mencin, MD, the new medical director, Dr. Reilly, and Bhambani are now collaborating with the CROWN team on setting up consult notes to autofax to the Referring Provider from the Patient Care Team. They will set up an automatic letter to be attached to every note generated, so that the provider does not have to manually check this off every time.

“It can be tricky to measure the amount of time saved because users have varied baseline workflows,” Bhambani said. “However, we do know that it takes two seconds for each click, and that using order folders and macros takes significantly fewer clicks than placing orders individually, and free-texting within the note,” she said.

In the spirit of maintaining ongoing communication with their peers, Dr. Mencin and Dr. Reilly have begun the distribution of a monthly outpatient EMR newsletter to all of the Department of Pediatrics.