Meaningful use of the Omaha System: Preparing for an EHR in difficult economic times

In order to improve quality, safety, efficiency and coordination of care in public health departments, it is imperative to incorporate the “meaningful use” of information technology into business operations. Representatives from all levels of San Diego County Public Health Nursing (PHN) staff have worked for the last four years to analyze and identify the Omaha System as the clinical information system to meet their needs. The current system for documenting PHN interventions is a homegrown, paper-based nursing record. Over the years, it has been difficult to demonstrate the effectiveness of PHN programs due to the inability to report meaningful outcomes. The Omaha System has a standardized terminology which will allow staff to show meaningful outcomes. Staff will finally be able to “tell the story” of what they do to reduce health disparities which promotes social justice and improves the health of the populations with whom they work. The PHN representatives have planned for implementation and have educated their peers with monthly overviews of the Omaha System. They have acted as ambassadors for change in order to prepare staff for the transition from a paper-based charting system to an automated one. A major challenge to overcome has been obtaining approval to purchase a software system when little funding is available. The problem of securing funds is compounded during difficult economic times, which has delayed timelines for purchase and implementation. This session will provide an overview of the complex and long term nature of the process to purchase and implement an EHR for public health nurses. It will describe the staff activities that have taken place to plan for a clinical information system. Finally, this session will discuss what has been done to keep staff actively engaged in a process that has extended beyond initial timelines.