Inside Duke Medicine

Maestro Care Successfully Launches in Specialty Clinics

On a Thursday, Oct. 11, visit to Duke Clinic 1K, Infectious Disease, to assess Maestro Care Wave 2, Kevin Sowers, MSN, RN, FAAN (second from left), president of Duke University Hospital; David Zaas, M.D. (second from right), chief medical officer for the PDC; and Mary Klotman, M.D. (right), chair of the Department of Medicine, talk with Nurse Manager Mary Denina, RN (left), and Trealve Hankins, CMA (center).

On Wednesday, October 10, the second phase of Duke Maestro Care implementation was a success, as an additional 34 clinics - including the first specialty clinics - began utilizing the system.

On the first day of go-live, when asked how the first hours working live in the system were panning out, providers, nurses, front desk staff and other staff members throughout Wave 2 clinics overwhelmingly stated that implementation day was going better than any one could have expected.

"This morning has gone really smoothly and we’re pretty much running on time,” said Gloria Sandy, RN, from Duke Clinic 1J on the first day of go-live. “We’re finding that everything works like it should in the system and patients seem happy.”

“The challenge of learning something new really showcases how people can come together in a united front and the excitement that it creates,” said David Zaas, M.D., chief medical officer for the PDC. “I think the leadership throughout the clinics has been tremendous and everyone has stepped up to any and all challenges.”

On average, Wave 2 clinics will provide records for 178,000 patient encounters per year throughout nine specialties: cardiology; dermatology; endocrinology; infectious disease; gastroenterology; gynecology; pulmonary; rheumatology and immunology; and urogynecology.

“It’s the first day, so I still feel some insecurities about entering the correct information and clicking the right buttons,” said Eleanor Austin, RN, triage nurse in Duke Clinic 1K. “But actually working in the system has been helpful. We can see what we’ll be doing on a daily basis, and we’re able to ask questions we may have not thought to ask in training."

On the first day of go-live, Wave 2 clinics documented 758 encounters in Maestro Care, and had more than 5,500 encounters within the first week.

“As each patient comes in, we are learning how to go through the system, correct what we need to, and move on to the next task,” said Terri Godwin, service access team leader in Duke Clinic 2F/2G. “We’ve gotten a lot of support and from what we can see, Maestro Care looks like it will be a lot easier for us to use.” 

In addition, patients are also beginning to realize the benefits that come with the Maestro Care system. Within the pulmonary division of Duke Clinic 2F/2G, Harvey E. Marshall, M.D., MS, mentioned that patients were already mentioning how much they enjoyed receiving the After Visit Summary document, and patients seemed enthused throughout Wave 2 clinics. 

"We've seen that patients really enjoy the After Visit Summaries (AVS). At checkout, we used to get a lot of requests that patients wanted a copy of their encounter forms,” said Sue Walker, service access manager at Duke Health Center at North Duke Street. “Now, they already have their AVS and it includes more information – blood pressure and vital signs, in addition to what medications they were taking."

Throughout Duke Clinics, providers and staff attribute the day’s success to thorough preparation, great on-site support, positive energy and teamwork. 

“I really am so proud of the teamwork that went into preparing for this day,” said Hope Richard, health center administrator for Duke Clinic 1J. “Our physicians, nurses and staff worked days, nights and even on Saturdays to make sure we were prepared and it really paid off.” 

Wave 2 clinics will need to continue on the path of success, as adapting to the Maestro Care system and learning how to maximize its features will be an ongoing process.  

“Providers have a very steep learning curve. It’s going to continue to be exciting as we learn how to do things more efficiently, how to capture all the data we want for our research trials, and how to communicate with referring providers the critical information about the patients that we are seeing,” said Zaas. 

Maestro Care goes live in Wave 3 clinics on March 6, 2013.