tri-state rec kick off meaningful use basics: developing a solid plan for your electronic practice...
TRANSCRIPT
Tri-State REC Kick Off
Meaningful Use Basics: Developing a Solid Plan for Your Electronic Practice
June 18, 2010Session 1A
You have left this world behind
Dr. David Trachenburg
A small community with successful EMR adoption
Matt Waldron, MD from Paoli, Indiana
Location independent work“It won’t make you faster
and won’t save you money,” he said. Why make the move? “EMR has portability and accessibility. I can read patients’ charts at any office location and log in anywhere I can get Internet access,” Dr. Waldron explained.
At work with EMR Lite
Using Clinical MessagingUsing eRxUsing dragon dictate for office visitsUsing forwarding to send reviewed path reports to Surg CtrReporting to registry with BH labs
HIE or EMR…need both
Hospitals
Primary care
physician
Specialty physician
Ambulatory center (e.g. imaging centers)
Payors
Pharmacy
Laboratory
Public health
Without planning
Specialty physician
Pharmacy
Laboratory
Hospitals
Primary care
physician
Ambulatory center (e.g. imaging centers)
Payors
Public health
HealthInformationExchange
Health Information Exchange Model
Indiana, Ohio HIEs reach milestone in clinical data
exchange "Coordination of care requires information
sharing," said Jim Laughlin, MD, of Southern Indiana Pediatrics.
"While many medical practices have systems that can share information internally, the connection between different regions and organizations allows me to track patient results from many labs or specialists. It is only through this kind of information sharing that we can hope to coordinate care in an efficient manner."
Physicians we know…Positives
AssertiveProductive
Negatives
• Assertive
• Critical
In the middle of every difficulty lies opportunity…
Albert Einstein
These are the customers of our Primary Care outreach for Meaningful Use
Throughout our area….
Tri-State REC Service Area
9
State
Ohio (11 counties)
Kentucky (37 counties)
Indiana (19 counties)
Integrate physician leaders in meaningful use plans – both inpatient and outpatient
Assessing your EMR
Empty vs. Empowered Medical Record– Receiving results before to upload– Receiving results at start up– Managing ordering
EMR and EMR lite—both are options
Finding the missing parts
Gap analysis– Going thru the full MU list– Defining the missing pieces– Timelining them– Getting help for the hard ones
– See MU criteria in clumps instead of individual items
Example of gap analysis 25 Meaningful Use Criteria
In Use
Not In Use Plan to implement Date Comment
8 Record and chart changes in vital signs
Visit Note
19 Provide clinical summaries to patients for each office visit
Visit Note\Patient Portal
2 Implement drug drug, ‐drug allergy, drug ‐ ‐formulary checks
eRx
4 Generate and transmit permissible prescriptions electronically
eRx
5 Maintain active medication list
eRx
6 Maintain active medication allergy list
eRx
21 Perform medication reconciliation at relevant encounters and each transition of care
eRx
Example of gap analysis 25 Meaningful Use Criteria
In Use
Not In Use Plan to implement Date Comment
10 Incorporate clinical lab-test results into EHR as structured data
HIE Interface
9 Record smoking statues for patients 13 years old or older
History
1 Use CPOE Orders
17 Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
Patient Portal
18 Provide patients with timely electronic access to their health information( including lab results, problem list, medication lists, allergies)
Patient Portal
15 Check insurance eligibility electronically from public and private payers
Practice Management Integration
Example of gap analysis 25 Meaningful Use Criteria
In Use
Not In Use Plan to implement Date Comment
7 Record demographics Registry
11 Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach
Registry
12 Report ambulatory quality measures to CMS or the States
Registry
23 Capability to submit electronic data to immunization registries and actual submission where required and accepted
Registry
24 Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
Registry (Public Health)
Example of gap analysis 25 Meaningful Use Criteria
In Use
Not In Use Plan to implement Date Comment
14 Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic testing ordering, along with the ability to track compliance with those rules
Alerts
13Send reminders to patients per patient preference for preventive/ follow-up care
Alerts\Patient Portal
20 Capability to exchange key clinical information( for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically
CCD
22 Provide summary care record for each transition of care and referral
CCD
Example of gap analysis
25 Meaningful Use Criteria
In Use
Not In Use Plan to implement Date Comment
16
Submit claims electronically to public and private payers
Claims
25
Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.
Security
3
Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT
Pushing the vendor
Each EMR practice have invested much in their vendorVendors provide service to the practiceMeaningful use achievement relies heavily upon their provisions to the practiceThe REC will help identify what to push onYou keep the pressure on, the heat turned up
Staying ahead of the curve
Tri-State wants to give time for change– Start now– Plan the steps– Meet the milestones– Accomplish the goal
Remember change is two part—– Technical change– Personnel change
Three areas to improve coordination
Join the Tri-State REC
Participate actively with your coach
Attend education we will provide
Network with other “like” practices
Hitting a homerun with Tri-StateA network tool
Your home team card
Divide and Share time
Raise hands for different EMRsSeparate into like groupsShare cards and plan network opportunities
Questions
Time for Q&A
Thank you Dr. Todd Rowland and Kathy
Church
Accessory slides
To follow
Why healthLINC =
Connect = technology, coordination, connected to patientsCare = care coordination, health careCollaborate = coordination, across organizationsConsumers = inclusive of patient and familiesConfidential = respectful of privacy and
confidentialityCommunicate = enhance communicationCost-effective = reduce administrative burdenComfortable = safe, secure place Community = oriented to larger community
Clinical perspective at the front line…
Linda Wells, NP:I get my results faster…The patients phone number is right there, making communication easier…
Souheil Haddad, MD:
Good, timely, easy to use, intuitive, hopefully we can extend to a full EMR lite at our office
Components of CCD--Continuity of Care
DocumentHeaderPurposeProblemsProceduresFamily HistorySocial HistoryPayersAdvance Directives*Alerts (allergies)
MedicationsImmunizationsMedical equipmentVital signsFunctional statsResultsEncountersPlan of care