Transcript What Is An EHR That Supports Meaningful Use?

Connecting Patients, Providers, and Payers
John D. Halamka MD
The US Healthcare IT
Program
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Improving quality, safety, efficiency, and
reducing health disparities
Engaging patients and families in their
health care
Improving care coordination
Improving population and public health
Ensuring adequate privacy and security
protections for personal health information
Physician Goals
Core Objective
Measure
1. CPOE
Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of
radiology
2. E-Rx
E-Rx for more than 50%
3. Demographics
Record demographics for more than 80%
4. Vital Signs
Record vital signs for more than 80%
5. Smoking Status
Record smoking status for more than 80%
6. Interventions
Implement 5 clinical decision support interventions + drug/drug and drug/allergy
7. Labs
Incorporate lab results for more than 55%
8. Patient List
Generate patient list by specific condition
9. Preventive Reminders
Use EHR to identify and provide reminders for preventive/follow-up care for more
than 10% of patients with two or more office visits in the last 2 years
Physician Goals
Core Objective
Measure
10. Patient Access
Provide online access to health information for more than 50% with more
than 5% actually accessing
11. Visit Summaries
Provide office visit summaries for more than 50% of office visits
12. Education Resources
Use EHR to identify and provide education resources more than 10%
13. Secure Messages
More than 5% of patients send secure messages to their EP
14. Rx Reconciliation
Medication reconciliation at more than 50% of transitions of care
15. Summary of Care
Provide summary of care document for more than 50% of transitions of
care and referrals with 10% sent electronically and at least one sent to a
recipient with a different EHR vendor or successfully testing with CMS
test EHR
16. Immunizations
Successful ongoing transmission of immunization data
17. Security Analysis
Conduct or review security analysis and incorporate in risk management
process
Hospital Goals
Core Objective
Measure
1. CPOE
Use CPOE for more than 60% of medication, 30% of laboratory, and 30%
of radiology
2. Demographics
Record demographics for more than 80%
3. Vital Signs
Record vital signs for more than 80%
4. Smoking Status
Record smoking status for more than 80%
5. Interventions
Implement 5 clinical decision support interventions + drug/drug and
drug/allergy
6. Labs
Incorporate lab results for more than 55%
7. Patient List
Generate patient list by specific condition
8. eMAR
eMAR is implemented and used for more than 10% of medication orders
Hospital Goals
Core Objective
Measure
9. Patient Access
Provide online access to health information for more than 50% with
more than 5% actually accessing
10. Education Resources
Use EHR to identify and provide education resources more than 10%
11. Rx Reconciliation
Medication reconciliation at more than 50% of transitions of care
12. Summary of Care
Provide summary of care document for more than 50% of transitions of
care and referrals with 10% sent electronically and at least one sent
to a recipient with a different EHR vendor or successfully testing
with CMS test EHR
13. Immunizations
Successful ongoing transmission of immunization data
14. Labs
Successful ongoing submission of reportable laboratory results
15. Syndromic Surveillance
Successful ongoing submission of electronic syndromic surveillance
data
16. Security Analysis
Conduct or review security analysis and incorporate in risk
management process
Patient Profile Screen
Patient Profile Screen, cont’d
Problems
Medications
Medication History and
Reconciliation
Reports
External Reports
Orders
Sheets
Care Plans
Health Information Exchange
MassHealth
BIDMC
Partners
DPH
EOHHS
NEHEN
NwHIN
eCW EHX
Statewide HISP
Direct gateway
services
Web
portal
PKI/certificate mgmt
Provider/entity
directory
Audit
log
Atrius
SafeHealth
MD
MD
MD
MD
Fallon Clinic
UMass Memorial
MD
MD
MD
MD
MD
MD
Updated plan
Original high-level plan from 12/11/2011
Updated plan as of 10/23/2012
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Multi-Stakeholder Governance Model
Chair: Secretary Judy Ann Bigby, MD
HIT Council
Co-Chairs:
-John Halamka
-Manu Tandon
HIE-HIT Advisory Committee
Facilitator:
-Micky Tripathi
Business Analyst:
-Mark Belanger
Legal & Policy
Workgroup
Technology &
implementation
Workgroup
Finance &
sustainability
Workgroup
Consumer and public
Provider engagement
engagement
& adoption workgroup
workgroup
Co-Chairs:
-Wendy Mariner
-Gillian Haney
Co-Chairs:
-John Halamka
-Manu Tandon
Co-Chairs:
-Andrei Soran
-Steve Fox
Co-Chairs:
-Jessica Costantino
-Kathleen Donaher
Co-Chairs:
-Michael Lee, MD
-Dirk Stanley, MD
Facilitator:
-Ray Campbell
Facilitator:
-David Delano
Facilitator:
-Micky Tripathi
Facilitator:
-Christina Moran
Facilitator:
-Mark Belanger
Business Analyst:
-Christina Moran
Business Analyst:
- Christina Moran
Analytics via Expert Query
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Hospital Analytics group
Community Practice Analytics group
Includes data cleansing, validity checking and
creating repeatable queries
Databases and data marts governed by a multistakeholder governance committee
Primarily for Care Management, Government
reporting, and Population Health
Analytics via Self Service
• Web-based graphical tool to query BIDMC’s
Clinical Data Repository
• Includes 2 million patients and 200 million “facts”
(e.g., demographics, diagnoses, medications, lab
tests, and procedures) from 1997 to the present
• Aggregate counts (e.g., preliminary data for grant
proposals, population studies, etc.) do not require
an IRB protocol
• With IRB approval, data sets can be obtained
with help from the Decision Support team
Self Service Web Interface
Analytics via Repeatable Reports
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Parameter driven web-based reports in
Performance Manager
Acceleration of business intelligence
capabilities with SQL Reporting and Analysis
Services
Dedicated expert consultant devoted to
implementation
Primarily for clinical and administrative
operational support
Analytics via Outsourced Community
Quality Repository and Claims
Registry
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Combines BIDMC, HMFP, BIDPO, APG, API
data into a single clinical care respository
Used for all our Meaningful Use Measures,
PQRS reporting, and AQC contract
Also creates data marts of clinical data to
support all payer claims data warehouse run
by HDS
Primarily for Pioneer ACO and Managed Care
efforts
Patient-Level Information Assets
BIDPO
QDC
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Provider Metrics and Measures
Measure sets:
• 35 Contract Incentive Measures
• 44 NQF Meaningful Use Measures
• 24 PQRS Measures
• 31 Pioneer ACO Measures
Qualified registry for the CMS 2010 PQRS
program
Certified as an ONC-ATCB (CCHIT) certified as a
modular EHR for Eligible Providers for all 44 MU
Stage 1 measures
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Provider Measure Scorecard
Slide title
Massachusetts eHealth Collaborative
© MAeHC. All rights reserved.
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Analytics via Innovative Pilots
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Natural Language Processing for
intelligent searching of free text
QueryHealth
PopHealth
Universal Availability of PHRs
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Tethered (Patientsite and eCW Patient
Portal)
Non-Tethered (Healthvault and others)
OpenNotes
Required PHR Functionality
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Secure Messaging with Provider
Access to all records
Convenience Transactions
Request Appointments
Medication Refills
Referrals to Specialists
Education
Disease specific content
Links to medication information
Diagnostic test explanations
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Decision Support Service Providers
Questions?
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