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Health Information Technology for Post Acute Care (HITPAC): Minnesota Project Overview Candy Hanson Program Manager Julie Jacobs HIT Consultant June 13, 2013 Objectives • Understand the purpose of the HITPAC project • Identify benefits of the HITPAC project to Minnesota health care communities and its patient populations • Learn about Minnesota’s adoption and use of electronic health records and health information exchange in its skilled nursing facilities Stratis Health • Independent, nonprofit, Minnesota-based organization founded in 1971 – Mission: Lead collaboration and innovation in health care quality and safety, and serve as a trusted expert in facilitating improvement for people and communities • Working at the intersection of research, policy, and practice The Six Goals of the CMS Quality Strategy 1 Make care safer by reducing harm caused in the delivery of care 2 5 6 Strengthen person and family engagement as partners in their care 3 Promote effective communication and coordination of care 4 Promote effective prevention and treatment of chronic disease Work with communities to promote healthy living Make care affordable Our Key Collaborators… Aging Services of Minnesota Care Providers of Minnesota CHIC (Community Health Information Collaborative) Minnesota Alliance for Patient Safety Minnesota Department of Health Minnesota Hospital Association LeadingAge /Center for Aging Services Technology 8 Minnesota HITPAC is: Centers for Medicare & Medicaid Services' Special Innovation Project: Health Information Technology for Post-Acute Care Providers (HITPAC). Collaboration between 3 Fairview Hospitals and 10 skilled nursing facilities 5 Minnesota HITPAC Communities Community 1A Fairview Ridges Hospital Fairview Southdale Hospital Augustana Minneapolis BHC Innsbruck Ebenezer Ridges Martin Luther St. Gertrude's The Colony of Eden Prairie Community 1B Fairview Lakes Hospital Birchwood Health Care Ecumen North Branch GoldenLiving Rush City Margaret S. Parmly 5 TWO MAIN FOCUS AREAS: Transitions of Care Improving Medication Management Electronic Health Record/EHR towards Health Information Exchange/HIE Improve quality and coordination of care through the effective use of health information technology (HIT) during care transitions Leverage standardized patient assessment content to facilitate health information exchange (HIE) with hospitals Reduce medical errors by improving the medication management process through the use of EHR functionality 6 Minnesota Environmental Scan • Provides a broad brush stroke of the state of Minnesota skilled nursing facilities adoption and use of EHRs • Describes EHR Functionality • Informs about Health Information Exchange (HIE) possibilities • Recommendations for moving forward Link to Minnesota Environmental Scan: http://intranet/c1/10sow/siphitpac/es/MN%20Environ mental%20Scan%20for%20HIT%20PAC%20%20%20Final%2001_08_13%20(2).pdf Minnesota EHR Adoption & Use • 69% Minnesota nursing homes report adopting/using EHR • 99% report using EHR to document activities such as MDS assessment • 98% report using EHR to document resident demographics • 96% report using EHR to document diagnosis or condition list Ref 2011 MDH Nursing home Survey Data Minnesota Nursing Homes with EHRs Medication Management Activities • 14% used EHRs for medication reconciliation • 62% used alerts for medications • 36% used an electronic medication activity record (e-Mar) • 3% used e-Prescribing Ref: 2011 MDH Nursing Home Survey Data Care Coordination Toolkit http://www.stratishealth.org/expertise/healthit/caretransitions Readiness Assessment Interviews Education and Technical Assistance Current and Future State Process Mapping • Findings: – Limited Long Term Post Acute Care (LTPAC) EHR functionality • • • • Interoperability CCD Medication Reconciliation and e-Prescribing Laws and rules that pre-date EHR use contribute to problematic work flows • Hybrid health records (paper/electronic mix) Findings: – LTPAC and Acute Care Facilities: • Understanding the needs of each • Inconsistent expectations of EHR users • Potential points for improving medication administration in current medication reconciliation workflows • Privacy and security practices in an electronic health record environment will continue to need attention • View-only access to hospitals’ EHR does not solve interoperability issues Next Steps: • Early Recommendations – All EHR Vendors should design software that can both generate and consume a Continuity of Care Document (CCD) • 225 Data points • MDS, OASIS, Interact, other proprietary formats – Configuration and training related to Clinical Decision Support and e-Prescribing tools • • • • Medication Libraries Predictive text Electronically generated reports Work flow re-designs to advocate for Computer Physician Order Entry (CPOE) – Best practice around Medication Reconciliation • Pharmacy consults • EHR CDS Next Steps (continued): • Early recommendations -LTPAC facilities consider investing in a “super-user” environment -Financial assistance to help non-EHR LTPAC settings prepare for EHR adoption and use -Financial assistance made available to help LTPAC settings who have EHR in place assess adoption and use and workflow issues Questions? For more information contact: Candy Hanson Program Manager Health Information Technology for Post Acute Care (HITPAC) Stratis Health [email protected]