Transcript Tri-State REC Kick Off - Tri-State Regional Extension Center

Tri-State REC Kick Off
Meaningful Use Basics: Developing a
Solid Plan for Your Electronic Practice
June 18, 2010
Session 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
Messaging
Using eRx
Using dragon dictate
for office visits
Using forwarding to
send reviewed path
reports to Surg Ctr
Reporting to registry
with BH labs
HIE or EMR…need both
Health Information Exchange Model
Without planning
Hospitals
Laboratory
Hospitals
Public
health
Primary
care
physician
Primary
care
physician
Laboratory
Pharmacy
Pharmacy
Public
health
Health
Information
Exchange
Specialty
physician
Specialty
physician
Payors
Payors
Ambulatory center (e.g.
imaging centers)
Ambulatory center (e.g.
imaging centers)
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
Assertive
Productive
Negatives
• Assertive
• Critical
These are the customers of our Primary Care outreach for Meaningful Use
Throughout our area….
In the middle of every difficulty lies opportunity…
Albert Einstein
Tri-State REC Service Area
State
Ohio (11 counties)
Kentucky (37 counties)
Indiana (19 counties)
9
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
8
19
2
4
5
6
21
In
Use
Not In
Use
Plan to implement
Date
Comment
Record and chart changes
in vital signs
Visit Note
Provide clinical summaries
to patients for each office
visit
Visit Note\Patient Portal
Implement drug‐drug,
drug‐allergy, drug‐
formulary checks
eRx
Generate and transmit
permissible prescriptions
electronically
eRx
Maintain active
medication list
eRx
Maintain active
medication allergy list
eRx
Perform medication
reconciliation at relevant
encounters and each
transition of care
eRx
Example of gap analysis
25 Meaningful Use Criteria
10
Incorporate clinical labtest results into EHR as
structured data
In
Use
Not In
Use
Plan to implement
Date
Comment
HIE Interface
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
Provide patients with
timely electronic access to
their health information(
including lab results,
problem list, medication
lists, allergies)
Patient Portal
Check insurance eligibility
electronically from public
and private payers
Practice Management Integration
9
18
15
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
Report ambulatory quality
measures to CMS or the
States
Registry
Capability to submit
electronic data to
immunization registries
and actual submission
where required and
accepted
Registry
12
23
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
14
13
20
22
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
In
Use
Not In
Use
Plan to implement
Date
Comment
Alerts
Send reminders to patients
per patient preference for
preventive/ follow-up care
Alerts\Patient Portal
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
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.
3
Maintain an up-to-date
problem list of current and
active diagnoses based on
ICD-9-CM or SNOMED CT
Security
Pushing the vendor
Each EMR practice have invested much in
their vendor
Vendors provide service to the practice
Meaningful use achievement relies heavily
upon their provisions to the practice
The REC will help identify what to push on
You 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-State
A network tool
Your home team card
Divide and Share time
Raise hands for different EMRs
Separate into like groups
Share 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 patients
Care = care coordination, health care
Collaborate = coordination, across organizations
Consumers = inclusive of patient and families
Confidential = respectful of privacy and confidentiality
Communicate = enhance communication
Cost-effective = reduce administrative burden
Comfortable = 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 Document
Header
Purpose
Problems
Procedures
Family History
Social History
Payers
Advance Directives*
Alerts (allergies)
Medications
Immunizations
Medical equipment
Vital signs
Functional stats
Results
Encounters
Plan of care