Transcript Meaningful Use technology took

August 2016
MEANINGFUL TECHNOLOGY TOOL-KIT TO
IMPROVING PATIENT HEALTH
FEDERAL HEALTH INITIATIVE: MEANINGFUL USE
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The Medicaid EHR Incentive Program provides incentive
payments for eligible healthcare providers to adopt and use
electronic health record (EHR) technology in ways that can
positively affect patient care
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Objectives are established by the Centers for Medicare and
Medicaid Services (CMS) using a certified EHR; program is run
by individual States
10 OBJECTIVES: MEDICAID AND MEDICARE STANDARDS
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Protect Patient Health Information
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5
Clinical Decision Support (CDS)
Computerized Provider Order Entry (CPOE)
Electronic Prescribing (eRx)
Health Information Exchange
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Patient Specific Education
Medication Reconciliation
Patient Electronic Access
9 Secure Electronic Messaging
10 Public Health Reporting
GOAL: USE EHR TO IMPROVE HEALTH
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Improve quality, safety and reduce health disparities
Achieve better clinical outcomes
Engage and empower patients
Improve care delivery, coordination and public health
Build more robust research data on health systems
A VISION FOR UCSF
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Adopt clinic workflow to align with federal (CMS)
standards
Be at the forefront of the intersection of technology
and human health
Prepare to become integrated with UCSF Health
System
THE KEY TO OUR EXCELLENCE IS OUR….
Students
 Faculty
 Staff
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Everyone has a role
 What is YOUR role?
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FACULTY START CHECKS
Students are proxy providers
 Chart documentation is tracked by faculty and
by student
 No start check = no tracking for faculty, so
please obtain a start check at every session!!!
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MEDICAL HISTORY
Update allergies
 Update problem list
 eRx query and manage Medications Hx
 Review meds in “medications” tab by clicking
“reviewed button”
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VIDEO DEMO
1. Alerts/Allergies
 2. Patient problem list
 3. eRx managing medication history
 4. Reviewing medications
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MU TAB: THIS IS NEW!
@ every visit!
 Key to track continuous quality metrics related to
diabetes, hypertension, BMI, referral pattern, etc.
 In EHR, select “forms”, click
 Select “MU tab form” from pull down menu
 Fill out MU2 Measures Form
 THIS IS A KEY FORM FOR TRACKING VARIOUS
INTERVENTIONS!
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VIDEO DEMO
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5. How to fill out the MU form
NEED RX? – IT’S ALL IN ERX
Prescribe in under faculty log-in in eRx
 Print and have faculty sign
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 If
Schedule II drugs (ex: Vicodin, Norco, etc.), then
ask faculty to take the printed eRx to the
dispensary and request the triplicate pad
UC PROTOCOL FOR DISPENSING MEDS
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Available medications:
 Amoxicillin 500mg
 Clindamycin 150mg
 Acetaminophen 500mg and 325mg
 Ibuprofen 600mg and 200mg
Enter code Q0203 in AxiUm as “complete” in the patient’s EHR
Enter a progress note and indicate a). Medication name, b). Dose, c).
Primary reason for administration.
The attending faculty must provide an electronic signature
Enter the medication prescription into eRx, have the faculty sign it
electronically and print it
At the dispensary window, provide the staff member with the patient’s
EHR number, printed eRx prescription, and ask a staff member for the
requested medication
VIDEO DEMO
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6. Prescribing medications in eRx
Remember: your faculty must have eRx
password!!!
 See
a Clinic Director if faculty doesn’t have one
CLINICAL DECISION SUPPORT (CDS)
5 programmed prompts
 Follow the prompts when they pop up
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This is an example
only, not actual CDS
PATIENT EDUCATION
CAMBRA: In CRA click “yes, recommendations
given” and print the correct info for patient
 New: tobacco cessation
 New: BMI (letter for patients with BMI <17.8 or
>25)
 Go to “patient attachments”
 Click
under “letters and general letters”
 Select from a list of letters relevant to your patient
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VIDEO DEMO
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7. Patient education letters
 Smoking
cessation
 Metabolic health (obesity)
SMOKING IS ONE OF THE LEADING CAUSES OF STATISTICS
From January- December 2015:
 We saw 10,700 patients in predoc
 1,763 said “yes” to smoking
 225 clinic instruction days
 16.5% of our patients smoke
 12% of people smoke in CA
 Opportunity: 7-8 patients/day
MESSAGING WITH PATIENTS: NEW
Send a “welcome message”
 All in axiUm email
 Green name color = patient
 Can also use Exan DoctorAccess to view these
emails remotely
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PATIENT ONLINE ACCESS TO EHR
High level information
 Medication list
 Problem list
 Notes and details are not viewable to patients
 Patients go to: https://dentalhealth.ucsf.edu/
 Patients log in with access code provided at the
front desk
 Please engage your patients in this process
 FA and ACC staff maybe of help to patients
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VIDEO DEMO
8. Patient online access
 9. Patient messaging
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THANK YOU!
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Acknowledgements:
 Dr.
Mark Kirkland and the Dean’s office
 Lenh Tsan – Project Manager
 Tom Ferris and NIS team
 Maria Guerra
 Dr. Sean Mong
 Dr. Nakahara and Dr. Singh