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Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
Christopher Tashjian - How technology is changing rural medicine: Fact, not theory
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Christopher Tashjian - How technology is changing rural medicine: Fact, not theory

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Presented by Christopher Tashjian, MD, FAAFP, on September 27, 2013 at the fourth annual Center for Health Literacy Conference: Plain Talk in Complex Times.

Presented by Christopher Tashjian, MD, FAAFP, on September 27, 2013 at the fourth annual Center for Health Literacy Conference: Plain Talk in Complex Times.

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  • MH is approaching the goal of preventing a million heart attacks and strokes along two paths. Community prevention efforts to reduce the likelihood that people will need trea®ent and Clinical interventions to ensure that, if needed, care is optimal. Clinical efforts will draw the attention of patients, health professionals, and the systems in which they work to the power of excellence in the ABCS. HIT must work its magic for busy practitioners and people too busy to get meds refilled or to get in a daily walk. Innovations in care delivery are currently being developed and launched and MH is working to get the ABCS embedded in new models and to make sure that team members are included.On the community side, focus is on tobacco-free living and reduction in smoke and sodium and trans fats in the food supply.
  • Transcript

    1. How technology is changing rural medicine to improve outcomes and communication with patients: Fact, not theory. Plain Talk in Complex Times 2013: Communicating in a Time of Change September 26-27, 2013 | Arlington, VA Christopher H. Tashjian, MD, FAAFP Health IT fellow using electronic health records and practice innovations to increase participation in the Million Hearts® initiative and improve performance on the Million Hearts goal Chief Medical Advisor WHITEC
    2. Health literacy is dependent on individual and systemic factors:  Communication skills of lay persons and professionals  Lay and professional knowledge of health topics  Culture  Demands of the healthcare and public health systems  Demands of the situation/context
    3. Health literacy affects people's ability to:  Navigate the healthcare system, including filling out complex forms and locating providers and services  Share personal information, such as health history, with providers  Engage in self-care and chronic- disease management  Understand mathematical concepts such as probability and risk
    4. Who is at risk?  older adults  racial and ethnic minorities  people with less than a high school degree or GED certificate  people with low income levels  non-native speakers of English  people with compromised health status.7 Education, language, culture, access to resources, and age are all factors that affect a person's health literacy skills.
    5. EVERYONE!!!!
    6. Modern Solutions  Conversation  PCMH  EMR ◦ After Visit Summary ◦ Patient Education ◦ Patient Portal  Smart Phone
    7. Conversation
    8. Patient Centered Medical Home  is a model of care that emphasizes care coordination and communication to transform primary care into “what patients want it to be.”  NCQA Patient-Centered Medical Home (PCMH) Recognition is the most widely-adopted model for transforming primary care practices into medical homes.
    9. HIGH TECH First need to acquire data and enter into EMR
    10. Create Database
    11. Generate Patient Lists
    12. Use of Filters
    13. Patient Scorecards
    14. Results as of 8/1/2013 for Christopher Tashjian, MD IVD BP 99/104 95.2% LDL 86/104 82.7 Aspirin 104/104 100% Smoking 87/104 83.7 Hemoglobin A1C 82/104 78.8 Total (All 5) 57/104 55%
    15. EMR – After Visit Summary  information and instructions containing the patient name, provider’s office contact information, date  and location of visit, an updated medication list, updated vitals, reason(s) for visit, procedures and other
    16. EMR AVS (continued)  instructions based on clinical discussions that took place during the office visit  any updates to a problem list, immunizations or medications administered during visit, summary of topics covered/considered during visit, time and location of next appointment/testing if scheduled, or a
    17. EMR AVS (continued)  recommended appointment time if not scheduled, list of other appointments and tests that the patient  needs to schedule with contact information, recommended patient decision aids, laboratory and other  diagnostic test orders
    18. EMR Patient Education  Required for Meaningful Use ◦ Krames ◦ Exit Care
    19.  Standard content written at or below the 8th grade reading level  Easy-to-Read content written at or below the 4th grade reading level
    20. Easy-to-Read documents include:  Need-to-Know and What-to-Do information  Simple words and sentences written in plain language  Ample white space  Simple illustrations  Uncluttered sections  Active voice style writing  Quality, clinician-reviewed medical information  Spanish translations
    21. Patient Portal  Patient portal helps you easily access your health information and contact your doctors and nurses. The patient portal empowers you to become an active participant in your care through a broad range of activities and services.
    22. Key Benefits Patient Portal Easy access to important health information Secure communications with your doctor Convenient appointment management Tools to manage your care and improve your health
    23. Medical Record Access View your medical record Download a copy of your medical record Share your record with health care professionals
    24. Secure Messaging Exchange secure messages with your doctor Receive a convenient email notification when you have a new message
    25. Appointments View appointment details Reschedule or cancel an existing appointment Schedule a new appointment Save appointments to your calendar
    26. Online Forms eVisits Pre-visit interviews Medical history surveys
    27. Smartphones- now above 61%
    28. Medical Apps for Docs Epocrates  The king of all medical apps, Epocrates enables physicians to review drug prescribing and safety information, select health insurance formularies for drug coverage information, perform calculations like BMI and GFR and access medical news and research.
    29. Medical Apps for Docs Up to Date Up to Date is a reference tool that comes with evidence-based recommendations, mobile-optimized calculators and a CME tracker.
    30. Medical Apps for Patients  Pill Management  Chronic Disease Management ◦ Diabetes ◦ Heart Disease  Diet Management  Exercise Management  More every day!
    31. Bottom Line
    32. Million Hearts® • National initiative co-led by CDC and CMS • Partners across federal and state agencies and private organizations Goal: Prevent 1 million heart attacks and strokes in 5 years
    33. Key Components of Million Hearts™ COMMUNITY PREVENTION Changing the context CLINICAL PREVENTION Optimizing care Focus on ABCS Health information technology Clinical innovations TRANS FAT
    34. For more information contact: Chris Tashjian, MD, FAAFP ctashjian@rfmc.org Ellsworth Medical Clinic 715-273-5041

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