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Employing the Phases of Electronic     Health Records (EHR)      The Journey from Paper to EHR
Introductions      Val                    Karin                  Erik                    Kent      Migliore,              ...
Introductions                                   Kent                                   CrosierIntroduceYourself           ...
Goals & Objectives1. Introductions                     5. Understanding What it Takes2. Benefits – What’s In it for Me?   ...
Where are you with EHR Currently?Rate your practice:         1                         No PMS                         No E...
Benefits    MU         Patient   ProductivityIncentive $    Quality       and                         Performance
What’s the Hold Up?
What’s the Hold Up?
Common EHR Myths                   What it is not     Broken                               You will no longerprocesses wil...
Reasonable Expectations of an EHR                   What it is   Guaranteed1                        Possible1             ...
Understanding What it Takes:              Building a House            Achieve Meaningful Use                              ...
Framework…Assess                                      Plan• Buy-In                                    • Identify physician...
It Takes a Village…..         Medical         Society          AMA                          Your Peers         MGMA       ...
Critical Success FactorsFrom Zero to Meaningful Use and Beyond!The HIT Extension Center ExperiencePaul Kleeberg, MD FAAFP,...
Critical Success Factors
Critical Success Factors By Shahid N. ShahThe Healthcare IT Guywww.netspective.com
Critical Success FactorsFrom Zero to Meaningful Use and Beyond!The HIT Extension Center ExperiencePaul Kleeberg, MD FAAFP,...
MEANINGFUL USE          •   Reforming the health care system          •   Improving health care qualityHHS       •   Impro...
MU Prep Checklist for Stage 1 (Medicare)      1. Register    2. Certified         CMS            EHR     3. Implement   4....
Medicare vs. Medicaid
Meaningful Use Criteria: Core                                                                                             ...
Meaningful Use Criteria: Core      Record smoking status for patients 13 years old or       More than 50 percent of all un...
Meaningful Use Criteria: Menu         Menu Set Objectives for EPs: Must Choose         and Meet 5 of the 10 from the Menu,...
Medicare Incentive PaymentTip: To determine your potential Medicare incentive payment – review 2010 1099(s)
Medicaid Incentive Payment
Services               • Strategic Planning               • Readiness Assessment               • Office Workflows: Clinica...
Resources       Source                              LocationCMS                http://www.cms.gov/EHRIncentivePrograms/CMS...
EMR, EHR and Meaningful Use Presentation
EMR, EHR and Meaningful Use Presentation
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EMR, EHR and Meaningful Use Presentation

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Transcript of "EMR, EHR and Meaningful Use Presentation"

  1. 1. Employing the Phases of Electronic Health Records (EHR) The Journey from Paper to EHR
  2. 2. Introductions Val Karin Erik Kent Migliore, Eichler, Riffel, Crosier, MBA RN Exec VP• Unity HealthSystem • Genesee Valley • Tri-Delta Resources • Tri-Delta Resources• Regional Extension OB/GYN, PC: • Virtual CIO • MediTech DisasterCenter / MCMS • Regional Extension • NYeC approved IT Recovery•Xerox Corporation Center / MCMS Vendor • NYeC approved IT• Certified Black •Genesee Hospital • MGMA Member VendorBelt, Lean Six • MGMA Member • MGMA MemberSigma• MGMA Member
  3. 3. Introductions Kent CrosierIntroduceYourself • Your Name • Practice Name • Practice Specialty • Your Role • Expectation
  4. 4. Goals & Objectives1. Introductions 5. Understanding What it Takes2. Benefits – What’s In it for Me? 6. Planning3. What’s the Hold Up? 7. Achieving Meaningful Use4. What EHR Is and Is Not 8. CMS Incentives
  5. 5. Where are you with EHR Currently?Rate your practice: 1 No PMS No EHR 5 2 Fully PMS Only Implemented EHR Audience Achieved MU Assessment 3 Implemented 4 EHR – not Implemented certified yet EHR – certified
  6. 6. Benefits MU Patient ProductivityIncentive $ Quality and Performance
  7. 7. What’s the Hold Up?
  8. 8. What’s the Hold Up?
  9. 9. Common EHR Myths What it is not Broken You will no longerprocesses will be You will be able need to reconcilefixed by an EHR. to eliminate staff. charts. You will never You will no Loose reportssearch for paper longer need to will no longer be charts again. store records. a problem.
  10. 10. Reasonable Expectations of an EHR What it is Guaranteed1 Possible1 Debatable1 • Legibility of notes • EHR Stimulus $ • Increased • Accessibility of charts • Transcription efficiency • No more lost patient cost savings • Quality of care records - EMR • Space savings • Improved • Multiple users access • Paper savings workflow to charts • Automated lab & • Improved coding • Disaster Recovery XRAY results accuracy & • E-Prescribing • Clinical Decision charge capture • Drug-to-drug & allergy Support • Better patient interactions • Improved patient services • Remote chart access communications • Time savings1 “Selecting the Right EMR” e-Book by John Lynn @ http://www.emrandhipaa.com/emr-selection-book/
  11. 11. Understanding What it Takes: Building a House Achieve Meaningful Use ImplementAssess Plan Select Optimize
  12. 12. Framework…Assess Plan• Buy-In • Identify physician champion• Assess readiness • Establish teams• Identify benefits • Workflow assessment• Set goals • Identify opportunities for improvement.• Determine migration path • Establish measurements• Develop budget & business case for • Establish chart conversion strategy EHR & IT • IT Infrastructure• Current network assessment • Connection to RHIO, Labs, HIE • Develop project plans & timelines • Communication PlanSelect Implement & Optimize• Understand requirements for • Implement rollout strategy practice’s workflow • Document new workflows and• Specify desired functions processes• Review the field of EHR / IT vendors • Implement chart & data conversions• Perform due diligence (to narrow field) • Manage installation of hardware & IT• RFP infrastructure• Demo & site visits, reference checks • TRAIN TRAIN TRAIN• Contract negotiations, pricing, terms • Rehearse GO-LIVE legal review, financing • COMMUNICATE COMMUNICATE!!!
  13. 13. It Takes a Village….. Medical Society AMA Your Peers MGMA Practice REC’s CMS NYeC HIMSS EHR IT VendorRHIO’s Universities Labs Colleges HIE’s SME’s Consultants
  14. 14. Critical Success FactorsFrom Zero to Meaningful Use and Beyond!The HIT Extension Center ExperiencePaul Kleeberg, MD FAAFP, FHIMSSClinical Director, REACHHIMSS11 Orlando, FloridaFebruary 21st, 2011,
  15. 15. Critical Success Factors
  16. 16. Critical Success Factors By Shahid N. ShahThe Healthcare IT Guywww.netspective.com
  17. 17. Critical Success FactorsFrom Zero to Meaningful Use and Beyond!The HIT Extension Center ExperiencePaul Kleeberg, MD FAAFP, FHIMSSClinical Director, REACHHIMSS11 Orlando, FloridaFebruary 21st, 2011,
  18. 18. MEANINGFUL USE • Reforming the health care system • Improving health care qualityHHS • Improving health care efficiencyVision • Improving patient safety • Certification Criteria Determined • CMS Publishes Final Rule July 2010 Path • Incentive Programs EstablishedDefined
  19. 19. MU Prep Checklist for Stage 1 (Medicare) 1. Register 2. Certified CMS EHR 3. Implement 4. Implement 5 15 Core of the 10 Menu Objectives Set Objectives 5. Declare 90 Day Reporting 6. Attestation Period
  20. 20. Medicare vs. Medicaid
  21. 21. Meaningful Use Criteria: Core * Reporting MU Objective MU Measure Method Exclusion? Core Set Objectives for EPs: Must Meet All 15 Measures Any EP who writes fewer than 100 prescriptions during theC1 Use CPOE for medication orders CPOE is used for more than 30 percent of unique patients EHR Tabulates EHR reporting period. Implement drug-drug and drug-allergy interactionsC2 checks The EP has enabled this functionality in EHR Attestation None More than 80 percent of all unique patients seen by the EP or admitted to the Maintain an up-to-date problem list of current and eligible hospital have at least one entry or an indication that no problems areC3 active diagnoses known for the patient recorded as structured data. EHR Tabulates None More than 40 percent (adjusted or unadjusted for patient preference) of all Generate and transmit permissible prescriptions permissible prescriptions written by the EP are transmitted electronically using Any EP who writes fewer than 100 prescriptions during theC4 electronically (eRx) certified EHR technology EHR Tabulates EHR reporting period. More than 80 percent of all unique patients seen by the EP or admitted to the eligible hospital have at least one entry (or an indication that the patient is notC5 Maintain active medication list currently prescribed any medication) recorded as structured data EHR Tabulates None More than 80 percent of all unique patients seen by the EP or admitted to the eligible hospital have at least one entry (or an indication that the patient is notC6 Maintain active medication allergy list. currently prescribed any medication) recorded as structured data EHR Tabulates None Record demographics: Preferred language, gender, For more than 50% of all unique patients seen by the EP or admitted to the eligibleC7 race, ethnicity, and date of birth hospital have demographics recorded as structured data EHR Tabulates None Any EP who either see no patients 2 years or older, or who For more than 50% of all unique patients age 2 and over seen by the EP or admitted believes that all three vital signs of height, weight, and blood Record and chart changes in vital signs: Height, to eligible hospital, height, weight and blood pressure are recorded as structured Count of pressure of their patients have no relevance to their scope ofC8 Weight, BP, BMI and growth charts for ages 2-20 data Patients in EHR practice.
  22. 22. Meaningful Use Criteria: Core Record smoking status for patients 13 years old or More than 50 percent of all unique patients 13 years old or older seen by the EP Count ofC9 older or admitted to the eligible hospital have smoking status recorded Patients in EHR Any EP who sees no patients 13 years or older. Core CQMs - EPs must report on 3 required core CQMs, and if the denominator of 1 or more of the required core measures is 0, then EPs are required to report results for up to 3 alternate core measures. EPs also must also select 3 additional CQMs from a set of 38 CQMs (excluding the core/alternate core measures). It is Report ambulatory clinical quality measures to CMS acceptable to have a 0 denominator provided the EP does not have an applicableC10 or in the case of Medicaid to the States population. EHR Tabulates None Implement 1 clinical decision support rule relevent to specialty or high clinical priority along with the ability Implement one clinical decision support rule related to efficiency or a clinicalC11 to track compliance to that rule quality measure relevant to the EP or eligible hospital Attestation None Provide patients with an electronic copy of their health information (including diagnostic test results, Any EP that has no requests from patients or their agents for problem list, medication lists, medication allergies), More than 50 percent of all patients who request an electronic copy of their an electronic copy of patient health information during theC12 upon request health information are provided it within 3 business days EHR Tabulates EHR reporting period. Provide clinical summaries for patients for each office Clinical summaries provided to patients for more than 50 percent of all office Count of Any EP who has no office visits during the EHR reportingC13 visit. visits within 3 business days Patients in EHR period. Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of Performed at least one test of certified EHR technologys capacity to electronicallyC14 care and patient authorized entities electronically exchange key clinical information. Attestation None Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implementC15 capabilities security updates as necessary Attestation None
  23. 23. Meaningful Use Criteria: Menu Menu Set Objectives for EPs: Must Choose and Meet 5 of the 10 from the Menu, one of the five must be related to improving public health *p Any EP who writes fewer than 100 prescriptions during M1 Implement drug-formulary checks Attestation the EHR reporting period. More than 40% of all clinical lab tests results ordered by the EP or by an authorized provider fo whose results are in a positive/negative or numerical Count of An EP who orders no lab tests whose results are either in Incorporate clinical lab-test results into EHR as format are incorporated in certified EHR Patients in a positive/negative or numeric format during the EHR M2 structured data technology EHR reporting period. Generate lists of patients by specific conditions to use for quality improvement, reduction of Generate at least one report listing patients of the EP or eligible hospital with M3 disparities, or outreach a specific condition. Attestation None More than 20 percent of all unique patients 65 years or older who were Count of An EP who has no patients 65 years old or older or 5 Send reminders to patients per patient preference identified by certified EHR technology as needing a reminder during the EHR Patients in years old or younger with records maintained using M4 for preventive/ follow up care reporting period were sent the appropriate reminder EHR certified EHR technology. Provide patients with timely electronic access to Any EP that neither orders nor creates lab tests or their health information (including lab results, information that would be contained in the problem list, problem list, medication lists, medication More than 10 percent of all unique patients seen by the EP are provided medication list, medication allergy list (or other allergies) within four business days of the timely electronic access to their health information subject to the EP’s information as listed at 45 CFR 170.304(g)) during the M5 information being available to the EP. discretion to withhold certain information. EHR Tabulates EHR reporting period. Use certified EHR technology to identify patient- specific education resources and provide those More than 10 percent of all unique patients seen during the EHR reporting M6 resources to the patient if appropriate period are provided patient-specific education resources EHR Tabulates None Count of Perform medication reconciliation at relevant Perform medication reconciliation for more than 50 percent of transitions of Patients in An EP who was not the recipient of any transitions of M7 encounters and each transition of care. care. EHR care during the EHR reporting period. Count of An EP who neither transfers a patient to another setting Provide summary care record for each transition Provide summary of care record for more than 50 percent of transitions of Patients in nor refers a patient to another provider during the EHR M8 of care and referral. care and referrals EHR reporting period. Capability to submit electronic data to immunization registries or Immunization An EP who administers no immunizations during the EHR Information Systems and actual submission Performed at least one test of certified EHR technology’s capacity to submit reporting period or where no immunization registry hasM9 *p according to applicable law and practice. electronic data to immunization registries. Attestation the capacity to receive the information electronically. An EP who does not collect any reportable syndromic Capability to provide electronic syndromic Performed at least one test of certified EHR technology’s capacity to provide information on their patients during the EHR reporting surveillance data to public health agencies and electronic syndromic surveillance data to public health agencies (unless none period or does not submit such information to any actual transmission according to applicable law of the public health agencies to which an EP or eligible hospital submits such public health agency that has the capacity to receive theM10 *p and practice. information have the capacity to receive the information electronically). Attestation information electronically.
  24. 24. Medicare Incentive PaymentTip: To determine your potential Medicare incentive payment – review 2010 1099(s)
  25. 25. Medicaid Incentive Payment
  26. 26. Services • Strategic Planning • Readiness Assessment • Office Workflows: Clinical & Practice Administrative Process Improvement • EHR Implementation ProjectPreparedness Management • Meaningful Use & Attestation Readiness and Preparedness • EHR Vendor Selection Vendor • Vendor Pricing & Contract NegotiationsCoordination • Collaboration with IT
  27. 27. Resources Source LocationCMS http://www.cms.gov/EHRIncentivePrograms/CMS FAQ’s http://www.cms.gov/EHRIncentivePrograms/Downloads/FA QsRemediatedandRevised.pdfHIPAA Security http://www.hhs.gov/ocr/privacy/hipaa/understanding/srsum mary.htmlHIMSS http://www.cms.gov/EHRIncentivePrograms/AMA http://www.ama-assn.org/ama/pub/physician- resources/health-information-technology.pageNYeC http://www.nyehealth.org/rec/MGMA http://www.mgma.com/ & http://www.nymgma.com/EMR & HIPAA Blog http://www.emrandhipaa.com/emr-selection-book/Linkedin Join Groups: HIMSS, HIT Works, MU Answers
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