Sedgwick © 2012 Confidential– Do not disclose or distribute.Maximizing Electronic HealthRecord Use in PhysicianPractices t...
Sedgwick © 2012 Confidential– Do not disclose or distribute.Presented by:Ann D. Gaffey, RN, MSN, CPHRM, DFASHRMSVP, Health...
3Objectives• Upon completion of this session, participants will: Describe the current status of the Meaningful Useincenti...
4Meaningful Use – Where We are Today• Eligible providers• Certified technology• Meaningful Use criteria Stage 1 Stage 2...
5CMS Final Rule: Stages 1 and 2• CMS Final Rule - Stage 1 MU: 25 objectives and measures 20 objectives must be completed...
6Stage 1 vs. Stage 2 Comparison
7Stage 2 Timeline
8Stage 2• Meaningful UseCore and MenuMeasures
9Stage 2 – Menu Objectives
10Percentage of office based physicians withEMR/HER (US 2001 – 2010, preliminary 2011-2012)Source: CDC/NCHS, National Ambu...
11Percentage of electronic health records(by physician age, practice size, ownership and specialty, 2011)Source: CDC/NCHS,...
12Percentage of office based physicians with abasic system by state (US preliminary, 2011)
13US ERM Adoption Model
14Potential Liability Issues in EHRs• Transitioning from paper to electronic records• Communication barriers• CPOE functio...
15Transitioning from paper to electronic• Populating the EHR -- All? Some? Abstract?• Physician and staff training – Initi...
16
17Strategies to Prepare for Implementation• “Dummy” patients• Become familiar with system and template layout• Practice op...
18Managing Labs & Test Results• Interface vs. delivered by fax/mail• Tasking of results• Timing of availability to all pro...
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Sedgwick © 2012 Confidential– Do not disclose or distribute.Formatting and Usability Issues:Where do they find what theyar...
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30Medication Reconciliation• Reconciliation functions Allergy documentation Who is responsible for what step? What “com...
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Sedgwick © 2012 Confidential– Do not disclose or distribute.Risk Reduction Strategies
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45Applying the Basic Risk Management Principles• Risks in the office practice setting Medication safety Appropriate mana...
46Getting Organized• Why are you assessing?• What are you assessing for?• What standard are you assessing against?• What i...
47Methods for Assessments• Policy and procedure review• Chart review Sample sizes• Interviews• Aggregating data• Reportin...
Sedgwick © 2013 Confidential – Do not disclose or distribute.Questions?
Sedgwick © 2013 Confidential – Do not disclose or distribute.Ann Gaffey, RN, MSN, CPHRM, DFASHRMSVP, Healthcare Risk Manag...
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Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk

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Ann D. Gaffey, RN, MSN, CPHRM, DFASHRM SVP, Healthcare Risk Management and Patient Safety Sedgwick

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Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk

  1. 1. Sedgwick © 2012 Confidential– Do not disclose or distribute.Maximizing Electronic HealthRecord Use in PhysicianPractices to Minimize Risk
  2. 2. Sedgwick © 2012 Confidential– Do not disclose or distribute.Presented by:Ann D. Gaffey, RN, MSN, CPHRM, DFASHRMSVP, Healthcare Risk Management and Patient SafetySedgwick
  3. 3. 3Objectives• Upon completion of this session, participants will: Describe the current status of the Meaningful Useincentive program, including participation, payments, andcurrent core and quality measures; Describe three risk management and patient safety issuesrelated to the use of EHRs in the physician office setting;and Describe three risk reduction strategies to implement tomitigate risk associated with use of EHRs in the physicianoffice practice setting.
  4. 4. 4Meaningful Use – Where We are Today• Eligible providers• Certified technology• Meaningful Use criteria Stage 1 Stage 2 Stage 3• Non-compliance
  5. 5. 5CMS Final Rule: Stages 1 and 2• CMS Final Rule - Stage 1 MU: 25 objectives and measures 20 objectives must be completed to satisfy MU and qualify for theincentive payments – All 15 from Core Set – 5/10 from the Menu Set.• CMS Final Rule - Stage 2 MU : Provide patients ability to view online, download and transmit theirhealth information within 4 business days of the information beingavailable to the EP Incorporate clinical lab-test results into Certified EHR Technology asstructured data
  6. 6. 6Stage 1 vs. Stage 2 Comparison
  7. 7. 7Stage 2 Timeline
  8. 8. 8Stage 2• Meaningful UseCore and MenuMeasures
  9. 9. 9Stage 2 – Menu Objectives
  10. 10. 10Percentage of office based physicians withEMR/HER (US 2001 – 2010, preliminary 2011-2012)Source: CDC/NCHS, National Ambulatory Medical Care Survey, 2001 - 2012
  11. 11. 11Percentage of electronic health records(by physician age, practice size, ownership and specialty, 2011)Source: CDC/NCHS, Physician Workflow study, 2011
  12. 12. 12Percentage of office based physicians with abasic system by state (US preliminary, 2011)
  13. 13. 13US ERM Adoption Model
  14. 14. 14Potential Liability Issues in EHRs• Transitioning from paper to electronic records• Communication barriers• CPOE functionality• Formatting and usability issues• Alert fatigue• Vendor contract issues• Managing labs and test results• Medication Reconciliation• Documentation “work-arounds”
  15. 15. 15Transitioning from paper to electronic• Populating the EHR -- All? Some? Abstract?• Physician and staff training – Initial and ongoing• Availability of data -- paper vs. electronic• Timing of data input -- document scanning• The new “legal” record
  16. 16. 16
  17. 17. 17Strategies to Prepare for Implementation• “Dummy” patients• Become familiar with system and template layout• Practice open-ended questioning associated with thetemplates imbedded in the system• Video and review physician experience
  18. 18. 18Managing Labs & Test Results• Interface vs. delivered by fax/mail• Tasking of results• Timing of availability to all providers
  19. 19. 19
  20. 20. 20
  21. 21. 21
  22. 22. Sedgwick © 2012 Confidential– Do not disclose or distribute.Formatting and Usability Issues:Where do they find what theyare looking for?
  23. 23. 23
  24. 24. 24
  25. 25. 25
  26. 26. 26
  27. 27. 27
  28. 28. 28
  29. 29. 29
  30. 30. 30Medication Reconciliation• Reconciliation functions Allergy documentation Who is responsible for what step? What “complete” reconciliation looks like in the EMR What “complete” reconciliation looks like to the patient
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  36. 36. 36
  37. 37. 37
  38. 38. 38
  39. 39. 39
  40. 40. 40
  41. 41. Sedgwick © 2012 Confidential– Do not disclose or distribute.Risk Reduction Strategies
  42. 42. 42
  43. 43. 43
  44. 44. 44
  45. 45. 45Applying the Basic Risk Management Principles• Risks in the office practice setting Medication safety Appropriate management of labs and tests Your concerns?
  46. 46. 46Getting Organized• Why are you assessing?• What are you assessing for?• What standard are you assessing against?• What is your “best practice”?• Who are your subject matter experts?
  47. 47. 47Methods for Assessments• Policy and procedure review• Chart review Sample sizes• Interviews• Aggregating data• Reporting findings
  48. 48. Sedgwick © 2013 Confidential – Do not disclose or distribute.Questions?
  49. 49. Sedgwick © 2013 Confidential – Do not disclose or distribute.Ann Gaffey, RN, MSN, CPHRM, DFASHRMSVP, Healthcare Risk Management and Patient SafetySedgwickann.gaffey@sedgwickcms.com(703) 597-5172

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