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.
4Meaningful Use – Where We are Today• Eligible providers• Certified technology• Meaningful Use criteria Stage 1 Stage 2 Stage 3• Non-compliance
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
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”
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
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
18Managing Labs & Test Results• Interface vs. delivered by fax/mail• Tasking of results• Timing of availability to all providers
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