Milwaukeesend 10 09 2009

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Presentation by Dr. C. Martin Harris of Cleveland Clinic. Dr. Harris came to Milwaukee on October 9th to provide the information in this presentation.

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Milwaukeesend 10 09 2009

  1. 1. EMR Use in the Age of Healthcare Reform C. Martin Harris, M.D. Chief Information Officer, Cleveland Clinic Executive Director, eCleveland Clinic
  2. 2. <ul><li>On February 17, President Barack Obama signed the $787 billion American Recovery and Reinvestment Act of 2009. </li></ul><ul><li>The “Act” includes $140 billion for “comprehensive healthcare reform.” </li></ul><ul><li>A net overall investment of $19.2 billion, will be used to promote Health Information Technology adoption and implementation. </li></ul><ul><li>Physicians and hospitals are eligible to receive portions of these funds based on: </li></ul><ul><ul><li>Having an integrated electronic medical record system in place by January 1, 2011. </li></ul></ul><ul><ul><li>Demonstrating EMR “meaningful use” </li></ul></ul>New Opportunities: HIT Stimulus
  3. 3. American Reinvestment and Recovery Act HIT Directives Definition of Meaningful Use Standards Definition Measures Definition Framework (HIT Adoption, Quality Management, and Interoperability) Secretary, Health and Human Services HIT Policy Committee HIT Standards Committee
  4. 4. Stimulus-related (Funding) <ul><li>HIT-related Programs </li></ul><ul><ul><li>Definition of “Meaningful Use” </li></ul></ul>
  5. 5. <ul><li>An enterprise-wide eHealth services program that is presently changing the paradigm of medical practice by applying Health IT solutions to improve patient care, enhance operational and administrative efficiency, reach out to patients and community physicians, and create new knowledge through ongoing research and education initiatives. </li></ul>
  6. 6. e Analytics and Research : Research Standardization Dr. Connect : Improved Communication; Improved Care My Practice : Electronic Medical Record System My Practice ● Community eHealth Services Virtual Visit : Patient/Physician Interaction Globally My Consult : Your First Choice for a Second Opinion My Chart : Your Personal Health Connection My Monitoring : Ongoing Condition Reporting from Home Providers Patients My Practice : Electronic Medical Record System
  7. 7. My Practice Electronic Medical Record Patients Front Desk Nurses Physicians Schedulers Residents Researchers Physicians = 6,004 Residents / Fellows = 850 Pharmacists = 364 Other End Users = 38,608 Patients in the EMR = 5,707,792 Prescriptions = 42,472,788 Orders = 126,649,261 Encounters = 24,174,250 Total Results = 484,072,179 Cleveland Clinic User and Encounter Statistics (Through August, 2009)
  8. 8. Ambulatory Functionality <ul><li>Messaging </li></ul><ul><li>Schedule </li></ul><ul><li>Results </li></ul><ul><li>Documentation </li></ul><ul><li>Physician Order Entry </li></ul><ul><li>Best Practice Alerts </li></ul>Electronic Medical Record
  9. 9. Inpatient Functionality <ul><li>Inpatient census </li></ul><ul><li>All results </li></ul><ul><li>Medication administration record </li></ul><ul><li>Vital signs and I&O </li></ul><ul><li>Documentation </li></ul><ul><li>Computerized Physician Order Entry (CPOE) </li></ul>Electronic Medical Record
  10. 10. Results
  11. 11. On-Line Documentation
  12. 12. Computerized Physician Order Entry
  13. 13. Drug Interaction Alert DRUGS: COUMADIN TABLET 2 MG PO ZOLOFT 50 MG PO SIGNIFICANCE LEVEL. Very High Can override and accept the interaction
  14. 14. Age, Gender, and Diagnosis Specific Health Maintenance Alerts
  15. 15. e Analytics and Research : Research Standardization Dr. Connect : Improved Communication; Improved Care My Practice : Electronic Medical Record System My Practice ● Community eHealth Services Virtual Visit : Patient/Physician Interaction Globally My Consult : Your First Choice for a Second Opinion My Chart : Your Personal Health Connection My Monitoring : Ongoing Condition Reporting from Home Providers Patients My Chart : Your Personal Health Connection
  16. 16. My Chart <ul><li>Patient Services </li></ul><ul><ul><li>View medical information </li></ul></ul><ul><ul><li>View health reminders </li></ul></ul><ul><ul><li>View schedule </li></ul></ul><ul><ul><li>Appointment request </li></ul></ul><ul><ul><li>Prescription renewal request </li></ul></ul>
  17. 17. s a l l y i      
  18. 18. x
  19. 21. e Analytics and Research : Research Standardization Dr. Connect : Improved Communication; Improved Care My Practice : Electronic Medical Record System My Practice ● Community eHealth Services Virtual Visit : Patient/Physician Interaction Globally My Consult : Your First Choice for a Second Opinion My Chart : Your Personal Health Connection My Monitoring : Ongoing Condition Reporting from Home Providers Patients My Monitoring : Ongoing Condition Reporting from Home
  20. 22. eEnabled Chronic Care Management Model
  21. 23. eEnabled Chronic Care Management Model Connectivity
  22. 24. My Practice: Physician Results View , , , , , Patient’s Blood Pressure Measures from Home
  23. 25. eEnabled Chronic Care Management Model Connectivity My Chart
  24. 26. Dear Patient, I recommend the following: Begin spironolactone 25mg once daily. I sent this as a secure ePrescription to your preferred pharmacy. Stop Norvasc (amlodipine), but do not discard. Decrease potassium to 20mEq once daily Stop by the lab for blood potassium test 2-3 weeks after making these changes. Message me if you have additional questions.
  25. 27. e Analytics and Research : Research Standardization Dr. Connect : Improved Communication; Improved Care My Practice : Electronic Medical Record System My Practice ● Community eHealth Services Virtual Visit : Patient/Physician Interaction Globally My Consult : Your First Choice for a Second Opinion My Chart : Your Personal Health Connection My Monitoring : Ongoing Condition Reporting from Home Providers Patients My Practice ● Community
  26. 28. Connectivity / Interoperability <ul><li>My Practice Community database pre-loaded with: </li></ul><ul><ul><li>100+ million data elements </li></ul></ul><ul><ul><li>Insurance information for all major payors </li></ul></ul><ul><li>My Practice Community connected to: </li></ul><ul><ul><li>Laboratories </li></ul></ul><ul><ul><ul><li>Cleveland Clinic Health System </li></ul></ul></ul><ul><ul><ul><li>Quest Diagnostics </li></ul></ul></ul><ul><ul><li>Retail Pharmacies </li></ul></ul><ul><ul><ul><li>Acme ● Sam’s Club </li></ul></ul></ul><ul><ul><ul><li>CVS ● Walgreens </li></ul></ul></ul><ul><ul><ul><li>Giant Eagle ● Wal  Mart </li></ul></ul></ul><ul><ul><ul><li>RITE AID </li></ul></ul></ul><ul><ul><li>Transcription Companies </li></ul></ul><ul><ul><ul><li>MedQuist ● Precis ● Premier </li></ul></ul></ul><ul><ul><ul><li>Spheris ● Cymed ● Chase </li></ul></ul></ul>
  27. 29. 1. Independent Physician’s Office 2. Independent commercial pharmacy, labs, and patient at home 3. Cleveland Clinic Ambulatory sites 4. Cleveland Clinic Inpatient Meaningful Use Operating Model
  28. 30. Process to Achieve Meaningful Use Operating Model Objectives “ The ultimate vision is one in which all patients are fully engaged in their healthcare, providers have real-time access to all medical information and tools to help ensure the quality and safety of the care provided while also affording improved access and elimination of health care disparities.” “ Meaningful Use: A Definition” Recommendations from the Meaningful Use Workgroup to the Health IT Policy Committee June 16, 2009

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