This document provides an overview of Dignity Health's strategies for achieving Meaningful Use objectives across their large health system. It discusses their centralized governance structure and tools for tracking progress. Significant attention is given to challenging objectives like patient electronic access, summary of care exchange, and public health reporting. The document outlines communication plans, education provided to sites, and techniques for monitoring metrics and preparing strong audit defenses.
Development and implementation of a system to support prediction of suicide risk in the Department of Veterans Affairs - DR. Robert Bossarte and Paul Bradley
Development and implementation of a system to support prediction of suicide risk in the Department of Veterans Affairs - DR. Robert Bossarte and Paul Bradley
Summary of Recommendations on Provider and Patient Identity ManagementBrian Ahier
Deven McGraw, Center for Democracy & Technology (Co-Chair, Tiger Team)
Walter Suarez, Kaiser Permanente, (Co-Chair, Privacy & Security Working Group, HITSC)
Peter Tippett, Chief Medical Officer, Verizon
Elizabeth Franchi, Director, Veterans Health Administration Data Quality Program
Paul Uhrig, Chief Administrative, Legal & Privacy Officer, Surescripts
Providers need to move towards real-time analytics that have become critical to demonstrate their quality of care, as reimbursement by government programs can be contingent upon how providers are measured in “Quality of Care”. For example, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, also called the Permanent Doc Fix, changes the way Medicare doctors are reimbursed with the implementation of a merit based incentive. The performance-based pressure is huge, which makes it imperative that every provider consider technology solutions. Read more at https://www.solix.com/solutions/data-driven-solutions/healthcare/
Slide Presentation for the Week10 Activity of HI 201. Some of the pictures used in the presentation are from http://all-free-download.com/free-photos/.
Director Rodriguez provides an overview to the new impact of the Omnibus HIPAA Rulemaking and highlights OCR’s commitment to enforcement, audit and education initiatives in the coming year.
Closed-Loop EHR Integration Targets Burnout, Improves WorkflowsHealth Catalyst
The widespread adoption of EHRs has significantly altered the workflows of physicians and other healthcare workers. However, while EHRs were developed to better organize patient data and improve care coordination, most require significant and sometimes duplicative documentation, often resulting in workforce burnout.
Health Catalyst’s new Closed-Loop Analytics™ service tackles the EHR workload challenge by helping healthcare providers optimize their use of analytics in existing workflows. Closed-Loop Analytics leverages the knowhow of Health Catalyst clinical workflow experts with work experience at EHR vendors such as Epic, Cerner, and Allscripts. The team works with health systems to deploy analytics solutions directly into the EHR and better leverage analytics to simplify workflows and improve outcomes.
In this webinar, you will learn how Closed-Loop Analytics can help you:
- Determine where end-users are wasting time on duplicative tasks and how to optimize the EHR build to develop efficiencies.
- Develop analytical tools and deploy them into the EHR for increased utilization and improved insights at the point of decision-making.
- See the value of expanded integration capabilities with an analytics tool embedded into the EHR, such as launching to a patient’s chart or initiating an update to a treatment team.
- Understand how interoperability and FHIR are revolutionizing workflow integration and how you can put them to work.
HxRefactored 2015: Charles Boicey "Interoperability Exercise, Triple Store & ...HxRefactored
Charles Boicey, RN and Enterprise Analytics Architect for Stony Brook Medicine shares how RDF Triples can reconcile data from multiple and disparate sources to unlock great insight.
Challenges and Opportunities Around Integration of Clinical Trials DataCitiusTech
Conducting a Clinical Trial is a complex process, consisting of activities such as protocol preparation, site selection, approval of various authorities, meticulous collection and management of data, analysis and reporting of the data collected
Each activity is benefited from the development of point applications which ease the process of data collection, reporting and decision making. The recent advancements in mobile technologies and connectivity has enabled the generation and exchange of a lot more data than previously anticipated. However, the lack of interoperability and proper planning to leverage this data, still acts as a roadblock in allowing organizations truly harness their data assets. This document will help life sciences IT professionals and decision makers understand challenges and opportunities around clinical data integration
The healthcare industry has quietly shed the laggards tag and has quickly emerged as frontrunners in digitization. Hospitals are driving technology advancements by creating a digital framework for seamless integration of all aspects of patient care and administration. There are 5 major themes that are seen as critical in the hospital IT ecosystem – Smart Care, Patient Information Management, Remote Care, Medical Devices, and Intelligent Enterprise Systems.
Large enterprises such as Microsoft and Accenture are collaborating with healthcare providers to address a variety of use cases such as chronic disease management, virtual care solutions, risk scoring, patient tracking and monitoring, precision medicine, and patient on/off-boarding. Accenture and Microsoft helped Spain’s Basque Country Health Centre build a remote elderly patient monitoring system. Athenahealth’s cloud-based network system helps Minnie Hamilton Health System identify bottlenecks and streamline the revenue cycle.
Download the report as we provide an overview of the hospital IT landscape, understand digital transformation trends across these 5 major themes and the opportunities available for vendors and service providers.
ssuming that after having launched ACTION in pilot Hospital X for 12 months, we are
ready to expand the ACTION program and launch it in an additional 4 restructured Hospitals A, B,
C, and D. The program will proceed for 4 more years. At this point, however, we are now more
prepared and organized to plan a process evaluation of one of the 4 hospitals. We will be
planning and conducting the evaluation with co-evaluators as a team
The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Summary of Recommendations on Provider and Patient Identity ManagementBrian Ahier
Deven McGraw, Center for Democracy & Technology (Co-Chair, Tiger Team)
Walter Suarez, Kaiser Permanente, (Co-Chair, Privacy & Security Working Group, HITSC)
Peter Tippett, Chief Medical Officer, Verizon
Elizabeth Franchi, Director, Veterans Health Administration Data Quality Program
Paul Uhrig, Chief Administrative, Legal & Privacy Officer, Surescripts
Providers need to move towards real-time analytics that have become critical to demonstrate their quality of care, as reimbursement by government programs can be contingent upon how providers are measured in “Quality of Care”. For example, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, also called the Permanent Doc Fix, changes the way Medicare doctors are reimbursed with the implementation of a merit based incentive. The performance-based pressure is huge, which makes it imperative that every provider consider technology solutions. Read more at https://www.solix.com/solutions/data-driven-solutions/healthcare/
Slide Presentation for the Week10 Activity of HI 201. Some of the pictures used in the presentation are from http://all-free-download.com/free-photos/.
Director Rodriguez provides an overview to the new impact of the Omnibus HIPAA Rulemaking and highlights OCR’s commitment to enforcement, audit and education initiatives in the coming year.
Closed-Loop EHR Integration Targets Burnout, Improves WorkflowsHealth Catalyst
The widespread adoption of EHRs has significantly altered the workflows of physicians and other healthcare workers. However, while EHRs were developed to better organize patient data and improve care coordination, most require significant and sometimes duplicative documentation, often resulting in workforce burnout.
Health Catalyst’s new Closed-Loop Analytics™ service tackles the EHR workload challenge by helping healthcare providers optimize their use of analytics in existing workflows. Closed-Loop Analytics leverages the knowhow of Health Catalyst clinical workflow experts with work experience at EHR vendors such as Epic, Cerner, and Allscripts. The team works with health systems to deploy analytics solutions directly into the EHR and better leverage analytics to simplify workflows and improve outcomes.
In this webinar, you will learn how Closed-Loop Analytics can help you:
- Determine where end-users are wasting time on duplicative tasks and how to optimize the EHR build to develop efficiencies.
- Develop analytical tools and deploy them into the EHR for increased utilization and improved insights at the point of decision-making.
- See the value of expanded integration capabilities with an analytics tool embedded into the EHR, such as launching to a patient’s chart or initiating an update to a treatment team.
- Understand how interoperability and FHIR are revolutionizing workflow integration and how you can put them to work.
HxRefactored 2015: Charles Boicey "Interoperability Exercise, Triple Store & ...HxRefactored
Charles Boicey, RN and Enterprise Analytics Architect for Stony Brook Medicine shares how RDF Triples can reconcile data from multiple and disparate sources to unlock great insight.
Challenges and Opportunities Around Integration of Clinical Trials DataCitiusTech
Conducting a Clinical Trial is a complex process, consisting of activities such as protocol preparation, site selection, approval of various authorities, meticulous collection and management of data, analysis and reporting of the data collected
Each activity is benefited from the development of point applications which ease the process of data collection, reporting and decision making. The recent advancements in mobile technologies and connectivity has enabled the generation and exchange of a lot more data than previously anticipated. However, the lack of interoperability and proper planning to leverage this data, still acts as a roadblock in allowing organizations truly harness their data assets. This document will help life sciences IT professionals and decision makers understand challenges and opportunities around clinical data integration
The healthcare industry has quietly shed the laggards tag and has quickly emerged as frontrunners in digitization. Hospitals are driving technology advancements by creating a digital framework for seamless integration of all aspects of patient care and administration. There are 5 major themes that are seen as critical in the hospital IT ecosystem – Smart Care, Patient Information Management, Remote Care, Medical Devices, and Intelligent Enterprise Systems.
Large enterprises such as Microsoft and Accenture are collaborating with healthcare providers to address a variety of use cases such as chronic disease management, virtual care solutions, risk scoring, patient tracking and monitoring, precision medicine, and patient on/off-boarding. Accenture and Microsoft helped Spain’s Basque Country Health Centre build a remote elderly patient monitoring system. Athenahealth’s cloud-based network system helps Minnie Hamilton Health System identify bottlenecks and streamline the revenue cycle.
Download the report as we provide an overview of the hospital IT landscape, understand digital transformation trends across these 5 major themes and the opportunities available for vendors and service providers.
ssuming that after having launched ACTION in pilot Hospital X for 12 months, we are
ready to expand the ACTION program and launch it in an additional 4 restructured Hospitals A, B,
C, and D. The program will proceed for 4 more years. At this point, however, we are now more
prepared and organized to plan a process evaluation of one of the 4 hospitals. We will be
planning and conducting the evaluation with co-evaluators as a team
The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Every hospital and health care system is significantly impacted by readmission policies mandated by new regulations.
And every facility must implement strategies to reduce the number of costly and unnecessary readmissions.
During this presentation you will discover how to decrease your readmission rates and take advantage of incentives, rather than suffer penalties that can significantly impact your bottom line.
Due to popular demand, the Comprehensive Primary Care Plus (CPC+) team hosted a repeat of the webinar that was originally held on Thursday, April 21, 2016. During this webinar Model team members provided an overview of the model specifically for health IT vendors.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center held the fifth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Wednesday, June 26, 2013 from 1:00–2:00pm EDT, focused on measuring project success and developing an operational plan.
- - -
CMS Innovations
http://innovations.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The way healthcare services are now planned, monitored and evaluated has considerably changed in the last decade. Many healthcare organizations have now moved from Activity-Based M&E(ie, what are we really doing?) to Performance-Based M&E which focuses on the overall results (ie what have we achieved?).
Therefore the focus now is on the Results and consequences of actions and implementations, rather than on the inputs (treatment, time, human resources) provided.
In Secondary Healthcare Management for instance, this is called Results-Based Management (RBM) and Performance-Based M&E play a vital role in Results-Based Management.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Karen Bell, MD, MMS
Director, Center for Sustainable Health and Care
JBS International, Inc.
Former Chair
Certification Commission for Health Information Technology
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
Healthcare transition in GCC: Current Painful Realities & Proposed Strategic ...STELIOS PIGADIOTIS
Goals of research effort
1. Hands on analysis of GCC and specifically UAE healthcare market.
2. Proposed 2016 strategies for CEOs in GCC healthcare ecosystem
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience” with Lori Posk, MD, Medical Director for MyChart, Cleveland Clinic
Read her full interview here - http://bit.ly/1f9enfC
View photos from the program here - http://on.fb.me/1cZFDpO
Case Study "Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience"
Presentation will include a discussion on our patient portal activation and release of data. A review of our Opt Out model for portal activation will be discussed and our journey of data and documentation release to engage patients. The discussion will include how we used a Physician Advisor Group to release lab, imaging, procedures, pathology, problem list, provider notes and how we educated patients. Lessons learned on data release will be shared. Our implementation of message to engage patients and next steps will also be included in the discussion.
Learning Objectives:
∙ Create a model to activate patients on a patient portal
∙ How to engage a large organization in test result release to a patient portal
∙ Develop a model for physician note release with the option of having sensitive notes not released to the patient
∙ How to educate providers and patients on test result and note release
∙ Review the potential impact of an engaged patient and provider team
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
3. 3
Learning Objectives
Learn
effective
program
management
strategies for
achieving
Meaningful
Use for
multiple
sites, stages,
vendors and
jurisdictions
for Stage 1
and Stage 2
Learn
successful
techniques
for the most
challenging
Meaningful
Use Stage 2
objectives:
• Patient
Electronic
Access (View-
Download-
Transmit)
• Summary of
Care
transmission
• Public Health
Interfaces
Learn proven
techniques
for proactive
audit defense
and audit
response for
Figliozzi
audits and
OIG audits
Learn new
challenging
scope and
targets for
Stage 3
4. Dignity Health
Background:
• Dignity Health, one of the nation’s largest health care systems,
is a 20-state network of nearly 9,000 physicians, 56,000
employees, and more than 400 care centers, including
hospitals, urgent and occupational care, imaging centers,
home health, and primary care clinics. Headquartered in San
Francisco, Dignity Health is dedicated to providing
compassionate, high-quality and affordable patient-centered
care with special attention to the poor and underserved.
Mission
• Dignity Health is committed to furthering the healing ministry
of Jesus. We dedicate our resources to delivering
compassionate, high-quality, affordable health services;
serving and advocating for our sisters and brothers who are
poor and disenfranchised; and partnering with others in the
community to improve the quality of life.
Community Activity:
• In FY14, Dignity Health provided nearly $2 billion in charitable
care and services
HQ: San Francisco
Net Operating Revenue:
(FY14) $10.7 billion
Hospitals: 39
Clinics/Ancillary Care
Centers: 400+
Medical Groups within
Dignity Health Medical
Foundation: 15
Employees: 56,000
Physicians: 9,000
Acute Care Beds: 8,500
Skilled Nursing Beds: 700
Last updated: May 6, 2015
6. 6
Dignity Health Meaningful Use Program Management
Program Governance
and Organization
Structure – Centralized
Meaningful Use
Attestation Plan
Communication Plan
Education Events
(workshop, webinars)
MU Objective
Compliance Plans with
focus on tougher
measures
Attestation Activities
(Data generation and
review, sign-off,
entry/submission)
Document retention
(SharePoint and secure
network archives)
Financial impact
analysis and
monitoring
Audit defense
preparation and
response
7. 7
Program Governance and Organization Structure
Clinical
Program
Executive
Program
Director
Clinical
Analyst(s)
Business
Analyst(s)
Business
Intelligence
Analyst(s)
Regulatory
Compliance
SME (s)
e.g., CHAN
Interoperability
SME(s)
Leadership Core Team Specialists
Security Risk
SME(s)
Application
Interface
SME(s)
Patient Portal
SME(s)
8. 8
Program History and Summary
• The MU program has grown from 8 sites to 29 sites attesting
• 77 total hospital attestations to date
9. 9
Meaningful Use Program Tools
Public health authority
readiness status
tracker tool
(Example follows)
Audit defense checklist
and manual
(Example follows)
Audit defense toolkit
(includes sample
screenshots needed)
Financial incentives
and reductions log /
pivot analysis tool
Audit defense materials for all known requests to
date for each site (e.g., redacted vendor contracts
for certified software)
Attestation status
tracker by year
Certified Health
Product List / CMS
certification ID log tool
by site by program year
Attestation timeline
(flight plan)
(Example follows)
10. Helpful for …
• visualizing all sites in flight regardless of year,
stage, or EHR platform
• communicating with project management and
application scheduling team
Dignity Health Meaningful Use Attestation Timeline
11. 11
• ARRA Overview – Regulatory Context
• HHS Strategic Framework
• Financial Incentives and Reductions
• Attestation Timeline
• Specific MU Objectives by Stage,
especially Security Risk Analysis, Public
Health, Clinical Decision Support
• Audit Defense and Response
• Document retention
• Clinical Quality Measures
• MU Program Team; roles and
responsibilities
• Identifying key site stakeholders; roles
and responsibilities
• Workflow for key elements data
capture
• Lessons learned by MU objective
• Training on report execution and
monitoring
• Strategic Conversation; Identification
of key decisions to be made
Meaningful Use Education Workshops
Executive Overview and Deep Dive Conducted at Each Site
13. 13
Program Management Meeting
Agenda Topics
Vendor update
MU measures
data monitoring
& trending
RAID
management
Review of
regulatory
rulings
Workflow
analysis
Decisions on
changes needed
Communication
strategy
developed
Tip Sheets
developed
14. 14
Site Steering Meeting
Agenda Topics
Review of MU
Functional Reports
Sharing Lessons
Learned & leading
practices
Speakers on
Security Risk
Analysis, CHAN,
patient portal
Workflow
optimization
discussion &
decision making
Status updates
vendor code fixes,
packages, etc.
Live
demonstrations on
workflow
Legal discussion/
review
15. 15
Use Dashboards to Monitor Metrics and Progress…
Each facility can
evaluate their stage
status with this multi-
stage graph.
Color coordination
along with bubble
presentations allow a
site to review each
metric, if the metric has
changed from one stage
or any course
corrections necessary.
These metrics are
available monthly for
site consideration.
17. 17
Challenging Objectives:
Patient Electronic Access
Hospital Leadership
Sponsor is key for
Portal Success (CFO
or CNO)
Must have a Portal
lead
Patient Registration
– needs to collect
35% emails
Round on Patients:
Portal Lead /
Volunteers / Light
Duty Worker
18. 18
Challenging Objectives: Patient Electronic Access
Meet weekly until you
hit the 8% level for
inpatients/ observation
then bi-weekly status
updates
Go for the two-for-
one opportunities
(Mom and Baby)
Portal Lead – manage the daily Unclaimed
Portal Invite report
• Assign rounding duties and focus on in-house patients
with portal invites
• Round on Cardiac and Orthopedic patients
• Round on Rehabilitation therapy clinic and Cardiac
therapy patients
19. 19
Challenging Objectives:
Patient Electronic Access
Use of volunteers, staff
members, and
temporary staff
Registration
involvement / gather
email address upon
admission
Accept invite before
discharge
Patient population does
matter
20. 20
• Clinical staff, HIM and Clinical
Informaticists can send invite to
access the portal
• Develop marketing materials
• Clinical staff needs to discuss the
portal when talking with patients
• Dignity Health hired a marketing
expert to develop materials and
outreach to work with our
hospitals marketing departments
Challenging Objectives: Patient Electronic Access
21. Domain A – Observation Services Method
(82% of Year-long Attestation)
21
Hospital Jul 26 Enroll Patients/Day 6%/Day Needed % of Goal
Site 1 9.7% 756 26 -2.8 -186 133%
Site 2 (Stage 1) 7.0% 246 12 0.2 13 95%
Site 3 (Stage 1) 5.3% 655 41 3.8 250 72%
Site 4 (Stage 1) 2.6% 256 33 7.1 468 35%
Site 5 6.5% 334 17 0.6 41 89%
Site 6 6.2% 440 24 1.2 82 84%
Site 7 8.0% 1241 52 -1.7 -110 110%
Site 8 11.4% 617 18 -3.3 -220 156%
Site 9 5.5% 189 12 1.0 65 75%
Site 10 9.5% 199 7 -0.7 -46 130%
Site 11 13.5% 1114 28 -7.7 -509 184%
Site 12 9.2% 288 10 -0.9 -60 126%
22. The VDT Marathon – Keeping the 6% Pace
22
Key to Columns:
A – Hospital Name
B – Week ending date and
cumulative % of goal
through last week’s data end
date
C – Week ending date and
cumulative % of goal
through this week’s data
end date
D – Number of days into this
365 day year as of ending
date for this week’s data and
corresponding day into the
365 day year based on the
hospital’s percent
completion as of this week’s
data
E – Month equivalent of
column D
F – Visualization of
corresponding month in the
year for current pace of
adoption
G – Finish Line; current rate
should achieve >5% for the
year even if no more OPC
enrollments
23. Challenging Stage 2 Meaningful
Use Objectives
Summary of Care
Public Health Reporting
24. 24
Challenging Objectives: Summary of Care
Cleaning up problem
lists (problems, allergies,
medications)
Identifying recipients
with Direct email
addresses (less than 1%)
Identifying top referring
providers and providing
Direct emails
• Credentialing
• Training/Education
Vendor selection and
procurement for Direct
email
25. 25
Challenging Objectives: Summary of Care
Resource needs for
manual sending of
summary of care
documents
Implementation and
testing of the ops
job (6 month effort)
Determining content
for C-CDA (e.g.,
including Radiology
results and timing)
Legal considerations
(referring
physicians)
NIST submission –
done by corporate
MU team
27. 27
Challenging Objectives:
Public Health Objectives
Dignity Health operates in 20 counties across three states
Most counties are not ready for Syndromic Surveillance
Monitor each public
health authority for
readiness to receive
data
Work with interface
team for testing and
readiness
Keep Audit defense
documentation
(emails)
Provide education
and training for the
hospital sites
Coordinate with
Vendor for Go lives
and MU Stages for
each hospital
Participate in
conference call with
vendors and state
agencies
Monitor failures and
recovery plan
28. 28
Public Health Status Tracker
Tracker data
elements:
• Hospital, Region,
County
• Cerner Domain
• Status and Notes
for each public
health objective:
–Registration
–Training
–Testing
–Production
30. 30
Source: MDEverywhere, Jan 2015
10,000
unique audits were
conducted on
265,075
Eligible Professional
attestations
4,601
have been completed
22.7%
of EPs failed to meet
meaningful use standards
98.9%
of failing EPs did not meet
appropriate measures and
objectives
31. 31
Source: MDEverywhere, Jan 2015
4,637
Eligible Hospital Attestations
(13.2%)
613
post-payment audits
were initiated from
4.9% of EHs failed their audits
The average incentive returned was $1.1 M
Total incentive recoupment has totaled $33 M
32. 32
Meaningful Use Attestation and Audit Statistics
Stage 2 attestations
through FFY 2014:
Dignity Health 10/10
= 100%
Successful
CMS/Figliozzi Audits:
• FFY 2013 2/2 = 100%
• FFY 2014 7/7 = 100%
State Medicaid Pre-
payment Audits: FFY
2013 1/1 = 100%
State Medicaid On
Site Financial Audits
– 1 pending
OIG Audits of State
Medicaid EHR
program – 7 pending
CHAN Internal Audits
– documented action
plans
33. 33
Audit Defense Template Guide
Detailed audit defense checklist
documents:
• Audit documentation
requirements
• Supplied by (department)
• Completion status
• Owner (individual’s name)
• Owner facility, department and
title
• Document name
• Document Specifics and
Comments
• Document location (electronic
and paper-based)
34. CMS/Figliozzi Audits Against FFY 2013
Milestone Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 Site 7
Initial
notification
May 20 May 20 May 20 May 20 May 20 May 20 Jun 30
Due date Jun 17 Jun 17 Jun 17 Jun 17 Jun 17 Jun 17 Jul 14
Response date Jun 13 Jun 13 Jun 11 Jun 16 Jun 13 Jun 13 Jul 3
Follow-up
Request
Aug 8 N/A Aug 8 N/A Aug 8 Aug 8 Jul 8
Follow-up Due
Date
Aug 22 N/A Aug 22 N/A Aug 22 Aug 22 Jul 22
Follow-up
Response
Aug 13 N/A Aug 13 N/A Aug 13 Aug 13 Jul 9
Final
determination
Sep 2 Aug 25 Sep 2 Sep 8 Sep 2 Sep 8 Jul 28
Outcome PASS PASS PASS PASS PASS PASS PASS
34
35. Figliozzi Scope of Request – Five Topics in Three Parts
35
• Proof of use of a Certified EHR system
• Documentation to support the method chosen to
report ED admissions
Part I – General
Information:
• Supporting documentation for core measures used in
the completion of the Attestation Module
• Provide proof that a security risk analysis of the
Certified EHR Technology was performed prior to the
end of the reporting period
Part II – Core Set
Objectives/Measures:
• Supporting documentation for menu measures used in
the completion of the Attestation Module; supporting
documentation for non-measurable menu items
claimed
Part III – Menu Set
Objectives/Measures:
36. 2015 Office of the Inspector General (OIG) Audits
Summary
Milestone Site 1 Site 2 Site 3 Site 4 Site 5 Site 6
Initial notification Apr 15* Apr 17 Apr 17 Apr 15 Apr 17 Apr 15*
Due date Apr 28 Apr 30 Apr 30 Apr 28 Apr 20 Apr 28
Response date May 6 Apr 28 Apr 29 Apr 27 Apr 28 May 7
Notification
letter sent to:
Administration
Manager Senior
Executive Assistant
Chief
Financial
Officer
Vice President
of Finance and
CFO
Regulatory
Compliance
Manager
Facility
Compliance
Professional
Director of Quality
Years Audited 2013-14 2012-14 2011 & 13 2012-13 2011-13 2011-14
At Stake $4.75M $5.66M $3.213M $3.304M $3.785M $5.249M
2nd Request Jun 12 Jun 17 Jun 15 N/A Jun 11 N/A
2nd Request Due Jul 6 Jul 6 Jul 6 N/A Jul 6 N/A
2nd Submission Jul 1 Jun 26 Jun 24 N/A Jun 23 N/A
Final
determination
TBD TBD TBD TBD TBD TBD
Outcome PENDING PENDING PENDING PENDING PENDING PENDING
36
* Initial notification went undetected until after the response due date. OIG
was contacted and a new 10 business day response period was granted.
37. 37
See Appendix for detailed questions.
OIG Audits of State Medicaid EHR Incentives
Scope of Initial Request
State Medicaid
Enrollment
Medicaid Patient
Volume
Medicaid EHR Hospital
Payment Calculation
Certified EHR
22 Questions in Four
Sections, Covering…
38. 38
OIG Audits of State Medicaid EHR Incentives
Submitted Documents
Cover Letter
Questionnaire and
Document Request with
Embedded Responses or
Reference to
Attachments
Patient Volume
Information
Cost Report Documents Calculation Tools
Vendor Verification
Letter(s)
CMS Certification ID;
Certified Product List
Screen Shots of Access
to EHR
40. New Rules –
Released Oct 6; Published Oct 16, 2015
40
Electronic Health Record Incentive
Program -- Stage 3 and
Modifications to Meaningful Use in
2015 through 2017
Released Oct 6
https://federalregister.gov/a/2015-
25595
PI version = 752 pages
2015 Edition Health Information
Technology Certification Criteria,
2015 Edition Base Electronic Health
Record Definition, and ONC Health
IT Certification Program
Modifications
Released Oct 6
https://federalregister.gov/a/2015-
25597
PI version = 560 pages
41. Stage Of Meaningful Use Criteria By First Payment Year
41
• The focus of the first three
stages remains as follows:
stage 1, capture data in
structured formats; stage 2,
improve clinical processes;
stage 3, drive patent
population health outcomes
• First year measurement
requirement (regardless of
year) remains 90 continuous
days of meaningful use in
that payment year.
• All subsequent years, the
measurement requirement
is for the entire year. For
2015, the measurement
period is 90 days within the
15 months ending Dec 31,
2015. Stage 3 period in
2017 is 90 days.
Source: 2015-25595-PI.pdf, pp. 60-61
1st Yr MU 2015 2016 2017 2018 2019ff
2011 M M M or
2012 M M M or
2013 M M M or
2014 M M M or
2015 M M M or
2016 N/A M M or
2017 N/A N/A M or
2018 N/A N/A N/A
2019ff N/A N/A N/A N/A
M = Modified Stage 2
= Stage 3
42. 1. Protect Patient Health Information
• Conduct/review Security Risk Analysis (SRA);
correct deficiencies
2. Electronic Prescribing (eRx)
• >60% Eligible Professionals; >25% Eligible
Hospitals
• Permissible prescriptions only
• Drug formulary checks
3. Clinical Decision Support (CDS)
• 5 CDS interventions
• Drug-drug/allergy checks
4. Computerized Provider Order Entry (CPOE)
• >60% medication orders
• >60% laboratory orders
• >60% diagnostic imaging orders
5. Patient Electronic Access to Health Info
• >80% can access to View, Download or
Transmit (VDT) w/in 24 hours via portal or
Application Programming Interface (API)
• >35% identify patient education and
electronic access to education materials
6. Coordination of Care through Patient
Engagement *
• >5% 2017 >10% 2018ff VDT (portal or API)
• >5% 2017 >25% 2018ff exchange secure
messages
• >5% patient-generated health data from non-
Inpatient or Emergency setting
7. Health Information Exchange (HIE) *
• >50% create and send Summary of Care (SOC)
electronically
• >40% SOC incorporation from other EHR
• >80% clinical information reconciliation
(meds, allergies, problems)
8. Public Health and Clinical Data Registry
Reporting **
• “Active engagement” with three options:
registration, testing & validation, production
• Six data types: immunizations, syndromic
surveillance, electronic case reporting, public
health registry, clinical data registry,
electronic reportable laboratory results
Final EP and EH Objectives and Measures for Stage 3 MU
2017 and Following
* Must report data on all three measures but only meet thresholds for two of three measures.
** Must choose four of six data types to report on for EH; three of six for EP
42
43. 43
Key Takeaways - Critical Success Factors
Governance and program
organization are critical to
success
Executive and clinical
sponsorship are essential
for decision making,
resource allocation and
barrier elimination
Identify and involve all
stakeholders
Use program and project
management
methodology
Share and leverage
leading practices between
sites
Monitor performance on
key measures
continuously
Focus on documentation
anticipating audits
Communicate,
communicate,
communicate!