Practical guide for achieving meaningful use of an EMR in ambulatory care

1. Ambulatory Care EMR Meaningful Use:A Three-Level Approach LEVEL THREE: IT-ENABLED COMMUNITY Evidence-Based Practice Health Information Exchange Management Reporting Patient Interaction with the Medical Record Advance LEVEL TWO: INTEGRATED EMR SYSTEM Clinical Workflow Improvements Referrals & Results Tracking Document Management Streamlined Coding & Reimbursement Measureable Improvements in Patient Outcomes Integrate LEVEL ONE: BASIC EMR ADOPTION Stable Technical Environment Standards-Based EMR Application 80% Rule Full Documentation of Allergies, Vital Signs, Problem List, Medications, Orders E-Prescribing Cultivate K Galambos, RN, MSN, CPHIMS

3. More than 80% providers use EMR all the time AND/OR more than 80% of all patient charts are electronic.

4. Basic health information is entered as discrete data.

5. Electronic prescribing is used for more than 80% of eligible prescriptions. * In order to meet requirements for future data sharing, the EMR application must be standards-based K Galambos, RN, MSN, CPHIMS

7. Leadership adopts model practice recommendations for organizational change management, system selection, implementation planning, deployment, training, and follow-up

8. EMR adoption is measured and rewarded

9. Electronic prescribing identified as key indicator of success K Galambos, RN, MSN, CPHIMS

10. Level Two: Integrated EMR System LEVEL TWO: INTEGRATED EMR SYSTEM Clinical Workflow Improvements Referrals & Results Tracking Document Management Streamlined Coding & Reimbursement Measureable Improvements in Patient Outcomes In an Integrated EMR System, Meaningful Use is achieved as a result of consistent, standard usage of the EMR across the enterprise. Advanced EMR functionality such as decision support, lab processes, internal communications, and referrals tracking are incorporated into daily processes. Quality data is reliably produced and used for tracking individual and organizational performance, EMR optimization, and outcomes measurement. Organizational support and accountability are dedicated to optimizing and sustaining the EMR. K Galambos, RN, MSN, CPHIMS

12. Business Process Redesign/ Move Toward Paperless Flow

13. Integration with Ancillary Systems (labs, financial)

14. Quality and Performance Measurement Using EMR Data

15. Secure Technical Infrastructure with Privacy & Security OversightK Galambos, RN, MSN, CPHIMS

16. Level Three: IT- Enabled Community LEVEL THREE: IT-ENABLED COMMUNITY Evidence-Based Practice Health Information Exchange Management Reporting Patient Interaction with the Medical Record Few organizations have realized the degree of Meaningful Use inherent to an IT-Enabled Community. In this future state of EMR adoption, EMR data will be used to drive operational and quality improvements across the enterprise. Quantifiable health data will enable sophisticated initiatives such as patient-centric health care coordination, data-mining, and population health management. Technical components such as Patient Portal will allow self-scheduling, patient/provider communications, and access to health information for care transitions and continuity. Technology will be fully integrated into all aspects of the daily workflow, with resulting efficiency and cost savings. New roles & responsibilities will evolve for personnel to sustain the community. K Galambos, RN, MSN, CPHIMS

18. Mandatory Use of Standards-Based, Discrete Data Sets Enables Electronic Health Information Exchange

19. Technical Infrastructure Supports Interactions Between Patient/Family with Provider/Staff/Health InformationK Galambos, RN, MSN, CPHIMS

20. K Galambos, RN, MSN, CPHIMS