MU presentation I presented tot he champions. Survey after presentation is at: http://bit.ly/NYUMUSURVEY For more details I can be reached at: leanthonyrn@gmail.com or LinkedIN

1. M EANINGFUL U SE FOR
NYU C HAMPIONS
Leanthony Mathews, MSN, RN, CNML
LEANTHONY.MATHEWS@NYUMC.ORG
Presentation online at: http://bit.ly/NYUMUSLIDES

2. A GENDA
• Welcome
o Review of agenda and goals for the session
• History of Meaningful Use
• Define Meaningful Use
• Demo Epic Workflow MU Allergy objective
• Demo Epic Workflow MU Smoking objective
• Review Key Points
• Answer questions
• Next Steps
o Review homework

3. S ITUATION : P OOR
ADOPTION OF H.I.T.
• US lags behind other in industry
sectors and developed countries.

4. B ACKGROUND :
R EASONS
 Cost
 Software Quality and
Usability
 Standards

5. A SSESSMENT: P OOR
H.I.T.:
• Medical Errors
• Increased
healthcare cost
• Decreased quality
of care
• Increase
paperwork

6. • Increase the adoption of
the Electronic Medical
Record (EMR)
• Advance Health
Information
Technology(HIT)

7. S OLUTION : HITECH
A CT
• Signed into Law Feb 17,2009 by
President Obama with a Goal by
2015 to:
o reduce the -cost of care
o Improve patient-health
centered care
o Enhance patient safety
o Improve population care

8. W HAT IS M EANINGFUL
U SE?
• Meaningful Use (MU) =
Objective measures
that hospital report as a
result of HITECH act.

9. M EANINGFUL U SE -
R EPORT C ARD
Hospital Reports on 21 Different
Objectives

10. E XAMPLE F INAL H OSPITAL
R EPORT

11. M EANINGFUL U SE:
T HE RELIGION
• GIGO
• Adoption of
technology
Homework: What
one paper
• “Information
document in your
department do
wants to be free”
you feel Epic will
have problems
making
electronic?

12. W HY CHANGE ?
• Voluntary program and you attest to being a
MU.
• I don’t need an EHR to be a good clinician?
• Where do I find time to learn a new system?
• How do I find time to see patients and enter
my own data?
• It will slow me down?
• It so uncaring and not patient friendly.
• I like paper records!

13. I NCENTIVE : I MPROVE
PATIENT C ARE
o MU supports evidence based objectives to
improve patient outcome.
o MU supports patient-centric care that
engages patients and families
o MU helps reduce health disparities and
improve Population and Public Health
o MU improves care coordination
o DSS supports safe patient care

14. I NCENTIVE : R EVENUE
• $31 Billion Dollars available
for meaningful users of
electronic health systems.
• Hospital can receive
substantial income for
“meaningful use”

15. I NCENTIVE : N ON U SE
P ENALTY
• Penalties start in
2015

16. N EXT UP : E XAMPLES
• Any Questions
before we
move to
examples?

17. 21 C OMPONENTS OF
“M EANINGFUL U SE ”
• 1. Interoperability objectives
• 2. Objectives that measure clinical
use of EHR

18. MU O BJECTIVES : MEASURE
INTEROPERABILITY
Homework:
Currently,
what clinical
information
about your
patient do • Report hospital quality measures to CMS (Stoke, ED
you throughput)
constantly
struggle • Exchange clinical information with other institutions
locating in the
patient chart? • Submit electronic data to immunization registries

19. MU O BJECTIVES : MEASURE
CLINICAL USE OF EHR
• Computerized Practitioner Order Entry
(CPOE)
• Record demographics
• Maintain active medication list
Every Patient
Encounter • Maintain active problem list
Homework: • *Maintain active Allergy list
Currently,
which one • *Record smoking status for patients 13
Clinical MU
Measure does
years or older
your unit
struggle to
• Medication Reconciliation
complete?

20. MU R ULE : A LLERGY L IST
• Objective :Maintain active
medication allergy list.
• Measure : More than 80 percent of all
unique patients admitted to the eligible
hospital’s have at least one entry (or an
indication that the patient has no known
medication allergies) recorded as structured
data.
Evidence:
Adverse drug events in hospitalized patients. Excess
length of stay, extra costs, and attributable mortality.
JAMA. 1997 Jan 22-29;277(4):301-6.

21. W ORKFLOW TO MEET MU OR
ITEM
-Patient admitted using
Admission Navigator in
Epic.
-During your admission
suggested workflow you
Homework:
Describe one
will come to the allergies
clinical section.
workflow you
are concerned
that Epic EHR
will struggle to
capture,
specific to your
department?

22. W ORKFLOW TO MEET MU OR
ITEM
-Select No known allergies check box
-Select Mark as Reviewed.
-If patient leaves the hospital with no
data in the No known allergies measure
Fails.

23. R ECORD A LLERGY OBJECTIVE

24. E XAMPLE F INAL H OSPITAL
R EPORT
Allergy
Objective
(80%):
Out of 1287
patients seen:
92% (passed)
8% (failed)

25. MU R ULE : S MOKING S TATUS
• Objective :Record smoking
status for patients 13 years old
or older.
• Measure : More than 50 percent of all
unique patients 13 years old or older or
admitted to the eligible hospital’s inpatient
or emergency department have smoking
status recorded as structured data.
Evidence:
Smoking cessation counseling should be provided. Smokers
are 2 to 3 times more likely to get pneumonia than
nonsmokers and are at risk of more severe disease Cleve
Clin J Med. 2005 Oct;72(10):916-20.

26. W ORKFLOW TO MEET MU OR
ITEM
-Select Tobacco use status of patient.
-If patient leaves the hospital Never Assessed measure
Fails. All other sections give credit. Including Unknown
If Ever Smoked.

27. R ECORD S MOKING O BJECTIVE

28. E ND OF YEAR R ESULTS FOR
S MOKING O BJECTIVE
Record Smoking
-End of the reporting
period
-For the entire Hospital
-Inpatient and ER
admissions

29. K EY TAKEAWAYS
• Key: Start with education of users on correct
workflow – Minimize Work Around
• Key: Real Time Documentation - Minimize
Batch Documentation
• Key: Utilize reports / Best Practice Advisories –
Reports and Advisories are your friend.
• Key: Standard data capture. Put information in
correct electric place - Paper is going away.

30. S OURCE READING
• Centers for Medicare & Medicaid Services
https://www.cms.gov
• The Meaningful Use Attestation Calculator
https://www.cms.gov/apps/ehr/

31. M EANINGFUL U SE :
• Questions?

32. H OMEWORK
• Currently, what clinical information about your
patient to do you constantly struggle locating in
the patient chart?
• What one paper document in your department
do you feel Epic will have problems making
electronic?
• Currently, which one Clinical MU Measure does
your unit struggle to complete?
• Describe one clinical workflow you are
concerned that Epic EHR will struggle to capture,
specific to your department?

33. Thank you for your
Time!
This entire presentation can be found online at:
http://bit.ly/NYUMU2012
Please take 5 minutes to complete the Survey about MU in you area:
It can be found at: http://bit.ly/NYUMUSURVEY