WHAT IS THE DEFINITION OF MEANINGFUL USE (MU)?
• MU is using certified electronic health record (EHR) technology to:– Improve quality, safety, efficiency, and reduce
health disparities– Engage patients and family– Improve care coordination, and population
and public health– Maintain privacy and security of patient
health information DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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WHAT ARE THE OBJECTIVES OF MEANINGFUL USE
• Ultimately CMS hopes that MU will result in – Better clinical Outcomes– Increased transparency and efficiency– Empowered individuals– More robust research data on health systems
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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STAGES OF MEANINGFUL USE
• 2014• Stage 2• Advance clinical
processes
• 2016• Stage 3• Improve
outcomes
• 2011-2012• Stage 1• Data capture
and sharing
• NWH is preparing to begin MU Stage 2 reporting on July 1st 2014
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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OVERVIEW – MU 2 OBJECTIVESObjective Stage 2 Measure Stage 1 Measure
CPOE >60% Med orders>30% Lab >30% Radiology orders
>30 % Med orders
Demographics >80% of eligible patients >50% of eligible patients
Vital Signs >80% of eligible patients >50% of eligible patients
Smoking Status >80% of eligible patients >50% of eligible patients
Clinical Decision Support 5 Clinical Decision Support RulesAligned with Clinical Quality Measures
1 Clinical Decision Support Rule
Patient Electronic Access >50% of eligible patients have their info avail. online within 36 hours of discharge>5% view download or transmit health info.
New for stage 2
Protect E PHI • Continued review and security risk analysis
• Encryption of data at rest
Initial review / security risk analysis
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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OVERVIEW – MU 2 OBJECTIVES CONT.Objective Stage 2 Measure Stage 1 Measure
Clinical Lab – Test Results >55% >40%
Patient Lists At least one list (required) At least one list (optional)
Patient Specific Education Resources
>10% (required) >10% (optional)
Medication Reconciliation >50% (required) >50% (optional)
Summary of Care >50% of transitions of care and referrals>10% of transitions leverage electronic transmission, Healthcare exchange
Not pursued by NWH(optional)
Immunization Registries Data Submission
Ongoing submission of Immunization data to an Immunization registry
Test of capability
Submission of Lab results to Health Agency
Ongoing submission of Lab results to Health Agency
(Optional)
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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OVERVIEW – MU 2 OBJECTIVES CONT.Objective Stage 2 Measure Stage 1 Measure
Syndromic Surveillance Data Submission
Ongoing submission of Syndromic Surveillance data to Health Agency
(Optional)
Electronic Medication Administration Record (eMAR)
>10% of med orders are tracked using eMAR
New for stage 2
Advanced Directives >50% of eligible patients have an indication of an advanced directive status recorded
(Optional)
Imaging Results in Certified EHR
>10% of all scan and test images are accessible through cert. EHR
New for Stage 2
ePrescribing >10% of hospital discharge med orders are transmitted electronically
New for Stage 2
Reporting on Clinical Quality Measures
Reporting on 16 of 29 available CQMs
Successfully report to CMS hospital clinical quality meas. using certified technology.
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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MU INITIATIVES
• CPOE• Med Reconciliation• Drug-Drug/ Drug-Allergy
Alerts• Plans of Care – Problem
Management• Patient and Clinical Portals• Data Standards• LOINC Codes/ ELR Interfaces• Ethnicity • Race
• Smoking Status • Immunizations• Discharge Process
– Discharge Assessment– Discharge Clinical Letter– Patient Specific Education
• Transition of Care Document
• Krames Patient Education• ePrescribing
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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USES FOR TRANSITION OF CARE DOCUMENT
• One Document leveraged to address the needs of 2 MU measures.
• 50 % of patients able to View online Download and Transmit info related to their hospital visit w/in 36 hours
• 50% of patients transfers or referrals include a Summary of Care doc; 10% of these sent electronically
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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TRANSITION OF CARE SECTIONS Extracted from Data Sources Document Header Allergies (RxNorm) Problems and Encounter Diagnosis
(SNOMED-CT) Configured Results (LOINC for
Laboratory) Discharge Medications (RxNorm) Immunizations (CVX) Procedures (SNOMED-CT) Chief Complaint Customer Configurable
Detailed instructions Social History Functional Status Vital Signs (HT, WT, BP, BMI) and
other configured Observations Reason for Visit Treatment Plan Hospital Course
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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TRANSITION OF CARE DOCUMENT HEADER
Auto-populated with data when the CCDA has been generated. STAR is the data source The Header includes:
Date range that the document summarizes Location of Care, Entity, Service, Caregivers Race and Ethnicity Patient’s sex and date of birth Patient’s preferred language Account number, medical record number, visit identifier
Patient’s masked Social Security number – Last 4 digits
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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CHALLENGES
• Not being able to limit results• Vendor limitations• Capturing Medical Problems • Capturing Procedures
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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CHALLENGES (CON’T)
• Auto Generation of ToC• Communication to staff/patients• Patient Provisioning
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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DISCHARGE PROCESS• Discharge Assessment
– Timing of Discharge Orders– Appropriate Roles/ Scope of Practice in completion of
assessment– Moving from paper to electronic (Soarian)
• Discharge Instructions Report– Creating a patient friendly, readable report– Supplemented by patient education materials from Krames
• Patient Specific Education ( Krames)• UW Medicine Standard for patient education
– Using “infobutton” in Soarian
DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist
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Our MU2 reporting period starts on July 1st, we’ll collect data to prove that we’re meeting our objectives and making it all work
Q: The recognition and incentive reward will be nice, but what’s our real, big-picture goal?A: We have amazing technology & want to use it in the best possible way to benefit our patients!
Secure online website that gives patients convenient 24-hour access to personal health information and other
health tools from anywhere with an Internet connection
THE PATIENT PORTAL