Selecting and Implementing a Meaningful EHR System

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REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. . Speakers. David Groves, HealthBridge Executive Director, Tri-State Regional Extension CenterMary Zile, Director, Practice Consu

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Selecting and Implementing a Meaningful EHR System

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1. Selecting and Implementing a Meaningful EHR System ScottScott

2. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Speakers ScottScott

3. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Many Good Systems Tri-State REC has 5 supported EHR systems Preferred pricing & contract terms Looking For the Best Fit for Your Practice ‘First Look’ at an EHR Office Flow Evaluate Your Initial “Need versus Want List’ Vendor Demonstrations Qualifying Vendors Differentiating Factors Vendor Bids Vendor Quotes Site Visits to Look at Qualifying EHRs References Informed Decision Contract Analysis Overview ScottScott

4. Qualifying Vendors REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . ScottScott

5. Differentiating Factors REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . ScottScott

6. Soliciting Vendor Bids REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Request For Bid (RFB) Gather information and understand each vendor’s functionality Rate the contenders against your Differentiating Factors Use an objective scoring methodology ScottScott

7. Vendor Quotes REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Standardized Format Enables head-to-head price comparison Roll everything up into 5-year grand totals for: Software Services (e.g. implementation) Hardware MichelleMichelle

8. Compare “Apples to Apples” REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

9. Vendor Demonstrations REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

10. Site Visits REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

11. References REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

12. Informed Decision REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

13. Contract Analysis REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

14. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Implementation Overview ScottScott

15. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Collaborative Implementation Plan ScottScott

16. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Technical Assessment ScottScott

17. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Hardware Lessons Learned ScottScott

18. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Software ScottScott

19. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Health Information Exchange ScottScott

20. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Quality Reports ScottScott

21. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Data Conversion ScottScott

22. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Work-Flow Re-Design & Template Customization ScottScott

23. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services. Patient / Practice Communication ScottScott

24. EHR Goals for Practice Transformation Patient Centered Medical Home Meaningful Use is the use of a Certified EHR: In a meaningful manner such as e-prescribing or providing a patient with an electronic copy of their clinical record. For electronic exchange of health information to improve the quality of health care. To submit Clinical Quality Measures (CQM) and other measures as selected by the Secretary of HHS. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

25. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Personal Physician - each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care. Team Care - the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients Whole Person Orientation - the personal physician is responsible for providing for all the patient’s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. Care is Coordinated - across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g., family, public and private community-based services). Care is facilitated by Information Technology – EHRs, Registries and Health Information Exchanges are utilized to support optimal patient care, performance measurement, patient education, and enhanced communication Enhanced access to care is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff. Quality and safety are hallmarks of the medical home and Physicians in the practice accept accountability for continuous quality improvement Joint Principles of PCMH

26. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Enhance Access and Continuity: Accommodate patient needs with access and advice during and after office hours; provide patients with team-based care Identify and Manage Populations: Collect and use data for population management Plan and Manage Care: Use Evidence-based guidelines for preventive, acute and chronic care management. Provide Self Care Support and Community Resources – Assist patients and their families in self-care management with information, tools, and connections to community partners Track and Coordinate Care: Track and manage referrals, care transitions, and clinical results. Measure and Improve Performance: Use data to continuously measure and improve care quality and patient experience. PCMH Recognition Standards

27. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

28. REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Value-Driving Elements of Patient Center Medical Home and Accountable Care Organizations Enhanced Access Better Care Coordination Better Health IT Payment Reform for Primary Care

29. Donald M. Berwick, MD Administrator Centers for Medicare and Medicaid Services Dear Colleagues: As you may know, the topic of patient-centered care is dear to my heart. I believe that, of the six IOM Aims for Improvement - safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity - “patient-centeredness” is the keystone and that, from it, the others properly devolve. To me, “patient-centered care” is care that respects each person as an individual, honoring his or her backgrounds, their families and their choices.

30. Raising the Bar for PCMH NCQA Releases New Standards for PCMH PCHM 2011 More Patient-Centeredness required Increase emphasis on Patient Feedback Federal Meaningful Use Language is embedded in the standard Greater emphasis on the use of HIT Reinforces incentive to use HIT to improve quality Implements 6 “must pass” elements

32. PCMH 2011 and Meaningful Use Electronic Prescribing Drug Formulary, drug-drug, drug-allergy checks Maintain active problem list and current diagnosis and meds Record patient demographics including race, ethnicity and preferred language Record and chart changes in vital signs Record smoking status Report quality measures Implement clinical decision support 3E: Use Electronic Prescribing 3E: Use Electronic Prescribing 2B: Clinical Data 2A: Patient Information 2B: Clinical Data 2B: Clinical Data 6F: Report Data Electronically 3A: Implement Evidence-based Guidelines

33. Summing Up Health IT is essential to PCMH recognition Health IT elements that enable practice transformation Certified EHR system Disease Registry (within or integrated with the EHR) Patient Portal supporting Electronic receipt of patient care information and results Schedule requests Prescription refill requests Secure patient-provider e-mail Information about the primary care practice and services Patient surveys Health Information Exchange supporting Results delivery Electronic Referrals and Transitions of Care Future EHR Certification and Meaningful Use Requirements will be influenced by evolving aspirations for PCMH

34. Questions? REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

35. END REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

36. Objective Scoring Tool REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . Weighted Decision Matrix Award points to vendor responses Total points in each category (differentiating factor) Multiply points by the weight you assigned Grand total score will rate how well the vendor’s functionality meets your needs ScottScott

37. Vendor Responses REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . ScottScott

38. Open-Ended Questions REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . ScottScott

39. Compare Scores Add up scores in each category Highest overall score means this vendor is most likely to perform well in your practice Highest score is also an indication of Best Functionality Eliminate vendors that “settle to the bottom” REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . ScottScott

40. Vendor Quotes REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

41. Services Quotes REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

42. Hardware Quotes REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

43. Vendor Demonstrations REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . MichelleMichelle

44. Site Visits REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

45. References REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services . JimJim

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