Harnessing the Potential of EHR s Clinical Decision Support and Portals to Improve the Quality of Care. Virna Little, PsyD, LCSW-r, SAP

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1 Harnessing the Potential of EHR s Clinical Decision Support and Portals to Improve the Quality of Care Virna Little, PsyD, LCSW-r, SAP

2 If You Do What You Have Always Done.. You are going to get what you always got.

3 Triple AIM

4 Triple AIM Improve Patient experience Decrease Costs Improve Quality

5 What is a Clinical Decision Support Simply Stated Individual patient prompt Meet a quality measure Real time prompt at point of care Reminder for evidence based practices/guidelines

6 Why Decision Supports? Improve quality of care Improve outcomes Track compliance to quality guidelines Identify providers who need support Compliance

7 Tremendous Opportunities Comprehensive Management Making decisions from real data Population Management Quality Care/ Outcomes Patient Experiences

8 What are the benefits? Communication Improved Care Compliance Savings 8

9 Looking to the Future

10 EMRs in the therapy session can be used to engage patients and review decision supports together! 10

11 The New Manager. How can we use the system to solve this problem? What data do we need to help solve this problem? Where in the system will we want this information? What do you do differently?

12 A Real Life Example.. Addressing issue of suicide risk across system Thinking of a spectrum and using the system across the spectrum to address a problem

13 PHQ9 Tool Used consistently throughout health centers Speak the same language Attention to question 9

14 Screening for Depression BPA for annual PHQ-2 PHQ-9 BPA

15 Decision Support Reminder to providers Allows quick access to needed tools or resources Can be hard stop Ability to report on providers who ignore decision supports

16

17 Monitoring Depression Graphing Results

18

19 Suicide on the Problem List Blows into all encounters Readily seen by providers of all disciplines Able to be reported on ( number of patients)

20 Suicidal Ideation Problem List Documentation

21

22

23 FYI and Flagging

24 Suicidal Ideation- New Red Banner

25 Safety Planning- An interdisciplinary collaborative effort using the electronic record My Safety Plan document Allows safety plan information to be available to all providers during all visits for review and/or modification Patients can access the document via patient portal for reference Community providers can see patients at risk through physician portals Provided in print to patients as part of after visit summary Signed by patient and provider

26 Safety Planning

27 Safety Plan Suicidal Ideation

28 Shared Care Plan

29 What is a Patient Portal? A patient portal is a healthcare related online application that allows patients to interact with their healthcare providers.

30

31 My Goals and Plans You have a diagnosis of DEPRESSION Here are your personal treatment goals: Call you friend Ana on Tuesday at 7pm 31

32 Monitoring DePression with My Chart MyChart Questionnaires

33 Monitoring Depression

34 Suicide Risk Assessment Suicidal Ideation

35 Population Management Operational Reporting Key Parameters

36 Monitoring Depression PHQ-9 Reports

37 Dashboard Components

38 Registry and Analytic Reporting Depression Registry

39 It takes a Family.. Physician portal as link to community Almost 100 organizations and specialty providers on Institute Link Foster care, mental health residences, DD programs Pharmacy providers Seamless care system By-pass admissions Expedited services Decreased admissions

40 Overview of content in Medical Record

41 Chart Review

42 DIRECT SCHEDULING

43 What Does The Future Hold? Review of all patients completed and attempts analysis Hard stop decision supports for patients who are considered high risk Reports of patients who did not have safety plans reviewed

44 Compliance Use EMR for Compliance Program Documentation Completion Decision Supports Billing and Coding Reports Treatment Plans -60, 85 and 91 days

45 Regulatory and Compliance Ability to track and report on providers who ignore decision Supports

46 A Schedule Is Not Just a Schedule Anymore Clinical and Administrative Decision Supports Patient Status Incentives like my chart or other enrollment Open Encounters Hospital Discharges Shadow Templates Hotspotting Open Slot Reports

47

48 On The Back End Billing Collections Authorizations Credentialing Denials Decision Supports to Remind Providers to do OTR.

49

50 Patient Care Oversight.. Concurrent Documentation Time Spent Review Notes from Afar Open Encounters

51 Clinical Decision Supports A tough balancing act Support fatigue Rotating Supports Coordinating with current initiatives

52 Questions??? VirnaLittle.com

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