6/9/14. Life Beyond File Folders WHY I M HERE. Understanding Electronic Health Records (EHRs) OBJECTIVES WHAT ARE YOUR OBJECTIVES?

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1 Life Beyond File Folders Understanding Electronic Health Records (EHRs) Annie Schwain, MA, LADC, LAMFT With special thanks to: Trish Stark, Ph. D, LP, MPA Pam Luienburg, MSW, LGSW Kristin Fiedler, BS WHY I M HERE There is an EHR Mandate in MN Want to support and encourage understanding of the mandate and compliance with it Want to provide basic information, including first steps to begin the process Want to work collaboratively across the behavioral health disciplines to support each other OBJECTIVES WHAT ARE YOUR OBJECTIVES? Know that there is an EHR mandate and that it applies to you Understand what a certified EHR is Understand the interoperability process Be aware of privacy and security concerns and how these can be addressed Learn points to consider when selecting / implementing and EHR Identify next steps and resources to assist in the process Review the quiz that you just filled out What concerns did this bring up for you? What questions do you want to have answered? WHAT IS THE MINNESOTA MANDATE? WHO DOES THIS APPLY TO? The 2007 Minnesota Legislature mandated in Minnesota Statute 62J.495 (Electronic Health Record Technology), that By January 1, 2015, all hospitals and health care providers must have in place an interoperable electronic health records system within their hospital system or clinical practice setting. The commissioner of health, in consultation with the Minnesota e- Health Advisory Committee, shall develop a statewide plan to meet this goal, including uniform standards to be used for the interoperable system for sharing and synchronizing patient data across systems. MDH understands the 62J.03 portion of the 2015 Interoperable EHR Mandate to include any health care provider who provides a service that could be reimbursed by Medical Assistance or Minnesota Care, whether or not the provider accepts these patients or accepts payment for the service. This includes mental health centers; group/private practice; and chemical dependency services Reference: Reference: Guidance for Understanding the Minnesota 2015 Interoperable EHR Mandate 1

2 WHAT ARE WE TALKING ABOUT? BENEFITS OF EHRS There are 3 commonly referenced items that are similar, yet distinct: EMR (Electronic Medical Record) EHR (Electronic Health Record) PMR (Personal Medical Record) Experience has shown that an EHR can actually facilitate providerpatient communication and patient education. Patients will increasingly expect e-health, including personal health records, online appointments and the ability to with their clinicians. Increased efficiency and quality outcomes Improved ability to avoid adverse events Timely access to information from your patients other providers They are needed to participate fully in the changing healthcare landscape Reference: Addressing Common Barriers to EHR Adoption: A Practical Guide for Healthcare Providers, MN Department of Health; HOW TO GET THERE CERTIFICATION Continuum of EHR Adoption The Minnesota Model Achievement of 2015 Mandate Adopt Utilize Exchange Assess Plan Select Implement Effective Use Readiness Interoperate To meet the requirements of the statute, providers must meet the following criteria when implementing a secure interoperable EHR system. The EHR must be certified by the Office of the National Coordinator (ONC) pursuant to the Federal Health Information Technology for Economic and Clinical Health (HITECH) Act. This criterion applies to providers if a certified EHR is available for their setting. Reference: The ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed. Reference: INTEROPERABILITY INFORMATION EXCHANGE What are we exchanging How are we exchanging it? Why are we exchanging it? 2

3 WHAT ARE WE EXCHANGING? CCD TEMPLATES Purpose Problems Procedures Family history Social history Payers Advance directives Alerts Medications Immunizations Medical equipment Vital signs Functional status Results Encounters Plan of care HOW ARE WE EXCHANGING IT? EXAMPLE OF A PUSH TRANSACTION Unstructured data Structured data for clinical decisions Analyzable Information Clinical Summary Provider A HIE Provider Received by Provider B Automatic EXAMPLE OF A PULL TRANSACTION Can Mary s therapist have her information? Request is sent for information Yes, she has given permission HIO Therapist Where is Mary s record? Can I get her information? Previous Care Provider 3

4 PRIVACY AND SECURITY PRIVACY AND SECURITY Secure logins and passwords Restrictions based on roles Audit trails Break the Glass Compliance officers can see when people access information that they should not have access to Ability to opt out of exchange process Remember that most breaches in confidentiality come from individual staff being careless in how they treat confidential information Protect your client s privacy! Protect your practice and license! There are two sets of documents. EHR Has all of the client s medical records and is ready to go when requested Snapshot More tailored requests for specific information Psychotherapy notes Personal notes you take for your own use IMPLEMENTATION PROCESS THINGS THAT YOU DON T WANT TO DO 1) Assess Your Practice Readiness 2) Plan your Approach 3) Select or Upgrade to a Certified EHR 4) Conduct Training &Implement EHR 5) Maintain 6) Optimize - Continue Quality Improvement Implement the software without proper planning Select the first EHR vendor you come across Select a EHR vendor without checking references Don t duplicate ineffective processes Perform little or no testing Skimp on training THINGS THAT YOU DON T WANT TO DO NEXT STEPS TO TAKE Learn to be a good consumer! Talk with colleagues about what has and hasn t worked in their process What concerns / problems have others had in using an EHR? Connect with colleagues for support stay in contact with your associations Check out the free BH Toolkit from Stratis Health Begin completing the assessment worksheets and identify the needs for your practice Analyze your work flow and identify changes to make Wait for the results of the vendor fair coming in mid-june Begin looking into options for financing, including loans 4

5 Minnesota Department of Health (MDH) E-Health Initiative : Explains the law and who is impacted Resources for implementing the guidance across all healthcare settings Support development of toolkits and resources for more health and health care settings Engage professional associations to develop resources and disseminate information to providers Web site with an extensive section on health data standards, including primers on the need for and types of standards, currently establish standards and other resources Grants & no-interest loans available from the State of Minnesota Stratis Health Doctor Office Quality Information Technology (DOQ-IT): Detailed planning and implementation roadmap, complete with dozens of worksheets and other planning tools Find it under Health Care Professionals, then Health Information Technology. Stratis Health also has a comparable toolkit for small and critical access hospitals (the Health Information Technology Toolkit for Small and Critical Access Hospitals). Developed a toolkit specific for behavioral health providers available free online HealthIT.gov Federal website that provides information regarding the EHR basics, implementation recommendations, and EHR research. Certification Commission for Healthcare Information Technology (CCHIT) at: List of nationally certified EHR products based on a demonstrated ability to meet criteria for functionality, interoperability and security. 5