CLINICAL DECISION-SUPPORT SYSTEMS (ALERTS), WHAT ARE THEY AND CAN THEY HELP MY PATIENT?
|
|
|
- Emma Crawford
- 8 years ago
- Views:
Transcription
1 CLINICAL DECISION-SUPPORT SYSTEMS (ALERTS), WHAT ARE THEY AND CAN THEY HELP MY PATIENT? Robert Sherwin, MD Assistant Professor of Emergency Medicine Wayne State University School of Medicine Sinai Grace Hospital/Detroit Receiving Hospital Detroit, MI USA March 6 th, 2013 Park City, Utah
2 Learning Objectives 1. Understand the background, requirements and structure of clinical decision support systems 2. Understand specific CDSS applications and the evidence supporting their use. 3.Understand specific components that improve the success of CDSS implementations.
3 Disclosures None
4 The concept was first introduced > 60 years ago Ledley & Lusted Proceedings of the IRE, Dec 1959
5 Abbreviations CPR computerizes EMR - electronic medical record EHR - electronic health record CDDS - computer decision-support system CCDS Computerized clinical decision support KMSs knowledge management systems CPOE - computerized provider order entry NSO Nursing safety issues
6 Clinical Decision Support Systems (CDSS) The Health Information Technology & Clinical Health Act (HITECH; a component of ARRA 2009) provides incentive payments (and future penalties) to support EHR adoption. $27 billion in incentives over 10 years Graduated penalties in Medicaid & Medicare payments beginning in 2015 for for those failing to adopt EHR Hospitals & eligible providers must demonstrate meaningful use of their EHR One of the meaningful-use core objectives involves the use of a clinical decision support rule (CDSS) that addresses a hospitaldefined, high-priority condition. CDSS goals: to help physicians make better decisions & avoid preventable errors.
7 Computer Decision Support System Sucher et al, J of Trauma 2008
8 Clinical Decision Support Systems (CDSS) CDSS may be defined as information systems that aid providers in various aspects of clinical decision-making laminated pocket cards that outline CPR checklists more typically are paper/computer-based order-sets & reminder systems. PDA s, ipad, iphones etc Going to focus on EHR-based CDSSs
9 Clinical Decision Support Systems CDSS utilize the patient information in the EHR & existing medical evidence à runs through various algorithms to deliver computer-generated recommendations CDSS can provide a broad variety of support: reminders for overdue treatments alerts for abnormal values assistance with medication prescribing & medication allergies Critical lab values Interpretations of images or waveforms Generation of differential diagnoses Immunization reminders Prompts for missing clinical data or regulatory compliance
10 Clinical Decision Support Systems Active (also called executable ) CDSS are found in computer software that integrates predetermined rules with patient data to automatically deliver information to the clinician. Recommendation for care offered, clinician makes final decision Passive CDSS consists of optional links for the clinician to seek information Reference to links and evidence based content is made available if the clinician chooses to view
11 Types of CDSSs Sucher et al, J of Trauma 2008
12 STRUCTURE & DEVELOPMENT OF CDSS
13 Sucher et al, J of Trauma 2008
14 Garg et al JAMA 2005
15 Were recommended treatments ordered? Were recommended studies ordered? Bright et al Annals of Internal Med 2012
16 Outcome Evidence # Studies Results (95% CI) Length of stay Low 6 RR, 0.96 ( ) Morbidity Moderate 22 RR, 0.88 ( ) Mortality Low 6 OR, 0.79 ( ) Adverse events Low 5 RR, 1.01 ( ) Preventive care High 43 OR, 1.42 ( ) Clin. study ordered Moderate 29 OR, 1.72 ( ) Recommended Rx High 67 OR, 1.57 ( ) Clinical Workload Insufficient NA Efficiency Insufficient NA Cost effectiveness Insufficient NA Bright et al Annals of Internal Med 2012
17 Lobach et al. Evidence Report No AHRQ 2012
18 Features found to be associated with CDSS success: Integration with charting or order entry Promotion of action versus inaction No need for additional clinician entry Justification of decision suppclinort via research evidence Local user involvement Provision of decision support results to patients & providers Automatic decision support as part of clinician workflow Provision at the time and location of decision making Provision of a recommendation, not just an assessment Lobach et al. Evidence Report No AHRQ 2012
19 CDSS Successful Development 75% of CDSS were successful if integrated into the physicians workflow / 0% were if they required an interruption. Kawamoto et al BMJ 2005 Alerts should be sensitive and specific, difficult to ignore, contained within the physician workflow and automatically captured by a reporting system Guilano et al AACN 2009
20 CDSS Successful Development Studies of home grown CDSS reported better performance w/studies w/independent CDSS development process (74% vs 28%; P=0.001) 7 / 100 CDSS trials reported any patient outcome improvement Garg et al JAMA 2005 Physicians are more likely to follow recommendations if they understand the rationale Schiffman et al JAMIA 1999
21 CDSS Successful Development CDSSs with these 9 features favorably impact health care processes No or limited evidence to suggest improvements in: morbidity clinical outcomes economics, workload or work efficiency patient length of stay Locally developed or commercial product Academic or community environment Ambulatory or hospital-setting Single or multiple sets or conditions
22 What types of rules? Dichotomous rule Inexplicit/judgment rule Threshold rule with executable instruction Sucher et al, J of Trauma 2008
23 CRITICAL CARE APPLICATIONS Critical problem is how to consistently and efficiently implement evidence based guidelines for critically ill patients
24 Dr Peter Provonost, Vice President of Patient Safety at Johns Hopkins, and a nationally known safety expert On average patients receive a little more than half of the therapies that they are supposed to. ICUs have so many machines, and doctors and nurses have so much to keep track of, they simply can t keep up. I need a technology that makes it easy and efficient for me to do the right thing in medicine. Not think I m going to remember 200 things,
25 Nelson et al Ann Emerg Med 2011
26
27
28 Sawyer et al Crit Care Med 2011
29 Rana et al Crit Care Med 2006
30 17% à 4.5% (p < 0.001) Rana et al Crit Care Med 2006
31 Sepsis Alert & Diagnostic System (SADS) Johns Hopkins Hospital Research coordinator gets an alpha-numeric page whenever a patient has 3 criteria
32 Sepsis Alert & Diagnostic System (SADS) Johns Hopkins Hospital
33 Sepsis Alert & Diagnostic System (SADS) Johns Hopkins Hospital PPV 87.5% / NPV 93%
34 Following CDSS implementation: - 6 hour bundle compliance increased 29% à 79% - Mortality from intra abdominal sepsis 24% à 12% Moore et al. Am J of Surgery 2010
35 A Nursing CDSS and Potential Predictors of HOB Position for Patients Receiving Mechanical Ventilation Lyerla et at Am J of Critical Care 2010
36
37
38 Potential Pitfalls Overreliance of users on technology Ignoring important alerts due to alert fatigue Incorrect advice due to accidental selection of wrong patient Incorrect entry of (verbal) orders decreased communication between physicians and nurses and other healthcare providers Taking the physician or nurse away from the bedside
39 Do no harm In their PICU, mortality increased 2.80%à 6.57% after CPOE implementation (OR 3.28, 05% CI )
40 DMC Sepsis Alert 2 SIRS and 1 organ dysfunction within the last 48 hours SIRS Triggers Temperature < 35.3 or >38.3 C Respiratory Rate >20 bpm Heart Rate > 90 bpm WBC < 4 or >12 and No order for Neupogen Organ Dysfunction Triggers Lactic Acid >2.2 mmol/l Creatinine >2 gm/dl Total Bilirubin >2 mg/dl Platelet Count < 100,000 INR >1.5 aptt > 60 seconds Systolic Blood Pressure < 90 or MAP < 65 mmhg Pa02/Fi02 Ratio <3 00 mmhg Systolic Blood Pressure drop > 40 mmhg Lethargic, Confused, Agitated or Anxious New Two Tier Alert: 1. Fever plus one other SIRS 2. Original alert (to left) 3. Any Lactate > 4.0 mmol/l PLEASE USE THE SEPSIS POWERPLAN FOR ALL PTS W/ SUSPECTED SEPSIS Clinical Transformation/MIS_
41 DMC Sepsis Alert First Net Sepsis Alert sent to ED Tracking Board as a Bug Icon (DMC s CDSS) Sepsis Alert Bug meansà Go to Orders & open Sepsis Care Powerplan Clinical Transformation/MIS_
42 DMC Sepsis Alert
43 The Performance of an EMR Based Alert to Iden7fy ED Pa7ents with Severe Sepsis & Sep7c Shock Nelson G, Leisy A, Kamash T, Sherwin R ACEP 2012 Alert performance: Positive predictive value % Negative predictive value 99.0% Sensitivity..62.2% Specificity..98.6% No significant difference in time to abx administration b/w patients who did (n = 28) or did not (n = 17) activate the sepsis alert system (87 +/- 49 vs /- 127 minutes; p = 0.417).
44 Factors associated with successful CDSS with respect to preventive care, clinical study adherence, treatment 1. Automatic provision of decision support as part of clinician workflow 2. Provision of decision support at time & location of decision making 3. Provision of a recommendation, not just an assessment 4. Integration w/charting or CPOE to support workflow integration 5. Promotion of action rather than inaction 6. No need for additional clinician data entry 7. Justification of decision support via provision of research evidence 8. Local user involvement in the development process 9. Provision of decision support results to patients as well as providers Lobach et al, ER No AHRQ Publication, April 2012 Also Consider home grown CDSS - may have better adoption CDSS should be automatically versus manually initiated Garg et al JAMA 2005
45 Titrate vasopressors & vasodilators Manage mechanical ventilation Insulin drips Hemodialysis Anesthesia IV fluid titration Oxygen titration Hanson et al Crit Care Med 2001
46 Artificial intelligence Machine intelligence Expert systems Fuzzy logic Bayesian (Belief) networks Case-based reasoning Data visualization Hanson et al Crit Care Med 2001
47 References Ledley, R, and L Lusted. "The Use of Electronic Computers to Aid in Medical Diagnosis." Proceedings of the IRE, Dec McCartney et al, Clinical Decision Support Systems, Then New Networking, Vol. 32 (1), 2007 Lobach et al, Enabling Health Care Decision-making Through Clinical Decision Support & Knowledge Management. Evidence Rpt. No (Duke Evidence Based Practice Center) AHRQ Publication, April Bright et al. Effect of Clinical Decision Support Systems, Annals of Internal Medicine 2012 Garg et al. Effects of CDSS on Physician Practices and Patient Outcomes. JAMA 2005 Hanson et al. Artificial intelligence applications in the intensive care unit. Critical Care Medicine Moore et al. Computerized clinical decision support improves mortality in intraabdominal surgical sepsis. Am J of Surgery 2010
Ruchika D. Husa, MD, MS Assistant t Professor of Medicine in the Division of Cardiology The Ohio State University Wexner Medical Center
Modified Early Warning Score (MEWS) Ruchika D. Husa, MD, MS Assistant t Professor of Medicine i in the Division of Cardiology The Ohio State University Wexner Medical Center MEWS Simple physiological scoring
Using Predictive Analytics to Improve Sepsis Outcomes 4/23/2014
Using Predictive Analytics to Improve Sepsis Outcomes 4/23/2014 Ryan Arnold, MD Department of Emergency Medicine and Value Institute Christiana Care Health System, Newark, DE Susan Niemeier, RN Chief Nursing
Clinical Decision Support in Nursing
School of Healthcare FACULTY OF MEDICINE AND HEALTH Clinical Decision Support in Nursing Dawn Dowding Professor of Applied Health Research d.dowding@leeds.ac.uk or 0113 343 1199 Overview What is Clinical
Case Study: Using Predictive Analytics to Reduce Sepsis Mortality
Case Study: Using Predictive Analytics to Reduce Sepsis Mortality 1 Learning Objectives 1. Understand how an automated, real time IT intervention can help care teams recognize and intervene on critical,
Proving Meaningful Use of a Certified EMR
Proving Meaningful Use of a Certified EMR In order to qualify for the incentive, you must first prove meaningful use of a certified EMR. Meaningful use is defined as the use of certified EHR technology
Toward Meaningful Use of HIT
Toward Meaningful Use of HIT Fred D Rachman, MD Health and Medicine Policy Research Group HIE Forum March 24, 2010 Why are we talking about technology? To improve the quality of the care we provide and
Sepsis: Identification and Treatment
Sepsis: Identification and Treatment Daniel Z. Uslan, MD Associate Clinical Professor Division of Infectious Diseases Medical Director, UCLA Sepsis Task Force Severe Sepsis: A Significant Healthcare Challenge
OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD. A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative
OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative Introductions Disclosures Successful completion of training
Clinical Decision Support (CDS) Options in a CPOE System. Lolita G. White, PharmD Clinical Applications Analyst
Clinical Decision Support (CDS) Options in a CPOE System Lolita G. White, PharmD Clinical Applications Analyst Clinical Decision Support Clinical decision support (CDS) systems provide clinicians, staff,
SE5h, Sepsis Education.pdf. Surviving Sepsis
Surviving Sepsis 1 Scope and Impact of the Problem: Severe sepsis is a major healthcare problem that affects millions of people around the world each year with an extremely high mortality rate of 30 to
Core Measures SEPSIS UPDATES
Patricia Walker, RN-BC, BSN Evidence Based Practice Manager Quality Management Services UCLA Health System, Ronald Reagan Medical Center Core Measures SEPSIS UPDATES Sepsis Core Measures Bundle Requirements
Lynda Richardson, RN, BSN Sepsis/Septic Shock Abstractor. No disclosures
Lynda Richardson, RN, BSN Sepsis/Septic Shock Abstractor No disclosures 1 2 3 Discuss data requirements -3 hour bundle -6 hour bundle Challenges and compliance issues Success 4 Based on the Surviving Sepsis
A Guide to Understanding and Qualifying for Meaningful Use Incentives
A Guide to Understanding and Qualifying for Meaningful Use Incentives A White Paper by DrFirst Copyright 2000-2012 DrFirst All Rights Reserved. 1 Table of Contents Understanding and Qualifying for Meaningful
Health Information Technology and the National Quality Agenda. Daphne Ayn Bascom, MD PhD Chief Clinical Systems Officer Medical Operations
Health Information Technology and the National Quality Agenda Daphne Ayn Bascom, MD PhD Chief Clinical Systems Officer Medical Operations Institute of Medicine Definition of Quality "The degree to which
Adopting an EHR & Meaningful Use
Adopting an EHR & Meaningful Use Learn how to qualify for the EHR Incentive Program The materials in this presentation, or prepared as part of this presentation, are provided for informational purposes
Health Management Information Systems: Clinical Decision Support Systems
Health Management Information Systems: Clinical Decision Support Systems Lecture 5 Audio Transcript Slide 1 Welcome to Health Management Information Systems, Clinical Decision Support Systems. The component,
AAP Meaningful Use: Certified EHR Technology Criteria
AAP Meaningful Use: Certified EHR Technology Criteria On July 13, 2010, the US Centers for Medicare and Medicaid Services (CMS) released a Final Rule establishing the criteria with which eligible pediatricians,
Conflict of Interest Disclosure
Leveraging Clinical Decision Support for Optimal Medication Management Anne M Bobb, BS Pharm., Director Quality Informatics Children s Memorial Hospital, Chicago IL, February 20, 2012 DISCLAIMER: The views
The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy
The Sepsis Puzzle: Identification, Monitoring and Early Goal Directed Therapy Cindy Goodrich RN, MS, CCRN Content Description Sepsis is caused by widespread tissue injury and systemic inflammation resulting
Inpatient Code Sepsis March Update. Sarah Prebil
Inpatient Code Sepsis March Update Sarah Prebil 3 hour bundle Time is life Kumar et al. Crit Care Med 2006; 34:1589-1596 But Sarah, why are you harassing us about sepsis? Pilot Results 10 Code Sepsis pabents
Dr. Peters has declared no conflicts of interest related to the content of his presentation.
Dr. Peters has declared no conflicts of interest related to the content of his presentation. Steve G. Peters MD NAMDRC 2013 No financial conflicts No off-label usages If specific vendors are named, will
Meaningful Use for Physician Offices
Meaningful Use for Physician Offices Eligibility, Registration and Meeting the Criteria Elizabeth M. Neuwirth 203 772 7742 eneuwirth@murthalaw.com H. Kennedy Hudner 860 240 6029 khudner@murthalaw.comemail
Meaningful Use and Lab Related Requirements
Meaningful Use and Lab Related Requirements ONC State HIE / NILA Workgroup August 20, 2013 What is an EHR? Electronic Health Record Information system used by healthcare providers to store and manage patient
Contact: Barbara J Stout RN, BSC Implementation Specialist University of Kentucky Regional Extension Center 859-323-4895
Contact: Barbara J Stout RN, BSC Implementation Specialist University of Kentucky Regional Extension Center 859-323-4895 $19.2B $17.2B Provider Incentives $2B HIT (HHS/ONC) Medicare & Medicaid Incentives
Clinical Decision Support
Goals and Objectives Clinical Decision Support What Is It? Where Is It? Where Is It Going? Name the different types of clinical decision support Recall the Five Rights of clinical decision support Identify
The EHR Incentive Program
The EHR Incentive Program Summary of the Centers for Medicare and Medicaid Services (CMS) Final Rule on Meaningful Use On July 13th, the Centers for Medicare and Medicaid Services (CMS) released its final
1/16/2015 HOW CLINICAL EDUCATORS CAN DISCLOSURE LEARNING OBJECTIVES MAKE MEANINGFUL USE MEANINGFUL. We have no financial disclosures
HOW CLINICAL EDUCATORS CAN MAKE MEANINGFUL USE MEANINGFUL Daryl Wieland, MD Tammy Gruenberg, MD Michelle Giannone, MD Albert Einstein College of Medicine, Bronx, NY DISCLOSURE We have no financial disclosures
Meaningful Use. Michael L. Brody, DPM FACFAOM CCHIT Ambulatory Workgroup HITSP Physician Perspective Technical Committee NYeHC
Meaningful Use Michael L. Brody, DPM FACFAOM CCHIT Ambulatory Workgroup HITSP Physician Perspective Technical Committee NYeHC What is Meaningful Use? Meaningful use is a term defined by CMS and describes
Implementing Advanced Inpatient EMR Systems: Hitting the Quality and Safety Bullseye
Implementing Advanced Inpatient EMR Systems: Hitting the Quality and Safety Bullseye Jeremy Theal MD FRCPC Director, Medical Informatics ehealth Summit June 16, 2011 1 Defining the Target ehealth solutions
Subject: Severe Sepsis/Septic Shock Published Date: August 9, 2013 Scope: Hospital Wide Original Creation Date: August 9, 2013
Stony Brook Medicine Severe Sepsis/Septic Shock Recognition and Treatment Protocols Subject: Severe Sepsis/Septic Shock Published Date: August 9, 2013 Scope: Hospital Wide Original Creation Date: August
BUNDLES IN 2013: SURVIVING SEPSIS CAMPAIGN
BUNDLES IN 2013: SURVIVING SEPSIS CAMPAIGN R. Phillip Dellinger MD, MSc, MCCM Professor of Medicine Cooper Medical School of Rowan University Professor of Medicine University Medicine and Dentistry of
Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com
Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com Meaningful Use On July 16 2009, the ONC Policy Committee unanimously approved a revised
Meaningful Use and Electronic Health Record. May 16, 2012
Meaningful Use and Electronic Health Record May 16, 2012 Who is Promedica? 2 Who is Promedica? ProMedica is a mission-based, not-for-profit healthcare organization formed in 1986. ProMedica has more than
Electronic Medical Record Position Paper December 2014
Electronic Medical Record Position Paper December 2014 Purpose: The purpose of this Electronic Medical Record (EMR) position paper is to present an overview of the electronic medical record along with
Norton Healthcare. Faith-Based Integrated Delivery Network of Five Not-for-Profit Hospitals 15 Out-patient Centers 130+ Physician Practices
Norton Healthcare Faith-Based Integrated Delivery Network of Five Not-for-Profit Hospitals 15 Out-patient Centers 130+ Physician Practices 2.2 Million yearly patient encounters $1.6 Billion yearly revenue
Incentives to Accelerate EHR Adoption
Incentives to Accelerate EHR Adoption The passage of the American Recovery and Reinvestment Act (ARRA) of 2009 provides incentives for eligible professionals (EPs) to adopt and use electronic health records
How To Qualify For EHR Stimulus Funds Under
BEST PRACTICES: How To Qualify For EHR Stimulus Funds Under Meaningful Use & Certified EHR Technology The American Recovery and Reinvestment Act (ARRA) set aside early $20 billion in incentive payments
Meaningful Use Objectives
Meaningful Use Objectives The purpose of the electronic health records (EHR) incentive program is not so much the adoption of health information technology (HIT), but rather how HIT can further the goals
Meaningful Use. Medicare and Medicaid EHR Incentive Programs
Meaningful Use Medicare and Medicaid Table of Contents What is Meaningful Use?... 1 Table 1: Patient Benefits... 2 What is an EP?... 4 How are Registration and Attestation Being Handled?... 5 What are
Disclosure. VeinExperts.org Principal
Disclosure VeinExperts.org Principal Documentation and EMR Usage Peggy Bush, APN, CNS, MSN Palm City, Florida Business of Medicine is Changing Government influences to improve public health Insurance Companies
REQUIREMENTS GUIDE: How to Qualify for EHR Stimulus Funds under ARRA
REQUIREMENTS GUIDE: How to Qualify for EHR Stimulus Funds under ARRA Meaningful Use & Certified EHR Technology The American Recovery and Reinvestment Act (ARRA) set aside nearly $20 billion in incentive
Meaningful Use - The Basics
Meaningful Use - The Basics Presented by PaperFree Florida 1 Topics Meaningful Use Stage 1 Meaningful Use Barriers: Observations from the field Help and Questions 2 What is Meaningful Use Meaningful Use
Implementation of the ABCDE Bundle: Results from a Real-World, Pragmatic Study Design. Andrew Masica, MD, MSCI Chief Clinical Effectiveness Officer
Implementation of the ABCDE Bundle: Results from a Real-World, Pragmatic Study Design Andrew Masica, MD, MSCI Chief Clinical Effectiveness Officer 0 Gap Between Knowledge and Delivery Translational Roadmap
Meaningful Use 2014: Stage 2 MU Overview. Scott A. Jens, OD, FAAO October 16, 2013
Meaningful Use 2014: Stage 2 MU Overview Scott A. Jens, OD, FAAO October 16, 2013 Overview General Overview of Stage 2 MU in 2014 Core Objectives for Stage 2 Menu Objectives for Stage 2 Complete summary
The Human Experiment- Electronic Medical/Health Records
The Human Experiment- Electronic Medical/Health Records Patient safety is one of the primary stated intentions behind the push for computerized medical records. To the extent illegible handwriting leads
1. Introduction - Nevada E-Health Survey
1. Introduction - Nevada E-Health Survey Welcome to the Nevada E-Health Survey for health care professional providers and hospitals. The Office of Health Information Technology (OHIT) for the State of
Streamline Your Radiology Workflow. With Radiology Information Systems (RIS) and EHR
Streamline Your Radiology Workflow With Radiology Information Systems (RIS) and EHR 2 Practicing medicine effectively requires transferring large amounts of information quickly, accurately, and securely.
Opportunities for Evidence-based Clinical Decision Support Systems: An Application for Oncology. BPM Roundtable Eindhoven University of Technology
Opportunities for Evidence-based Clinical Decision Support Systems: An Application for Oncology BPM Roundtable Eindhoven University of Technology 5/11/2012 Dr. Yaron Denekamp CMIO, Hospital Division, Clalit
Meaningful Use Updates. HIT Summit September 19, 2015
Meaningful Use Updates HIT Summit September 19, 2015 Meaningful Use Updates Nadine Owen, BS,CHTS-IS, CHTS-IM Health IT Analyst Hawaii Health Information Exchange No other relevant financial disclosures.
Using Health Information Technology to Improve Quality of Care: Clinical Decision Support
Using Health Information Technology to Improve Quality of Care: Clinical Decision Support Vince Fonseca, MD, MPH Director of Medical Informatics Intellica Corporation Objectives Describe the 5 health priorities
FROM DATA TO KNOWLEDGE: INTEGRATING ELECTRONIC HEALTH RECORDS MEANINGFULLY INTO OUR NURSING PRACTICE
FROM DATA TO KNOWLEDGE: INTEGRATING ELECTRONIC HEALTH RECORDS MEANINGFULLY INTO OUR NURSING PRACTICE Rayne Soriano MS, RN Manager of Nursing Informatics and Clinical Transformation Program Kaiser Permanente
MEANINGFUL USE. Community Center Readiness Guide Additional Resource #13 Meaningful Use Implementation Tracking Tool (Template) CONTENTS:
Community Center Readiness Guide Additional Resource #13 Meaningful Use Implementation Tracking Tool (Template) MEANINGFUL USE HITECH s goal is not adoption alone but meaningful use of EHRs that is, their
BEGINNER MEDICAID EHR INCENTIVE PROGRAM FOR ELIGIBLE PROFESSIONALS. » An Introduction to: Last Updated: April 2014
01 BEGINNER» An Introduction to: MEDICAID EHR INCENTIVE PROGRAM FOR ELIGIBLE PROFESSIONALS Last Updated: April 2014 Table of contents How to use this guide... 2 1. Program basics... 5 What is the Medicaid
Cash for Clunkers. Meaningful Use: No Cash for Clunkers. EHR Certification & Meaningful Use
Meaningful Use: No Cash for Clunkers EHR Certification & Meaningful Use ANCO/MOASC Business of Oncology: 2010 and Beyond October 28, 2010 Cash for Clunkers 2 1 NO Cash for Clunkers 3 What is a clunker?
Client Alert. CMS Releases Proposed Rule On Meaningful Use Of Electronic Health Record Technology
Contact Attorneys Regarding This Matter: Tracy M. Field 404.873.8648 - direct 404.873.8649 - fax tracy.field@agg.com Erin M. Rush 404.873.7030 - direct 404.873.7031 - fax erin.rush@agg.com Client Alert
Meaningful Use Stage 1:
Whitepaper Meaningful Use Stage 1: EHR Incentive Program Information -------------------------------------------------------------- Daw Systems, Inc. UPDATED: November 2012 This document is designed to
Presented by. Terri Gonzalez Director of Practice Improvement North Carolina Medical Society
Presented by Terri Gonzalez Director of Practice Improvement North Carolina Medical Society Meaningful Use is using certified EHR technology to: Improve quality, safety, efficiency, and reduce errors Engage
MEANINGFUL USE STAGE 2 2015 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY
MEANINGFUL USE STAGE 2 2015 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY STAGE 2 REQUIREMENTS EPs must meet or qualify for an exclusion to 17 core objectives EPs must meet 3 of the 6 menu measures.
Guide To Meaningful Use
Guide To Meaningful Use Volume 1 Collecting the Data Contents INTRODUCTION... 3 CORE SET... 4 1. DEMOGRAPHICS... 5 2. VITAL SIGNS... 6 3. PROBLEM LIST... 8 4. MAINTAIN ACTIVE MEDICATIONS LIST... 9 5. MEDICATION
Meaningful Use Stage 2:
Meaningful Use Stage 2: Where We Are Now, Where We re Going, and What it Means for Your Practice Russell B. Leftwich, MD, FAAAI Chief Medical Informatics Officer Office of ehealth Initiatives, State of
Electronic Medical Records. Robert M. Underwood, MD, CPE, FAAEM CMIO, RMH Healthcare
Electronic Medical Records Robert M. Underwood, MD, CPE, FAAEM CMIO, RMH Healthcare Disclaimer I am an employee of RMH Healthcare No financial interest in any IT company What is a CMIO? History: September
How To Use Ehr For Health Care
Increase Patient Impact Via Electronic Health Records (EHR) October 1, 2014 Mukesh Mehta, DPh, MBA, RPh Vice President, Clinical & Regulatory Solutions 201.358.7538 mukesh.mehta@pdr.net Dale Cooke, PhillyCooke
STAGE 2 of the EHR Incentive Programs
EHR Incentive Programs A program administered by the Centers for Medicare & Medicaid Services (CMS) Eligible Professional s Guide to STAGE 2 of the EHR Incentive Programs September 2013 TABLE OF CONTENTS...
Meaningful Use Qualification Plan
Meaningful Use Qualification Plan Overview Certified EHR technology used in a meaningful way is one piece of a broader Health Information Technology infrastructure intended to reform the health care system
Financial Incentives for EHR Use and The Washington- Idaho Regional Extension Center Program: WIREC
Financial Incentives for EHR Use and The Washington- Idaho Regional Extension Center Program: WIREC Jeff Hummel, MD, MPH UW Bio-Medical Informatics Dept. May 4, 2010 Disclosure: In the past 12 months Jeff
Sustainability: Achieving Clinical and Financial Benefits Through the Use of an EHR
Sustainability: Achieving Clinical and Financial Benefits Through the Use of an EHR Bert Reese SVP and CIO of Sentara Healthcare Sentara Healthcare October 6, 2014 1 Sentara Healthcare 126-year not-for-profit
Southern California Patient Safety First Collaborative Long Beach Memorial Medical Center Team Presentation. September 17, 2014
Southern California Patient Safety First Collaborative Long Beach Memorial Medical Center Team Presentation September 17, 2014 1907 2014 Not-for-profit, community-based One of few campuses home to adult
E Z BIS ELECTRONIC HEALTH RECORDS
E Z BIS ELECTRONIC HEALTH RECORDS CERTIFICATION AND THE HITECH INCENTIVE PROGRAM The Incentives On July 13, 2010, the U.S. Department of Health and Human Services finalized the Electronic Health Record
Advanced Clinical Decision Support & Acute Kidney Injury
Advanced Clinical Decision Support & Acute Kidney Injury Dr Jamie Coleman Senior Lecturer in Clinical Pharmacology and Honorary Consultant Physician eprescribing & CDS in Birmingham, UK Jamie Coleman 1
Secure Messaging Evidence Table
APPENDIX E. Evidence Tables Secure Messaging Evidence Table Health Outcomes Simon, 2011 9 RCT; N=208 patients; 04/09-10/09 Elkjaer, 2010 1 Zhou, 2010 2 Harris, 2009 3 Ralston, 2009 6 Tuil, 2007 4 RCT;
Retrospective review of the Modified Early Warning Score in critically ill surgical inpatients at a Canadian Hospital
Retrospective review of the Modified Early Warning Score in critically ill surgical inpatients at a Canadian Hospital Alisha Mills PGY 4 General Surgery Northern Ontario School of Medicine S Disclosures
convey the clinical quality measure's title, number, owner/developer and contact
CMS-0033-P 153 convey the clinical quality measure's title, number, owner/developer and contact information, and a link to existing electronic specifications where applicable. TABLE 20: Proposed Clinical
NHCHC Meaningful Use of Electronic Health Records Resource Catalogue. Meaningful Use Overview
Meaningful Use Overview Meaningful use is the use of a certified electronic health record (EHR) to demonstrate improved quality and safety of health care delivery for a patient population within a clinical
to the Medicare and Medicaid
With the changes made in the final rule, earning the EHR incentive is still not easy, but at least it s easier. A Physician s Guide to the Medicare and Medicaid EHR Incentive Programs: The Basics David
Beyond Alerts: Clinical Decision Support with Evidence & Expertise
Beyond Alerts: Clinical Decision Support with Evidence & Expertise Sandy J. Falk, MD, FACOG Director, Editorial Relations Deputy Editor Gynecology UpToDate Clinical Solutions,Wolters Kluwer Health About
Meaningful Use Criteria for Eligible Hospitals and Eligible Professionals (EPs)
Meaningful Use Criteria for Eligible and Eligible Professionals (EPs) Under the Electronic Health Record (EHR) meaningful use final rules established by the Centers for Medicare and Medicaid Services (CMS),
Lunch and Learn IFAF 09/24/11. Michael L. Brody, DPM
Lunch and Learn IFAF 09/24/11 Michael L. Brody, DPM Disclaimers Sammy Sponsor of this presentation PICA Biomedix All Pro Imaging The Brave New World of HIT Today s Topics: PQRS E-Rx EMR Health Information
Meaningful Use. Goals and Principles
Meaningful Use Goals and Principles 1 HISTORY OF MEANINGFUL USE American Recovery and Reinvestment Act, 2009 Two Programs Medicare Medicaid 3 Stages 2 ULTIMATE GOAL Enhance the quality of patient care
Meaningful Use of Certified EHR Technology with My Vision Express*
Insight Software, LLC 3050 Universal Blvd Ste 120 Weston FL 33331-3528 Tel. 877-882-7456 www.myvisionexpress.com Meaningful Use of Certified EHR Technology with My Vision Express* Eligible Professional
CLINICAL DECISION SUPPORT AND THE LAW: THE BIG PICTURE DAVID W. BATES*
CLINICAL DECISION SUPPORT AND THE LAW: THE BIG PICTURE DAVID W. BATES* The use of health information technology ( HIT ) in the United States appears to be growing rapidly, in part as the result of the
UAB HEALTH SYSTEM AMBULATORY EHR IMPLEMENTATION
UAB HEALTH SYSTEM AMBULATORY EHR IMPLEMENTATION Richard Rosenthal, MD Associate Chief of Staff Ambulatory Services Associate Professor of Medicine Department of Medicine Endocrinology Agenda About UAB
Comments to Legislative Workgroup on E-Prescribing
Comments to Legislative Workgroup on E-Prescribing eqhealth Solutions is a not-for-profit, physician sponsored health care organization operating in Louisiana, Illinois, Florida and Mississippi. It has
Concept Series Paper on Electronic Prescribing
Concept Series Paper on Electronic Prescribing E-prescribing is the use of health care technology to improve prescription accuracy, increase patient safety, and reduce costs as well as enable secure, real-time,
Care360 EHR Frequently Asked Questions
Care360 EHR Frequently Asked Questions Table of Contents Care360 EHR... 4 What is Care360 EHR?... 4 What are the current capabilities of Care 360 EHR?... 4 Is Care 360 EHR an EMR?... 5 Can I have Care360
Some Tout CMS Proposed Meaningful Use Definition for Use of Electronic Health Records As Too Ambitious
Some Tout CMS Proposed Meaningful Use Definition for Use of Electronic Health Records As Too Ambitious By Craig A. Conway, J.D., LL.M. (Health Law) caconway@central.uh.edu Just in time for the New Year,
Mark Anderson, FHIMSS, CPHIMSS Healthcare IT Futurist
Mark R. Anderson, FHIMSS, CPHIMS CEO of AC Group, Inc. Mark Anderson, FHIMSS, CPHIMSS Healthcare IT Futurist CEO of AC Group National Speaker on EHR > 800 sessions since 2001 Semi annual report on Vendor
ELECTRONIC MEDICAL RECORDS (EMR)
ELECTRONIC MEDICAL RECORDS (EMR) SAUDI BOARD FOR COMMUNITY MEDICINE FIRST PART - FIRST SEMESTER (FALL 2010) COURSE SBCM 002: MEDICAL INFORMATICS Osama Alswailem MD MA Medical Record function 1. It s a
Electronic Health Records & Healthcare Information Technology in the United States, 2011
Electronic Health Records & Healthcare Information Technology in the United States, 2011 Westlake III April 14, 2011 William A. Bornstein, MD, PhD Chief Quality & Medical Officer Emory Healthcare Acronyms
Question & Answer Guide. (Effective July 1, 2014)
Joint Commission Primary Care Medical Home (PCMH) Certification for Accredited Ambulatory Health Care Organizations Question & Answer Guide (Effective July 1, 2014) A. ELIGIBILITY/DECISION-RELATED Question:
EHR Meaningful Use Incentives for School-Based Health Clinics
EHR Meaningful Use Incentives for School-Based Health Clinics Denise Holmes Institute for Health Care Studies Michigan State University September 27, 2011 Background The Health Information Technology for
Going beyond Meaningful Use with EMR solutions from the Centricity portfolio
Going beyond Meaningful Use with EMR solutions from the Centricity portfolio The IT tools and services you need now. The support you need for the future. GE Healthcare is focused on providing customers
Medicare and Medicaid Programs; EHR Incentive Programs
Medicare and Medicaid Programs; EHR Incentive Programs Background The American Recovery and Reinvestment Act of 2009 establishes incentive payments under the Medicare and Medicaid programs for certain
What Is Patient Safety?
Patient Safety Research Introductory Course Session 1 What Is Patient Safety? David W. Bates, MD, MSc External Program Lead for Research, WHO Professor of Medicine, Harvard Medical School Professor of
Achieving Meaningful Use Training Manual
Achieving Meaningful Use Training Manual Terms EP Eligible Professional Medicare Eligible Professional o Doctor of Medicine or Osteopathy o Doctor of Dental Surgery or Dental Medicine o Doctor of Podiatric
Medicaid EHR Incentive Program Dentists as Eligible Professionals. Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.
Medicaid EHR Incentive Program Dentists as Eligible Professionals Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com Considerations Must begin participation by Program Year 2016 Not required
Meaningful Use Update Eligible Professionals. December 2011
Meaningful Use Update Eligible Professionals December 2011 Discussion Topics Welcome, HITECH Program Update Topics for Clarification (Stage 1) CPOE Quality Measures PQRI e-prescribing verses Meaningful
How to Achieve Meaningful Use with ICANotes
How to Achieve Meaningful Use with ICANotes Meaningful use involves using an EHR in a way that the government has defined as meaningful to collect incentive payments. but do not participate. Note: If you
Electronic Health Records: What it Means for Today s Radiologist By: Anne Reynolds
Electronic Health Records: What it Means for Today s Radiologist By: Anne Reynolds Introduction Program Overview In February of 2009, President Obama signed the American Recovery and Reinvestment Act of
DEMONSTRATING MEANINGFUL USE STAGE 1 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EHR TECHNOLOGY IN 2014
DEMONSTRATING MEANINGFUL USE STAGE 1 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EHR TECHNOLOGY IN 2014 The chart below lists the measures (and specialty exclusions) that eligible providers must
An Overview of Meaningful Use: FAQs
An Overview of Meaningful Use: FAQs On Feb. 17, 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA) into law. This new law includes provisions (known as the HITECH Act)