MGH/PHS has licensed technology to, receives royalties from and/or has financial interests in: LifeImage, Inc. Nuance, Inc.

Transcription

1

2 MGH/PHS has licensed technology to, receives royalties from and/or has financial interests in: LifeImage, Inc. Nuance, Inc.

3 Societies and Organizations ACR Chairman, IT Government Relations Cmte Co-Chairman, Informatics Cmte Co-Chairman, Clinical Decision Support Cmte Meaningful Use Presenter RSNA Chairman, IT Government Relations Cmte Member, Informatics Cmte Meaningful Use Presenter ABR Member, ABR IT Advisory Committee RBMA Meaningful Use Presenter RadiologyMU.org Meaningful Use Advisor Meaningful Use Presenter

4 MGH Experience EMR Imaging Integration IMR Imaging Medical Record Meaningful Use for Radiology ACR Message to Federal Agencies

5 Use EMR as a context platform for communication Hospital Distribution of Images

6 Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj EMR PACS

7 Use EMR as a context platform for communication Hospital Distribution of Images Enterprise Distribution of Images Multiple PACS to Enterprise EHR

8 Adsdf ald fsf Adsdf ff ald fsf ff Adf asfaf asdfdf Adf asfaf asdfdf Th rie his son Thwo rie his son wo Jswher wih Jswher sosfn wih sosfn Thwi neo whos Thwi mneo whos m Haf fueowhhaf oehw fueowh oehw Hwe rnie nroeon Hwe rnie nroeon New inwripwpw New inwripwpw Nf fjskd oernf o erj fjskd oer o erj Enterprise EMR with MPI PACS PACS PACS

9 Use EMR as a context platform for communication Hospital Distribution of Images Enterprise Distribution of Images Multiple PACS to Enterprise EHR CPOE for Radiology CDS for Radiology Ordering

10 ORDER IMAGING Adsdf ald fsf ff Adf asfaf asdfdf Th rie his son wo Jswher wih sosfn Thwi neo whos m Haf fueowh oehw Hwe rnie nroeon New inwripwpw Nf fjskd oer o erj EMR Medical Imaging Clinical Decision Support PACS RIS

11

12 actual tests per 000 members MGPO actual imaging tests per 000 members (MRIs, CT Scans, Nuclear Cardiology) 9% Decrease ( )

13 Use EMR as a context platform for communication Hospital Distribution of Images Enterprise Distribution of Images Multiple PACS to Enterprise EHR CPOE for Radiology CDS for Radiology Ordering 200 -Foreign Image Import Physical Media 20 - Extra-Enterprise Image Sharing

14 Physical Media Based Exchange Category I Radiology image CD of patient with an MRN Category II Non-Radiology image CD of patient with an MRN Category III Any image CD of patient without an MRN Standards Based Exchange To Other Providers To Patients Physician EMR LI Hosp PACS II Desktop III RSNA-NIBIB Image Sharing Project Hosp 2 I LifeIMAGE PHRs Hosp n

15 MGH Experience EMR Imaging Integration IMR Imaging Medical Record

16 Standalone Platform Radiology manages entire system Authentication, HIPAA, group privileges Session level security Browser and mobile device based External Access to Imaging Services Exam Ordering, Scheduling, CDS, Authorization Critical Communication System Report and Image Distribution

17 MGH EMR External EMR External EMR n Imaging Medical Record Medical Imaging Clinical Decision Support PACS RIS Hospital Dept Imaging Center Imaging Center Imaging Center Imaging Center Imaging Center

18 MGH Experience EMR Imaging Integration IMR Imaging Medical Record Meaningful Use for Radiology

19 Information Technology MGH Developed Complete EHR Certification Process

20 LMR Certification Timeline and Milestones Notice of proposed rule making LMR Exec. Approval for Cert. projects 60 day comment period Final Rules Published Insight into ONC-Authorized Testing and Certification Body LMR Certification Best case scenario Worst case scenario Q4 Q Q2 July Aug Sept Oct Nov Dec Jan Feb Mar Apr May Review Gap analysis based on proposed rule Define reasonable approaches to all LMR MU gaps Completed Final LMR Gap Analysis We are here LMR Fall 200 Release LMR Spring 20 Release Version 2.0 August 200

21 Information Technology MGH Developed Complete EHR Certification Process Vendor Components Modular EHR Certified Internal Support for EP Meaningful Use

22 Eligible Providers. Master e-prescribing (erx) CPOE (30% medication orders) Transmit prescriptions electronically (40%) Implement drug-drug / drug-allergy (attest) Maintain active medication list (80%) Implement drug Formulary (attest) 2. Leverage Care Team Record demographics (50%) Record vital signs (50%) Record smoking status (50%) Provide patients with an electronic copy of health info. (50%) Provide clinical summaries for each office visit (50%) 3. Leverage Enterprise Application Implement clinical decision support rule (attest) - test of EHR capability to exchange key clinical information (attest) Capability to submit immunization to immunization registries (attest) Capability to submit electronic syndromic surv. data (attest) Incorporate clinical lab test results unto EHR / structured data (40%) Generate Lists of patients by specific conditions (attest) 4. Focus on Structured Data Elements Maintain problem list (80%) Maintain active medication allergy list (80%) Quality Reporting (report measures) 5. Practice Assessment Work Conduct security risk analysis (attest) Core Menu Practice Staff IS and MGH/MGPO 5 5

23 Information Technology MGH Developed Complete EHR Certification Process <Show the MGH MU pathway slide> Vendor Components Modular EHR Certified Internal Support for EP Meaningful Use Radiologists don t directly input data to the EMR Voice => Reporting System => RIS => EMR Need to create a parallel system for radiologists to be seen as other EPs by the EMR

24 MU Reporting to CMS MGH EPs /Other Care Providers MU EP Dashboard MU Data Aggregation EMR Interpretations = Patient Encounters RIS Reporting System (Voice Recognition) Rad Rad 2 Rad n

25 MGH Experience EMR Imaging Integration IMR Imaging Medical Record Meaningful Use for Radiology Messages to Federal Agencies

26 Include Medical Imaging into HITECH care goals Quality, Safety, Cost, Outcomes Use Meaningful Use constructs when possible Create a distinction between: Medical Imaging Creators Medical Imaging Consumers

27 For Medical Image Consumers Images included in MU definition for exam results EMR, PHR, PHI Sharing Require electronic ordering of Imaging Require electronic not paper to imaging department Clinical decision support of Imaging Separate from disease centric, order sets, drug-drug

28 For Medical Image Creators Create CQM specific to these EPs Critical communication management Urgent Notification, Recommendation Follow up Require Report and Image Connectivity To EHR and PHR Provide Imaging CPOE and CDS Radiation Dose Registry Compliance Archival, Display, Access requirements Relax the requirement to purchase systems that measure what EPs are excluded from.

29 Embrace Clinical Decision Support for Imaging Demonstration Project for Imaging CDS Support Initiatives for CDS Rule Sets National, Transparent, Standard, Medical Societies Consider payment reform based on CDS

30 Radiation Dose Registry Patient Centric Exposure Monitoring Image Storage and Access Requirements Consumer based mobile visualization iphone, ipad

31 Demonstrate value of existing technologies CDS, Image Sharing, Critical Comm, Consumer Access Promote standardization of existing technologies Foster a common understanding of Imaging Throughout various governmental agencies Throughout Congressional oversight committees Throughout the White House and OMB

32