Meaningful Reporting From the EHR

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1 Meaningful Reporting From the EHR Rebecca Lagerquist EHR Software Analyst / Trainer Delaware Health Net, Inc. April

2 The Challenge In 2004 the White House set the goal that by the year 2014 most Americans have an Electronic Medical Record 2

3 ARRA In January of 2009, Congress passed the American Recovery and Reinvestment Act (The stimulus Package). 3

4 HITECH One part of ARRA,the HITECH Act (Health Information Technology for Economic and Clinical Health)sets aside 19 Billion dollars to encourage small physician practices to adopt Electronic Medical Records technology. 4

5 The HIT financial incentives are to help offset the large initial costs incurred during implementation of an EHR. (The initial cost to implement an EHR is between $30-50 thousand per provider) Eligible professionals who can demonstrate meaningful use of certified EHR technology can receive incentive payments of up to $44,000 from medicare or up to $63,500 from medicaid starting in

6 What is Meaningful Use Demonstrated use of the EHR by defined clinical and administrative measures On December 31,2009 CMS published an Interim Finale Rule of requirements to be met to prove meaning use of the EHR. These requirements were available for public comment until the end of March The final requirements for MU submission and measures are due in April 2010 The rules are available at 6

7 What Does This Really Mean??? To receive the incentive payments physicians will need to demonstrate the use of the system in a positive way to improve outcomes. This will require the use of a complete EHR and some customization 7

8 Our Approach As Federally Qualified Health Centers (FQHC s)we have specific reporting requirements already. Therefore, before implementation of our EHR we looked at what we needed to report and what clinical measures we might what to track. Then we began the job of customization. 8

9 Customization and Implementation During customization we built all visit templates with two guidelines in mind: Develop uniform documentation in order to capture consistent data The majority of documentation is Point & Click (limited free text) 9

10 Why Limit Free Text????? Free Text Point & Click Free texting is like adding water to a bucket You can not distinguish individual data entries Point & Click is like adding blocks to the bucket.each discrete data point can be selected and a report built from this information 10

11 11

12 The following report parameters are used to identify the target "patients and define the action to be taken if patient s A1c is >9 schedule appointment with CDE and order lab repeat in 3 months 12

13 Pop Up Clinical Reminder Generated From A1c>9 Report Results 13

14 Patient Message Generated From A1c>9 Report Results This patient message is sent to the patient s provider who will then forward to scheduling 14

15 Other Reporting Options The program s reporting tool is just one of our reporting options: As long as information is entered as discrete data third party reporting tools can also be utilized. We use Crystal Reports to extract statistical information from our database 15

16 Lessons Learned Prior to implementation of EHR review program reporting capabilities and discuss optional reporting tools. Have a strong IT resource Develop defined customization goals Plan for drastic Workflow changes Begin building reports as soon as you begin documentation. 16

17 References White House. Executive Order: Incentives for the use of health information technology and establishing the position of the National Health Information Technology Coordinator Computer Science Corporation, Update on Meaningful Use, January Blumenthal, Dr. David ; National Coordinator for Health Information Technology, Meaningful Progress Toward Electronic Health Information Exchange

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