EHR 2014 for MU2. Integrated Problem List

Size: px

Start display at page:

Download "EHR 2014 for MU2. Integrated Problem List"

Junior Higgins
10 years ago
Views:

1 R AF T EHR 2014 for MU2 D Integrated Problem List

2 Objectives Explain MU required features Provide an overview of the IPL Explain essential steps to train providers (postdeployment survival). Discuss recommended implementation plan for the IPL. Provide hands on training using the IPL

3 Why change to the IPL? 2014 CEHRT MU required features: SNOMED CT for problem list Care Planning Treatment regimen elements for Clinical Quality Measures Supports transition to ICD 10 for encounters

4 Essentials for IPL The IPL has a wide range of functionality. Most of the functionality is optional for clinicians, however, enabling staged implementation. Required entry is not overwhelming, so we will begin with the 3 required steps essential in the early transition period.

5 MU Required Features SNOMED CT Problem List Care Planning/Treatment Regimen

6 Integrated Problem List: IHS Additions Longitudinal Data Collection and Aggregation Problem data are stored and visible in the problem information Allows users to view the evolution of the problem over time Care planning is associated with problems Some visit data is now associated with problems used as POVs Visit Instructions Patient Education (when entered about a problem) Treatment/Regimen Referrals (when problem selected as reason for referral) Consults (when problem selected as clinical indication) We encourage user requests for report views to aggregate problem data and care planning that will better suit needs in the field.

Instructions Patient Education (when entered about a problem) Treatment/Regimen Referrals (when problem selected as reason for referral) Consults (when problem

7 Integrated Problem List: IHS Additions Get SCT Reverse Mapping Tool

8 Integrated Problem List: IHS Additions POV Selection Tool with Options for Additional Care Planning and Patient Education Documentation

9 Integrated Problem List: IHS Additions Care Planning and Patient Education Documentation

10 Integrated Problem List: IHS Additions Pick List Examples

11 Why Does This Mean For Clinical Users? Redesigned problem list Use of SNOMED CT terms Changes the way problems are entered and managed Changes the way POVs are selected Impacts all users that document a POV Supports transition to ICD 10 for encounters

problems are entered and managed Changes the way POVs are

12 Preparing for Transition Clean up Problem Lists singe most important task to prepare for the IPL transition Remove/consolidate redundant problem entries. Remove entries that do not belong on the problem list. Inactivate resolved problems. Code the un coded problems Provide training to end users Modify provider schedules to allow time for the transition post deployment

Remove entries that do not belong on the problem list. Inactivate resolved problems.

13 Hands On Learning Pick a patient and visit Convert current ICD 9 to SNOMED CT term Add a POV from the existing problem list Search for an additional POV URI Document education and treatment regimen Document care planning

existing problem list Search for an additional POV URI

14 Easing the Stress of the First Days Scenario: It is the first day of clinic after EHRp13 was installed. Providers have fewer patients scheduled in anticipation of delays to adapt to the software changes. The first patient is here for a follow up and has a sore throat and cold symptoms.

Providers have fewer patients scheduled in anticipation of delays to

15 Step 1: Update Problems Update ONLY those problems to be addressed with the patient today. Note that any problem with leading * in provider narrative needs update to SNOMED prior to use

16 Step 1: Update Problems 1. Highlight the problem and click Get SCT This opens the ICD 9 to SNOMED reverse mapping tool.

17 Step 1: Update Problems 2. Highlight the SNOMED Concept and click Select to update the entry

18 Step 1: Update Problems Reverse mapping tool will display a selection of SNOMED terms for most ICD coded problems Un coded problems (.9999) will NOT reverse map Use the Pick List or the SNOMED Search to update problems that are not coded Cleaning up the problem list is very important

9999) will NOT reverse map Use the Pick List or the SNOMED Search to

19 Step 2: Add New Problems ONLY add problems to be addressed with the patient today. 3. Click Pick List

20 Step 2: Add New Problems 4. Select problem(s) and click Save

21 POV and Clinical Indications Updated problems and new problems are now available to: Be selected for the POV Be selected for Clinical Indications when placing orders Only problems that have been updated to SNOMED terms are available to be selected on the Clinical Indication dropdown menu.

22 Step 3: Select POV 5. Highlight the problems to be managed today. 6. Click the POV button.

23 Step 3: Select POV 7. Click Save to set as POVs

24 MU Required Features SNOMED CT Problem List Care Planning/Treatment Regimen

25 Update Problem Review 1. Highlight problem for update and click Get SCT Use the Pick List or SNOMED Search for un coded problems 2. Highlight the SNOMED Concept and click Select to update the problem Add New Problem 3. Click Pick List 4. Select problem(s) and click Save Select POV 5. Highlight the problems to be managed today 6. Click the POV button 7. Click Save

26 IPL Projected Progression of Usage

27 IPL Projected Progression of Usage ** Visit Instructions, Goals and Care Planning notes display on the Clinical Summary and Transition of Care Summary, and can drop into encounter documentation.

28 It Takes a Village to Migrate to IPL Recommend leveraging all clinicians to participate as they encounter opportunities to update in their workflow: Nursing Example: ordering standing order labs can update problems prior to selecting as Clinical Indication Pharmacy Example: update problems and select as POVs for medication refills. It is NOT appropriate to engage non clinician staff (clerks, coders, medical records) in the migration of the problem lists from ICD 9 to SNOMED terms.

29 Hands On Learning Demonstrate Steps 1 3 to a partner (as if demonstrating to user) Use the Pick List to add an administrative SNOMED term

30 Questions

EHR v 1.1 p13 SNOMED CT and the Integrated Problem List (IPL)

EHR v 1.1 p13 SNOMED CT and the Integrated Problem List (IPL) CAPT Howard Hays, MD, MSPH, FAAFP Chief Information Officer (Acting) CDR Susan Pierce-Richards, MSN, ARNP, FNP-BC, ANP-BC Federal Lead EHR,