Keys to EMR/EHR Success

Transcription

1 Keys to EMR/EHR Success Tuesday September 2 nd, 2014 Presented by Ron Sterling Sterling Solutions, Ltd. [email protected] The information provided in AHC Media Webinars does not, and is not intended to constitute medical or legal advice. Opinions, references and links provided by our speakers are provided for your convenience and do not represent our endorsement of such opinions, products or services.

2 RONALD B. STERLING, CPA Sterling Solutions, Ltd. Ron Sterling is a nationally recognized thought leader on electronic health records and an award winning author. Ron has advised healthcare organizations across the country. He has analyzed software from over 150 vendors. Ron is a frequent speaker on EHR issues and strategies as well as the author of over 250 articles on health information technology for dozens of publications including the widely used Marketing Your Clinical Practice. [email protected] Office: (301)

3 Objectives 1. Review the planning, analysis and design needed to effectively use EHRs. 2. Discuss establishing metrics to monitor your current situation and EHR Use. 3. Explain key problems and mitigation strategies. 2

4 Why is EHR Success Important? Hard/Impossible to Retreat Supports Changing Expectations Patients Providers EHRs support evolving standards of care Meaningful Use Patient Centered Medical Home (PCMH) Patient Centered Specialty Practice (PCSP) Accountable Care Organization (ACO)

5 Why is EHR Success Important? EHRs reflect your due diligence Documentation of Care Patient Care Activities EHRs present new information for quality reviews, audits, etc. Clinical Life Cycle Audit Trails

6 Paper Transition to EHR 5

7 Paper Chart Challenges Maintaining Continuity of Care Compliance Locating Key Clinical Information Paper Chart Contents to Scan Key Patient Information to Enter 6

8 Paper Chart Challenges Defacto Patient Chart Contents Logs Shadow Medical Records Chart Conditions 7

9 Paper Chart Audit Trail Clinically Drive Process Paper Chart Decision Initial Patient Information Document Process Train Appropriate Staff Quality Assurance Problem Resolution Remediation 8

10 Case Study Practice did not convert any paper based information or documents into the EHR. What were the operational implications? Does the strategy present any continuity of care issues? 9

11 Clinical Decisions 10

12 Make Sure Clinical Content Works Gather Current Clinical Forms Inventory Clinical Content Needs Doctors Clinical Services Subspecialties Practice Focus Sample Documents 11

13 Make Sure Clinical Content Works Evaluate EHR Clinical Content Validate Appropriateness Check Breadth and Depth Match to Current Clinical Areas Personalize to Practice Standards 12

14 EHRize Your Workflow Identify Changes to Responsibilities Departments Employees Other Parties Plan, Analyze and Design Improve Patient Service Cut Response Cost/Time Quality Assurance 13

15 Workflow Areas Appointments Front Desk Clinical Triage/Intake Diagnostic Testing Physician Services Procedure/Surgery Scheduling Ancillary Service Conversion Billing Patient Follow-Up Patient Service Phone Calls Other Interactions Medical Records 14

16 Case Study Clinical content is used on an inconsistent basis by the doctors. What are the continuity of care challenges? Does the inconsistency affect patient service or care? How can inconsistency be addressed? 15

17 Case Study Clinical content has a serious deficiency in your area of medicine? What are potential measures to address the deficiency? How can you compel the vendor to address the problem? 16

18 Case Study A multiple office practice addresses patient calls with staff in each location using a centralized EHR. Is this the most efficient way to address patient calls? How does this structure support evolving electronic patient messaging under Meaningful Use? 17

19 Case Study Based on test setup that was never verified or reviewed, a doctor distributed patient notes that had inappropriate findings. Default note included findings that were not included in the doctor s ROS or PE. What are the patient service implications for the problem? What are the practice s risk issues? 18

20 Maintaining EHR Integrity

21 Clinical End of Day = Integrity Verify Record Standards Maintain Integrity of Patient Records Protect Against Quality Lapses Fraud Claim Medical Professional Liability Support Professional and Industry Standards 20

22 EOD Checklist Items Notes Signed Within X Hours/Days Messages Completed within Standards by Class Office Workflow Current Patient Portal Items Completed/Addressed 21

23 EOD Checklist Items Incoming Documents/Images Reviewed Quality Assurance Measures EHR Interfaces Working erx Transitions of Care Orders (Lab, Radiology) 22

24 EOD Checklist Items Patient Services Monitored Procedure/Surgery Follow Up Referral Follow Up Reminder Transmission Reminder Follow Up Health Maintenance Items Outstanding Orders Obsolete Orders 23

25 Periodic Checking Review Month Results and Trends Review Issues and Problems Develop and Maintain Issues Lists Privacy and Security Procedures Clinical Content Workflow 24

26 Case Study Many practices lack a clinical end of day process. What are the implications for practices that lack a clinical end of day? How does a clinical end of day process enhance patient care and practice operations? 25

27 Dealing with Upgrades

28 EHR Upgrades Review Changes and Enhancements Vendor release notes. Vendor problem notices. Upgrade testing and deployment. Verify Reliability with Others 27

29 EHR Upgrades Perform Quality Assurance Measures Clinical Content Update Procedures Retrain Doctors and Staff Verify EHR Interfaces Working Secure Messaging erx Transitions of Care Orders (Lab, Radiology) 28

30 Case Study - EHR upgrade resulted in loss of 70,000 injection records. Recovery resulted in only 1,000 missing records. - What are the potential patient service problems? - What could have been done to avoid the problem? 29

31 This presentation is intended solely to provide general information and does not constitute legal advice. Attendance at the presentation or later review of these printed materials does not create an attorney-client relationship with the presenter(s). You should not take any action based upon any information in this presentation without first consulting legal counsel familiar with your particular circumstances. 30

32 QUESTIONS AND ANSWERS 31

33 Thank you for attending!! Office: (301)