Elmhurst Memorial Healthcare Successfully Attests to Stage 1 Meaningful Use Welcome! Presented by: Larry Katzovitz & Judy Triano Elmhurst Memorial Healthcare Kay Jackson (978) 805-3104 [email protected]
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Elmhurst Memorial
Healthcare Successfully Attests to Stage 1
Meaningful Use
Welcome!
Presented by: Larry Katzovitz & Judy Triano Elmhurst Memorial Healthcare Kay Jackson (978) 805-3104 [email protected]
Judy Triano Larry Katzovitz 09 August 2012
Successfully Attesting to Stage 1 Meaningful Use
About Elmhurst Memorial Healthcare
• 15 Miles west of Chicago, IL • New Acute Care Hospital
– 860,000 ft2 Facility – Hospital operates 259 beds
• 16 locations – Outpatient sites located
throughout DuPage and Cook Counties
• 3,000 employees – Largest employer in Elmhurst – Among largest in DuPage
County • 600 Physicians on staff
• More than 800 volunteers
Guiding Principles
• Embrace the personal technology of patient and family members
• Empower the physicians and nurses with key clinical information – facilitate communication
• Allow clinicians to access key medical information anytime and everywhere
• Integrate medical information and clinical information, make it easy to access
• Ensure the medical record tells the “patients story”
• Make sure the technology delivers all of the time
age: 4
Accreditations and Certifications
STAGE 6!
The Joint Commission Gold Seal of Approval: Inpatient Diabetes
Stroke Acute Myocardial Infarction
Heart Failure
Outstanding Achievement Award
Our Applications
Merge CVIS &C-‐PACS
Sovera Medical Records
DR Systems PACS – Radiology
Imaging
Intego Nursecall
Varian Oncology
Meditech 5.65 C/S RegistraGon & Bar
Orders – POM, PWM, EDM Lab, Radiology, Pharmacy, Financials
Outline of Today’s Webcast
• Understanding HITECH Act and Your Organization – Organizational Road Map
• Organizing the Team for Success – MU Workgroups – Monitoring results – Documentation
• Finalizing and Realizing Your Goals – Attestation – Lessons learned & challenges – Celebration
• Q & A
Organizational Road Map
• Know HITECH ACT and EHR Incentive Programs • Research & select monitoring tool • Create Steering Committee • Create MU leadership/resource teams • Understand financial impact • Define each objective as a separate project • Create timeline • Communicate and address workflow changes • Monitor progress • Celebrate progress
Understanding HITECH Act
• Assigned one person to focus on interpreting HITECH Act and Final Rule
• Kept up to date with rule changes www.cms.gov Medicare list serve • Engaged outside counsel
Understanding HITECH Act
Frequently reviewing FAQ’s
Meaningful Use Working Groups
MU Steering Commi.ee
Meaningful Use Working Groups
Physicians Hospitalists Nursing HIM Registra<on Ancillaries Info Services
• Problem List (H) • CPOE (H) • Clinical Decision
Support (L)
• Record Vitals (L) • Maintain Act Meds (L) • Med Allergy List (L) • Record Smoking
Status (L) • EHR Education
Resources (L) • Med Reconciliation (L) • Advanced Directives
(L)
• Electronic Discharge Instructions (L)
• Patient e-Copy (L) • Clinical Data Target
Patient Specific Condition (L)
• Clinical Quality Measures (H)
• Patient Demographics (M)
• Electronic Exchange Key Clinical Info (H)
• Implement Secure Patient Data (M)
• Incorporate Lab Results in EMR (L)
• Electronic Transfer of Data to Health Agencies (M)
• Drug Formulary Checks (L)
• Drug/Drug/Allergy Checks (L)
• Ensure program objectives are met
• Gain active participation of all stakeholders
• Measure progress and success
• Remove roadblocks and ensure organizational commitment
• President CEO • CFO • CIO • CMIO • VP’s Patient Care • Director Medical Records • Hospitalist Leader • Board Members
CLEAR VISION & MISSION
Meaningful Use Steering Committee
MU Steering Commi.ee
• Drives day-to-day project activities
• Establish target objectives based on meaningful use criteria
• Work in teams to institute the change necessary in both process and technology to ensure criteria is met
• Escalate roadblocks as necessary
Meaningful Use Working Groups
Physicians Hospitalists Nursing HIM Registra<on
Ancillaries Lab &
Pharmacy Info Services
Determine Measure
Requirements
IdenGfy Content Sources
Develop Processes Workflow Impacts
Make Design Changes
Capture Data AXest
Approaching Meaningful Use
Workgroup Methodology
Review e-‐measure
Current workflow
data
Gap Assessment
Workflow changes
Re-‐assess & Monitor
• Individual Project - Charter - Clear objectives - Timelines
• Regular Meeting Schedule
• Minutes for Each Meeting
• Made Resources Available – IS
• Frequent Feedback
Workgroup Methodology
Examples of Workflow Change
• Demographics - Registration
• E-copy Discharge Instructions/Health Record - Nursing
• Problem List - Physicians & Coders • DVT Assessment for CQM’s - Physicians, Nursing, & HIM • RxNorm - Pharmacy & IS
Workflow Change - Demographics
• Registration - Preliminary Cause of Death
Workflow Change -E-copy Discharge Instructions
• Nursing
Workflow Change -E-copy Health Record
• HIM
Examples of Workflow Change
• Demographics - Registration
• E-copy Discharge Instructions/Health Record - Nursing
• RxNorm - Pharmacy & IS
• Problem List - Physicians & Coders
• DVT Assessment for CQM’s - Physicians, Nursing, & HIM
Problem List
• Comment: Several commenters noted that the coding of problem lists at the point of care is outside the normal workflow process and would be disruptive.
• Response: We did not and do not intend that coding of the diagnosis be done at the point of care. This coding could be done later and by individuals other than the diagnosing provider.
DVT Assessment – Quality Measures
“I think you should be more explicit here in Step Two.”
Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct
Meaningful Use Stage 1 Project Milestones
Kickoff MeeGng
Measurement Design
Workgroups Task CompleGon
Meditech Upgrade Live
IS/Workgroup Build/Approval Process
Test Data CollecGon/QA/OpGmize
AXestaGon Data CollecGon AXestaGon SubmiXal
Attested ahead of schedule in mid May 2012
Our Timeline
Over estimated time
Monitoring Results
MU Dashboard
• Track all Meaningful Use events, compliance and action items from one convenient Web-based dashboard
• Provide visibility to all stakeholders • Be alerted to problem areas daily • Centralize MU knowledge • Minimize audit risks • Certified • Past experience with vendor
MU Dashboard
MU Dashboard
All Systems Go!
Attestation Process
• Registration – start early - CMS Registration Guide
http://www.cms.gov/Regulations-and-Guidance/
Legislation/EHRIncentivePrograms/downloads/
EHRHospital_RegistrationUserGuide.pdf
NPI TIN
CCN PECOS
EHR Certification
Attestation Process
• CMS Registration cover Medicare and Medicaid
• Navigating CHPL - like shopping fill cart until 100%
of measures covered
• Attestation about 25 web screens
• Get a Check!
All Systems Go!
Attesting
Attesting CQM’s
MUM Source of Documentation
• Thank you - Team effort - Include complete healthcare organization • Education - It is not just about the $ - Putting the patient first Setting the foundation for Stages 2, 3, and beyond.
Celebrating Our Success
Celebrating Our Success
Lessons Learned
• CQM’s – very challenging
• Need components for all Menu Set measures
• Modular vs. Complete Meditech EHR
College of Healthcare Information Management Executives (CHIME) September 2011 Survey: Quarter of CHIME Healthcare CIOs Report Their Organizations Have Qualified for Stimulus Funding. Page 9. http://www.cio-chime.org/advocacy/CHIME_MU4_Survey_Report.pdf
Quality Measures #1 Concern
Quality Measure Concerns
• Confusing Requirements - Not always aligned with Joint Commission and other quality data being collected
- Challenging workflow changes to collect data • Identifying Data e-Elements • Measuring Progress
CQM Dashboard
CQM Drill Down
Applications for all Menu Set Measures
Question [9-10-017-2]: ….Do I need to possess EHR technology that has/have been tested and certified: A) to all of the applicable certification criteria adopted in ONC’s Standards and Certification Criteria Final Rule; or B) only to those certification criteria that correlate with the Stage 1 core set objectives and associated measures and menu set objectives and associated measures I select to report on to CMS?
Answer: “A - to all of the applicable certification criteria adopted in ONC’s Standards and Certification Criteria Final Rule.”
Applications for all Menu Set Measures
• Possession of Certified EHR Technology – Physical possession of medium on which a certified Complete EHR
or combination of certified EHR Modules resides – Legally enforceable right by an eligible health care provider to
access and use, at its discretion, the capabilities a certified Complete EHR or combination of certified EHR Modules includes.
– An eligible health care provider may determine the extent to which it will implement or use these capabilities, which will not affect the provider’s “possession” of Certified EHR Technology
Judy Triano: [email protected] Larry Katzovitz: [email protected]
• Meaningful Use Manager
• PtAccess
• Public Health Interfaces
• OrderEase-MAGIC
• Visual Flowsheet
• CDE
• PDI
• PHR Connect
Iatric Systems Certified Solutions
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Meaningful Use Manager
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Meaningful Use Manager
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