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 Kay.Jackson@iatric.com

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: jtriano@emhc.org Larry Katzovitz: lkatzovitz@emhc.org

• Meaningful Use Manager

• PtAccess

• Public Health Interfaces

•  OrderEase-MAGIC

•  Visual Flowsheet

•  CDE

•  PDI

•  PHR Connect

Iatric Systems Certified Solutions

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