Assistant Research Professor, Indiana University School of Medicine Research Scientist, Regenstrief Institute, Inc

CSM 2012 – HPA Tech SIG Feature Presentation

02.11.2012 © 2012

Daniel J. Vreeman, PT, DPT, MSc

Electronic Health Records healthcare system chicken soup or rotten egg?

Associate Director, APTA Practice Department

Matt Elrod, PT, DPT, MEd, NCS

Corporate Director of Technology Integration, Select Rehabilitation

Robert “Bob” Latz, PT, DPT, GCFP

Manager, St Luke's-Elks Rehab - Meridian

Steven G. Wilkinson, PT, PhD

Overview

1.  Why EHRs matter 2.  Selecting an EHR 3.  Mobile devices and other hardware 4.  Case study 5.  Implementation considerations 6.  Open discussion

photo via Vernio77

We are not alone

Why are we here?

The Future Great Scott!

Complete, longitudinal information that follows the consumer

Care that is value-based and coordinated across settings

photos via meddygarnet and brykmantra

Health decisions made with information tools that assist and guide

Have you considered…

Results Fewer errors, waste, variations Consumer-centered care Lower spending

Meanwhile, back on planet Earth…

Patients move faster and further than their health information

Growing Recognition

1960’s •  1st studies of

computers in healthcare

1991 •  IOM says

EHR’s are essential

2003 • HHS promotes

widespread use of HIT

2004 •  Pres. Bush

makes HIT a top national priority

2004+ •  Flurry of

federal activity

2009 •  ARRA has $20

billion for HIT adoption

Resolved, at the American Physical erapy Association supports the use of electronic health record systems (EHRs) and promotes the widespread adoption of interoperable EHRs in all physical therapy practice settings.

e "rst priority in realizing the bene"ts of health IT is to achieve nationwide adoption of EHRs and widespread information exchange.

“

CMS EHR Incentive Program

a.k.a. “Meaningful Use”

EHR “Meaningful Use” Reimbursement incentives for eligible providers who become “meaningful users” of certified EHR technology

EHR “Meaningful Use” PTs, OTs, SLPs are NOT eligible providers

“Meaningful Use” drug-drug checks structured lab results in your EHR clinical decision support exchange key clinical info report on quality measures

Do PTs today really use EHRs?

good question…

APTA 2010 Member Survey

28%

33%

38%

1%

Got EMR?

Yes, all electronic Yes, part paper, part electronic No

Don't know

APTA 2010 Member Survey

No plans to acquire

Plan to acquire but > 1yr

Plan to aquire within 1yr

Aquired, but not implemented

Implementation in progress

Fully implemented

0 10 20 30 40

EMR Use

Most common complaint?

anecdotal

Where’s the Rehab stuff???

3 Ways EHRs can Help Accelerate that Vision Data reuse Decision support Canopy computing

practice management, quality reporting, accreditation, public health, research…

Collect once. Use many.

EHR Decision Support A computer-generated suggestion about care for an individual patient

me

photo via liber

The secret sauce of the HIT chicken soup

photo via nosha

e rain forest canopy is a seamless web through which arboreal creatures efficiently

move to reach the edible fruits without any attention

to the individual trees. McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329.

Only way to corral the infinite indiosyncracies

is with standards.

photo via pfarrell95

Data standards are like telephones. They require a critical mass of users before they become useful.

photo via iboy_daniel

- Clem McDonald, MD 1998

Indiana Network For Patient Care A Unified Patient Record

An EHR is a suite of applications. WAY more than just electronic documentation

8 Core EHR Functions

Results Orders

Decision Support

Communication Patient support

Administrative

Population Health

Where’s the evidence?

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Evidence for Health IT

92% of 154 studies

1968!

is review suggests that EHRs have potential bene#ts for physical therapists. “

Benefits of EHRs

0

2

4

6

8

10

12

Improved Reporting

Improved Operational

Efficiency

Improved Communication

Improved Data Accuracy

Barriers to Implementing EHRs

0

1

2

3

4

5

6

Behavior or Workflow

Modification

Software or Hardware Inadequacy

Staff Training

Success Factors in Implementing EHRs

0

1

2

3

4

5

6

7

8

9

End-user Participation in Development

Data Standardization

Adequate Staff Training

Incorporating Workflow Analysis

Key Lesson of Today

photo via IMLS DCC

or

photo via Robert Couse-Baker and Nina Matthews Photography

Computer +

Human Human