Electronic Health Records &

Meaningful Use

The Complete Story of White River Family Practice

- Abridged -

EHR Implementation

• WRFP

• EHR Evaluation & Selection

• eClinicalWorks

• VITL Assistance

• Training - on EHR, Documentation, Security, etc.

• Workflow processes

• Good processes support optimal outcomes

WRFP Strategic Objective: Quality

• Provide & document excellent care

• Follow current national clinical guidelines

• Individual patients

• Patient population management

• Organize office as a clinical microsystem

• Practitioner is not solely responsible to provide care

• Use data over time to improve quality

What is “Meaningful Use” to CMS?

What is “Meaningful Use” to CMS?

Achieving Meaningful Use

• VITL Assistance

• Meaningful Use Survey

• Immunization Interface Development

• Security Assessment

• Establish electronic exchange capability

• WRFP <> DHMC Test

•Begin 90 Day Attestation Period

Critical Task Schedule

“Quality”

• Patient Satisfaction

• Wait times, surveys

•Office Functions

• Patients seen by their PCP, results notification

•Care Processes

• Health screening exams

•Care Outcomes

• Hgb A1c < 7%, LDL-C < 100, B/P control

• Immunizations

Quality Focus, 2011 Achieve Meaningful Use (MU)

• “Advance Healthcare Processes and Outcomes”

• Select Clinical Quality Measures (CQM’s)

• Core Ambulatory & additional CQM’s

• Configure EHR, Clinical Decision Support System

Example: A Mix of Process and Outcome Measures

• Anti-thrombotic medications for patients with vascular disease and DM

• Smoking Status and Smoking Cessation Intervention

• Adult Pneumococcal Immunization

• Alcohol use screening

Why Choose These?

• Satisfy MU Requirements

• Available Data

• Room for improvement

• National Commission on Prevention Priorities:

• Top priority:

Aspirin chemoprophylaxis

Childhood immunization

Tobacco use screening and intervention

• Second tier:

Pneumococcal & Influenza immunizations

Alcohol use screening Colorectal cancer screening Hypertension screening

Implementation Process: What Works

• Select targets to improve

• Measure progress over short intervals

• Improvement ideas from anyone

• Provide frequent feedback

• Understand and use graphical reporting tools

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What’s Next

• This year, 24-7-”90.” Soon, 24-7-365.

• Refine use of our Electronic Health Record

• Improve efficiency of patient care documentation

• Update patients’ records for care done elsewhere

• Registry management

• Increase primary care services for those in most need

• Increase focus on Outcomes Measures

• Improve population health

• Vermont Blueprint, NCQA Certification, PCMH...

What does “Meaningful Use” mean to WRFP?

CMS Measures, plus:

•EHR supports excellent patient care.

• Personalized

• Efficient

• Evidence-driven where appropriate

• Producing measurable care

•Outcomes improve.

• Over time

• Within White River Family Practice

• Regionally and nationally

Improve information management

Share medical information with other entities when appropriate

Thank you