june 18, 2010 marty larson. health information exchange meaningful use objectives conclusion
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An EHR isn’t Enough: Information Exchange for
Meaningful UseJune 18, 2010Marty Larson
Agenda Health Information Exchange Meaningful Use Objectives Conclusion
HIE Data Sendors
◦ Hospitals◦ Laboratories◦ Imaging Centers◦ Other providers
Data Receivers Providers
◦ EMR◦ Paper◦ Hybrid
Public Health Clinics Other Hospitals Other HIEs
Health Information ExchangeData Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
5
Pharmacies
CMS
Other States
Meaningful Use Objectives Use CPOE Implement drug-drug, drug-allergy, drug- formulary
checks Maintain an up-to-date problem list of current and
active diagnoses based on ICD-9-CM or SNOMED CT® Generate and transmit permissible prescriptions
electronically Maintain active medication list. Maintain active medication allergy list Record demographics. Record and chart changes in vital signs. Record smoking status for patients 13 years old or
older Incorporate clinical lab-test results into EHR as
structured data. Generate lists of patients by specific conditions to use
for quality improvement, reduction of disparities, research, and outreach.
Report ambulatory quality measures to CMS or the States.
Send reminders to patients per patient preference for preventive/ follow-up care
Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules
Check insurance eligibility electronically from public and private payers
Submit claims electronically to public and private payers.
Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)
Provide clinical summaries to patients for each office visit.
Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
Perform medication reconciliation at relevant encounters and each transition of care.
Provide summary care record for each transition of care and referral.
Capability to submit electronic data to immunization registries and actual submission where required and accepted.
Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.
Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities.
Meaningful Use Objectives Use CPOE
Health Information ExchangeCPOE
Data Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
8
Pharmacies
CMS
Meaningful Use Objectives Use CPOE Generate and transmit permissible
prescriptions electronically
Health Information ExchangeE-Prescribing
Data Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
10
Pharmacies
CMS
Meaningful Use Objectives
• Use CPOE• Generate and transmit permissible
prescriptions electronically• Incorporate clinical lab-test results
into EHR as structured data.
Health Information ExchangeStructured Lab Results
Data Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
12
Pharmacies
CMS
Meaningful Use Objectives Use CPOE Generate and transmit permissible
prescriptions electronically Incorporate clinical lab-test results into EHR
as structured data. Report ambulatory quality measures to CMS
or the States.
Health Information ExchangePQRI
Data Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
14
Pharmacies
CMS
Meaningful Use Objectives Provide patients with an electronic copy of
their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request
Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)
Health Information ExchangePHR
Data Senders
Hospitals LabsRadiolog
yOther
HIE
Public Health
PatientsOther HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
16
Pharmacies
CMS
Meaningful Use Objectives Capability to exchange key clinical
information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
Health Information ExchangeClinical Notes
Data Senders
Hospitals LabsRadiolog
yOther
HIEPublic Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
18
Pharmacies
CMS
Meaningful Use Objectives Capability to submit electronic data to
immunization registries and actual submission where required and accepted.
Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice.
Health Information ExchangePublic Health
Data Senders
Hospitals LabsRadiolog
yOther
HIE
Public Health
Patients
Other HIE’s
Totally Paper Practices
Practice Electronic
InboxCommunity Approved
EMR’s
Other Practice EMR’s
Paper Records
Paper Records
Interface Interface
Data Receivers
20
Pharmacies
CMS
Conclusion An EHR isn’t Enough: Information
Exchange for Meaningful Use◦ 9 Meaningful Use Objectives met by using a
Health Information Exchange◦ Reduction in Cost◦ Reduction in Hassle◦ Increased staff Productivity
Questions/Comments