PEHRChar

t

Claims Data

Breadth and Depth

Population

Qua

lity

Mea

sure

s

2

Quality Improvement Measure Category

CCNC QMAF Claims

CCNC QMAF Chart Audit 

CHIPRA C - Chart Extraction Data CHIPRA D - PEHR Reporting 

Obesity Prevention BMI V-codes   BMI percentiles.Evidence of Counseling.

BMI percentiles.Evidence of Counseling.Blood pressure percentiles.

Oral Health Dental visit (annual) & dental varnishing rates

  Documentation of dental home.Oral Health Risk Screen and counseling.

Documentation of dental home.Oral Health Risk Screen and counseling.

Developmental and Behavioral Health

Screening rates   Maternal Depression Screen.Referral/follow-up done for positive screens.

Maternal Depression Screen.Referral/follow-up done for positive screens.

Early Periodic Screening Diagnosis and Treatment (EPSDT)

Well-child visits and components

  Adolescent Immunizations. Well-child visits and components.Adolescent Immunizations.

Asthma Asthma management and utilization

Asthma Action Plan recorded

  Asthma Action Plan recorded

NC EvaluationData to Support QI Measures

CHIPRA Team/Provider Assessment

Provider Survey Vendor Self-Report Tool Patient Survey

Completeness Function Ease of interpretationPatient experience of

care

Medical relevance UseabilityEase of

implementation 

 Satisfaction with

implementation   

3

Additional Measures

NC Evaluation

High Level Plan - PracticeM

ajor

Act

iviti

es a

nd

Tim

efra

mes

(app

rox.

)O

ngoi

ng

Act

iviti

esR

oles

/Res

ourc

es • EHR Consultant• EHR Coach• Office Manager • Lead Clinician• Other Reps

frompractice

Recruitment

• Introduction to Practice

• Brief overviewof CHIPRA

• Review benefits

• Determine practice readiness

• Establish MoU

2-4 weeks

QI Reporting Benefits Realization Review and Feedback

Lessons Learnt, Patient Surveys and Project Closure

Reporting

• Provide overview of CHIPRA

• Establish Team and Roles• Confirm scope, processand benefits• Introduction to & completion of survey tool

Orientation &

Assessment6-8 weeks

• EHR Consultant• EHR Coach• Office Manager • Lead Clinician• Other Reps from

practice

• Training on enhancedfunctionality• Testing of system• Reassess EHR capability & user satisfaction• Assess patient satisfaction

Testing &Implementation

• EHR Consultant• EHR Coach• Office Manager • Lead Clinician• Other reps from

practice• Vendor

• Analyze survey responses

• Assess QI Objectives and set Goals

• Identify Training, Developmentand Resource Needs

Analysis

• EHR Coach• Office Manager • Lead Clinician• Other Reps

from practice

2-4 weeks

• Training

• Workflow re-design

• Enhance EHR Content & Functionality

• Ongoing Review and provide feedback on EHR development

Design &Development

• AHEC Rep• EHR Consultant• EHR Coach• Office Manager • Lead Clinician• Other Reps from

practice

4 – 6 months ………………….

Real-timereporting, prompts and care alerts

Closure of gaps identified in EHR products and workflow

Additional training and improved productivity using enhanced technology

National recognition by helping influence the future of EHR and national policy

Better clinical data capture, storage, and retrieval

Practice Benefits

Sample Practice Survey

 

EHR Currently Capable?

Medically Relevant?

Feature in Use? Use Detail EHR Coach Notes - KE Action Required

Vendor APractice

APractice

APractice

A Practice A Practice A  Obesity header header header header header headerReq-110 The system SHALL capture patient vital signs, including weight, height or length, head circumference, blood pressure, temperature, heart rate, respiratory rate, severity of pain, and calculate/store BMI as discrete elements of structured or unstructured data.

Yes Yes Strongly Agree Yes  

Req-111 The system SHALL calculate and display child age and percentiles and/or z-scores for height, weight, and BMI for measure instances included in growth charts.

Yes Yes Strongly Agree Yes  

Req-115 System MAY store and display waist circumference and hip circumference and calculate/display waist to hip ratio in patients identified with obesity or cardiovascular risk.

No No Agree No Training Needed Development Opportunity

Req-1164 The system SHOULD incorporate documentation of pertinent family history to screen children at risk for common chronic conditions such as asthma and diabetes (Trotter & Martin, 2007)

Yes Yes Strongly Agree Yes  

Req-1170 The system SHOULD incorporate Chronic disease and age specific educational materials, for example diabetes and asthma (Spooner, 2007; Kim & Lehmann, 2008; Brown et al., 2010; Howe, 2005)

Yes Partially Strongly Agree Partially Work-around in use

Materials not built in to current system. Must buy Pediatric Care Online to use interface. (S. Driver on 4/3/2013)

Training Opportunity