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Health Care Workflow Process Improvement Process Redesign Lecture d This material (Comp 10 Unit 6) was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024. This material was updated by Normandale Community College, funded under Award Number 90WT0003. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
Process Redesign Learning Objectives Use knowledge of common software functionality and meaningful use objectives to inform a process redesign for a given clinic scenario 2
Process Redesign Topics Lecture d Objectives, skills and knowledge for Process Redesign Matching common clinic system functionality to solve process problems or optimize existing clinical processes Process redesign for Meaningful Use Objectives 1 through 10 3
Meaningful Use The Medicare and Medicaid EHR Incentive Programs provide a financial incentive for the "meaningful use" of certified EHR technology to achieve health and efficiency goals. By putting into action and meaningfully using an EHR system, providers will reap benefits beyond financial incentives such as reduction in errors, availability of records and data, reminders and alerts, clinical decision support, and e- prescribing/refill automation. Source: (CMS EHR Meaningful Use Overview, n.d., para. 1) 4
Meaningful Use Stages Source: Alicia Nesvacil 2016 5
Resources for this unit The Specification Sheets outline the criteria an Eligible Professional or Eligible Hospital must meet to achieve Meaningful Use Links to the Table of Contents and Specification Sheets are available on the next slide 6
Links to Table of Contents Eligible Professionals https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Dow nloads/2016_EPTableOfContents.pdf Eligible Hospitals https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Dow nloads/2016_EHTableOfContents.pdf 7
Meaningful Use Objectives Two sets of objectives Eligible Professionals (10 objectives) Eligible Hospitals/Critical Access Hospitals (CAH) (9 objectives) The criteria impact workflow 8
Eligible Professional Objective 1 1. Protect Patient Health Information Protect electronic protected health information (ePHI) created or maintained by the CEHRT through the implementation of appropriate technical capabilities. Workflow Impact Organizations complete an annual security risk assessment as part of compliance with requirements under HIPAA. 9
Eligible Professional Objective 2 2. Clinical Decision Support Use clinical decision support to improve performance on high-priority health conditions. Workflow Impact Decision tools, such as best practice alerts, provide targeted guidance at various points during the encounter. New workflow. 10
Eligible Professional Objective 3 3. Computerized Provider Order Entry (CPOE) Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines. Workflow Impact Role entering the order is determined by state, local and professional guideline. New workflow for an existing task. 11
Eligible Professional Objective 4 4. Electronic Prescribing (eRx) Generate and transmit permissible prescriptions electronically (eRx). Workflow Impact Role entering the order is determined by state, local and professional guideline. Task sequence is specified by the Meaningful Use Objective. New workflow for an existing task. 12
Eligible Professional Objective 5 5. Health Information Exchange The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral. Workflow Impact When clinicians place orders for a referral, they can specify the receiving provider and location. Summary of care documentation is electronically sent to receiving provider or location. New workflow. 13
Eligible Professional Objective 6 6. Patient-Specific Education Use clinically relevant information from CEHRT to identify patient-specific education resources and provide those resources to the patient. Workflow Impact The EP identifies educational resources specific to patients' needs. The EP provides these educational resources to patients. New workflow for an existing task. 14
Eligible Professional Objective 7 7. Medication Reconciliation The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation. Workflow Impact Process re-design takes advantage of the automation that exists in CEHRT because the functionality assists providers and facility staff in maintaining and reconciling an up-to-date medication list. New workflow for an existing task. 15
Eligible Professional Objective 8 8. Patient Electronic Access Provide patients the ability to view online, download, and transmit their health information. Workflow Impact The requirements include automating the release of health information to an online portal, including lab results and updates to medications and the problem list. Additionally, patients need the capability to download and transmit their health information. New workflow. 16
Eligible Professional Objective 9 9. Secure Electronic Message Use secure electronic messaging to communicate with patients on relevant health information. Workflow Impact Provider initiated action and interactions with a patient-authorized representative require secure transmission. New workflow. 17
Eligible Professional Objective 10 10. Public Health Reporting The EP is in active engagement with a public health agency to submit electronic public health data from CEHRT except where prohibited and in accordance with applicable law and practice. Workflow Impact The CEHRT provides many opportunities for capturing health data through clinician workflows involving patient care. 18
Process Redesign Summary Lecture d Eligible Provider and Hospital/Critical access Hospital objectives Using the Table of Contents and specification sheets for objectives Assessing possible workflow impact of Meaningful Use Objectives 19
Process Redesign References Lecture d References CMS EHR Incentive Program https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html Joint Commission: Using Medication Reconciliation http://www.jointcommission.org/assets/1/18/sea_35.pdf CMS EHR Incentive Program Eligible Providers Table of Contents. Retrieved from: https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads/2016_EPTableOfContents.pdf CMS EHR Incentive Program Eligible Hospitals Table of Contents. Retrieved from: https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads/2016_EHTableOfContents.pdf 20
Process Redesign Lecture d This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024. This material was updated by Normandale Community College, funded under Award Number 90WT0003. 21
