Ambulatory Care EMR Meaningful Use:A Three-Level Approach LEVEL THREE: IT-ENABLED COMMUNITYEvidence-Based PracticeHealth Information Exchange Management ReportingPatient Interaction with the Medical RecordAdvanceLEVEL TWO: INTEGRATED EMR SYSTEMClinical Workflow ImprovementsReferrals & Results TrackingDocument ManagementStreamlined Coding & ReimbursementMeasureable Improvements in Patient Outcomes IntegrateLEVEL ONE:  BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingCultivateK Galambos, RN, MSN, CPHIMS
Level One:  Basic EMR AdoptionLEVEL ONE:  BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingThe ability to obtain Meaningful Use from an EMR means that a basic level of Adoption has been achieved.  A basic level of EMR Adoption is characterized by:  A stable, reliable technical environment that allows consistent EMR availability.
  More than 80% providers use EMR all the time AND/OR more than 80% of all patient charts are electronic.
  Basic health information is entered as discrete data.
  Electronic prescribing is used for more than 80% of eligible prescriptions. *  In order to meet requirements for future data sharing, the EMR application must be standards-based K Galambos, RN, MSN, CPHIMS
How to Achieve Basic EMR AdoptionLEVEL ONE:  BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingEstimated Time to Achieve: 12 – 36 months  Technical environment meets industry standards for system administration, performance , and HIPAA
  Leadership adopts model practice recommendations for organizational change management, system selection, implementation planning, deployment, training, and follow-up
  EMR adoption is measured and rewarded

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EMR Meaningful Use

  • 1. Ambulatory Care EMR Meaningful Use:A Three-Level Approach LEVEL THREE: IT-ENABLED COMMUNITYEvidence-Based PracticeHealth Information Exchange Management ReportingPatient Interaction with the Medical RecordAdvanceLEVEL TWO: INTEGRATED EMR SYSTEMClinical Workflow ImprovementsReferrals & Results TrackingDocument ManagementStreamlined Coding & ReimbursementMeasureable Improvements in Patient Outcomes IntegrateLEVEL ONE: BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingCultivateK Galambos, RN, MSN, CPHIMS
  • 2. Level One: Basic EMR AdoptionLEVEL ONE: BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingThe ability to obtain Meaningful Use from an EMR means that a basic level of Adoption has been achieved. A basic level of EMR Adoption is characterized by: A stable, reliable technical environment that allows consistent EMR availability.
  • 3. More than 80% providers use EMR all the time AND/OR more than 80% of all patient charts are electronic.
  • 4. Basic health information is entered as discrete data.
  • 5. Electronic prescribing is used for more than 80% of eligible prescriptions. * In order to meet requirements for future data sharing, the EMR application must be standards-based K Galambos, RN, MSN, CPHIMS
  • 6. How to Achieve Basic EMR AdoptionLEVEL ONE: BASIC EMR ADOPTIONStable Technical EnvironmentStandards-Based EMR Application80% RuleFull Documentation of Allergies, Vital Signs, Problem List, Medications, OrdersE-PrescribingEstimated Time to Achieve: 12 – 36 months Technical environment meets industry standards for system administration, performance , and HIPAA
  • 7. Leadership adopts model practice recommendations for organizational change management, system selection, implementation planning, deployment, training, and follow-up
  • 8. EMR adoption is measured and rewarded
  • 9. Electronic prescribing identified as key indicator of success K Galambos, RN, MSN, CPHIMS
  • 10. Level Two: Integrated EMR SystemLEVEL TWO: INTEGRATED EMR SYSTEMClinical Workflow ImprovementsReferrals & Results TrackingDocument ManagementStreamlined Coding & ReimbursementMeasureable Improvements in Patient Outcomes In an Integrated EMR System, Meaningful Use is achieved as a result of consistent, standard usage of the EMR across the enterprise. Advanced EMR functionality such as decision support, lab processes, internal communications, and referrals tracking are incorporated into daily processes. Quality data is reliably produced and used for tracking individual and organizational performance, EMR optimization, and outcomes measurement. Organizational support and accountability are dedicated to optimizing and sustaining the EMR. K Galambos, RN, MSN, CPHIMS
  • 11. How to Achieve an Integrated EMR SystemLEVEL TWO: INTEGRATED EMR SYSTEMClinical Workflow ImprovementsReferrals & Results TrackingDocument ManagementStreamlined Coding & ReimbursementMeasureable Improvements in Patient Outcomes Estimated Time To Achieve: 1-5+ Yrs Post-Installation Resources & Processes Dedicated to EMR Training & Support
  • 12. Business Process Redesign/ Move Toward Paperless Flow
  • 13. Integration with Ancillary Systems (labs, financial)
  • 14. Quality and Performance Measurement Using EMR Data
  • 15. Secure Technical Infrastructure with Privacy & Security OversightK Galambos, RN, MSN, CPHIMS
  • 16. Level Three: IT- Enabled CommunityLEVEL THREE: IT-ENABLED COMMUNITYEvidence-Based PracticeHealth Information Exchange Management ReportingPatient Interaction with the Medical RecordFew organizations have realized the degree of Meaningful Use inherent to an IT-Enabled Community. In this future state of EMR adoption, EMR data will be used to drive operational and quality improvements across the enterprise. Quantifiable health data will enable sophisticated initiatives such as patient-centric health care coordination, data-mining, and population health management. Technical components such as Patient Portal will allow self-scheduling, patient/provider communications, and access to health information for care transitions and continuity. Technology will be fully integrated into all aspects of the daily workflow, with resulting efficiency and cost savings. New roles & responsibilities will evolve for personnel to sustain the community.K Galambos, RN, MSN, CPHIMS
  • 17. How To Achieve an IT-Enabled CommunityLEVEL THREE: IT-ENABLED COMMUNITYEvidence-Based PracticeHealth Information Exchange Management ReportingPatient Interaction with the Medical RecordEstimated Time To Achieve: 2- 6+ Yrs Post-Installation The EMR is configured, deployed, and sustained to embody the Organizational Mission, Standards of Practice, and Operational Policies & Procedures
  • 18. Mandatory Use of Standards-Based, Discrete Data Sets Enables Electronic Health Information Exchange
  • 19. Technical Infrastructure Supports Interactions Between Patient/Family with Provider/Staff/Health InformationK Galambos, RN, MSN, CPHIMS
  • 20. K Galambos, RN, MSN, CPHIMS