Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk
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This document discusses maximizing the use of electronic health records (EHRs) in physician practices while minimizing risks. It provides an overview of the meaningful use incentive program and its stages of implementation. It identifies potential liability issues with transitioning to EHRs, such as communication barriers and alert fatigue. The document recommends strategies for practices to prepare for EHR implementation, including using "dummy" patients and reviewing physician experience. It stresses the importance of organizing EHR assessments, applying basic risk management principles, and developing methods to evaluate policies, charts and interviews.
Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk
- 1. Sedgwick © 2012 Confidential– Do not disclose or distribute. Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk
- 2. Sedgwick © 2012 Confidential– Do not disclose or distribute. Presented by: Ann D. Gaffey, RN, MSN, CPHRM, DFASHRM SVP, Healthcare Risk Management and Patient Safety Sedgwick
- 3. 3 Objectives • Upon completion of this session, participants will: Describe the current status of the Meaningful Use incentive program, including participation, payments, and current core and quality measures; Describe three risk management and patient safety issues related to the use of EHRs in the physician office setting; and Describe three risk reduction strategies to implement to mitigate risk associated with use of EHRs in the physician office practice setting.
- 4. 4 Meaningful Use – Where We are Today • Eligible providers • Certified technology • Meaningful Use criteria Stage 1 Stage 2 Stage 3 • Non-compliance
- 5. 5 CMS Final Rule: Stages 1 and 2 • CMS Final Rule - Stage 1 MU: 25 objectives and measures 20 objectives must be completed to satisfy MU and qualify for the incentive payments – All 15 from Core Set – 5/10 from the Menu Set. • CMS Final Rule - Stage 2 MU : Provide patients ability to view online, download and transmit their health information within 4 business days of the information being available to the EP Incorporate clinical lab-test results into Certified EHR Technology as structured data
- 6. 6 Stage 1 vs. Stage 2 Comparison
- 8. 8 Stage 2 • Meaningful Use Core and Menu Measures
- 9. 9 Stage 2 – Menu Objectives
- 10. 10 Percentage of office based physicians with EMR/HER (US 2001 – 2010, preliminary 2011-2012) Source: CDC/NCHS, National Ambulatory Medical Care Survey, 2001 - 2012
- 11. 11 Percentage of electronic health records (by physician age, practice size, ownership and specialty, 2011) Source: CDC/NCHS, Physician Workflow study, 2011
- 12. 12 Percentage of office based physicians with a basic system by state (US preliminary, 2011)
- 13. 13 US ERM Adoption Model
- 14. 14 Potential Liability Issues in EHRs • Transitioning from paper to electronic records • Communication barriers • CPOE functionality • Formatting and usability issues • Alert fatigue • Vendor contract issues • Managing labs and test results • Medication Reconciliation • Documentation “work-arounds”
- 15. 15 Transitioning from paper to electronic • Populating the EHR -- All? Some? Abstract? • Physician and staff training – Initial and ongoing • Availability of data -- paper vs. electronic • Timing of data input -- document scanning • The new “legal” record
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- 17. 17 Strategies to Prepare for Implementation • “Dummy” patients • Become familiar with system and template layout • Practice open-ended questioning associated with the templates imbedded in the system • Video and review physician experience
- 18. 18 Managing Labs & Test Results • Interface vs. delivered by fax/mail • Tasking of results • Timing of availability to all providers
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- 22. Sedgwick © 2012 Confidential– Do not disclose or distribute. Formatting and Usability Issues: Where do they find what they are looking for?
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- 30. 30 Medication Reconciliation • Reconciliation functions Allergy documentation Who is responsible for what step? What “complete” reconciliation looks like in the EMR What “complete” reconciliation looks like to the patient
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- 41. Sedgwick © 2012 Confidential– Do not disclose or distribute. Risk Reduction Strategies
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- 45. 45 Applying the Basic Risk Management Principles • Risks in the office practice setting Medication safety Appropriate management of labs and tests Your concerns?
- 46. 46 Getting Organized • Why are you assessing? • What are you assessing for? • What standard are you assessing against? • What is your “best practice”? • Who are your subject matter experts?
- 47. 47 Methods for Assessments • Policy and procedure review • Chart review Sample sizes • Interviews • Aggregating data • Reporting findings
- 48. Sedgwick © 2013 Confidential – Do not disclose or distribute. Questions?
- 49. Sedgwick © 2013 Confidential – Do not disclose or distribute. Ann Gaffey, RN, MSN, CPHRM, DFASHRM SVP, Healthcare Risk Management and Patient Safety Sedgwick ann.gaffey@sedgwickcms.com (703) 597-5172