Meaningful Use Case Study Telana Fairchild, MSN, FNP 10/14/2014 N707 Biomedical Informatics University of Massachusetts- Worcester Graduate School of Nursing

Small Practice Monitors Clinical Quality through EHR System Templates Middlebury Family Health (MFH) Middlebury, Vermont

Medent 19.5 MFH Details March 2010 January 2011 June 2011 About 4,500 active patients 4 Providers Worked with the Vermont Information Technology Leaders (VITL) Provided with various tools and resources Began Implemented EHR Attested MU Medent 19.5 Started March 2010 Implemented Medent in January 2011 Version 19.5 Attesting to Meaningful Use in June 2011 March 2010 January 2011 June 2011

EHR Selection Implementation PCMH VITL and State collaborative Achieve NCQA-PCMH Level 3 Vermont HER collaborative educational programs 5 different vendors Polled other medical practices AAFP Practice Management Journal VITL and State collaborative Created flow charts of workflow Allowed a member from each department to be a part of process Chose month of lower volume 100 hrs in-house training

Templates and Packages Created templates for chronic conditions Asthma, Diabetes, Hyperlipidemia Evidence based research Guidelines Enables to collect quality measures “Plan Package” Checklist Ordering system for common diagnoses Labs, procedures, referrals Within patient’s progress note

Meaningful Use Stg 1, Step 5 3 Core CQMs & 3 Menu CQMs HTN: Blood pressure measurement Preventive Care and Screening: Tobacco Use Assessment and Invervention Adult Weight Screening and F/U DM: HgA1C poor control DM: Blood pressure management CAD: Oral antiplatelet therapy Ex: Poor A1C- lists patients >8 and actions taken Objective: Report ambulatory clinical quality measures to CMS Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS Their report on Diabetes Hemoglobin A1c Poor Control, for instance, returns a list of patients whose A1c is greater than 8 percent and what actions have been taken to follow up with the patient (such as scheduling a follow up appointment or requesting additional laboratory tests). This also allows MFH to generate a list of patients for whom follow is needed.

Conclusion Process- 9 months Medent Pleased Lost productivity Productive Monthly fee- support Has MU department Medent Lost productivity Fewer patients Hired additional staff Longer appointments Overtime