Clinical Decision Support at Partners Healthcare Blackford Middleton, MD, MPH, MSc Corporate Director, Clinical Informatics R&D Chairman, Center for IT.

Slides:

Advertisements

Similar presentations

Meaningful Use and Health Information Exchange

Advertisements

PBHCI Project Sustainability Analyzing Clinical Workflows to Support Integrated Care and Seamlessly Maximize Revenue 1:00 – 2:00 PM ET 3/15/2012.

Improving Diagnosis and Management of Hypertension: Implementation of Ambulatory Blood Pressure Monitoring in Primary Care* Scot B. Sternberg, MS; Kristine.

Area 4 SHARP Face-to-Face Conference Phenotyping Team – Centerphase Project Assessing the Value of Phenotyping Algorithms June 30, 2011.

Meeting Stage 1 Meaningful Use Criterion Carlos A. Leyva, Esq. Digital Business Law Group, P.A.

INTRODUCTION TO PRACTICE BASED RESEARCH

Proposed Meaningful Use Criteria for Stage 2 and 3 John D. Halamka.

Measuring Quality and Clinical Performance Indicators at Partners HealthCare System Blackford Middleton, MD, MPH, MSc Corporate Director, Clinical Informatics.

US Perspectives on HIT Adoption and Assessment under Meaningful Use Blackford Middleton, MD, MPH, MSc Partners HealthCare System, Inc. Harvard Medical.

Role of the EHR in Healthcare Reform of Integrated Health Care Systems Blackford Middleton, MD, MPH, MSc Partners HealthCare System, Harvard Medical School.

Cohort Studies Hanna E. Bloomfield, MD, MPH Professor of Medicine Associate Chief of Staff, Research Minneapolis VA Medical Center.

ETIM-1 CSE 5810 CSE5810: Intro to Biomedical Informatics Mobile Computing to Impact Patient Health and Data Exchange and Statistical Analysis Presenter:

IMPROVING HEALTH AND HEALTHCARE FOR MENTAL HEALTH CONSUMERS: FROM RESEARCH TO PRACTICE AND BACK AGAIN Benjamin Druss MD, MPH Knowledge Network Summit October.

Medicare & Medicaid EHR Incentive Programs

Elizabeth I. Molina Ortiz Diabetes Medical Director Institute for Family Health.

Paul Kaye, MD VP for Practice Transformation Hudson River HealthCare October 1, 2010.

A First Look at Meaningful Use Stage 2 John D. Halamka MD.

Meaningful Use Stage 2 Esthee Van Staden September 2014.

Medical Informatics "Medical informatics is the application of computer technology to all fields of medicine - medical care, medical teaching, and medical.

August 9, 2013 Patient Engagement: The Time is Now Weekly Webinar Series Overcoming Meaningful Use Barriers: Solutions from the Field.

Establishing Preventive Cardiology Programs Nathan Wong Nathan Wong.

Unit 6.2: Clinical Decision Support Systems that Help Improve Quality Decision Support for Quality Improvement Component 12/Unit 6.21Health IT Workforce.

EHRS as a Tool to Improve BP Control 1.Brief history of OQIUN, CCI. Began 1999 using data cards. Started working with multiple practice sites using different.

SMART EMR Diabetes Demo. FOR DYNAMIC DEMO   Userid: sEMRguest  Pwd: guest  CAVEAT: This is not a functional.

NAPHSIS Annual Meeting 2009 Electronic Health Records: Why are they important? Linette T Scott, MD, MPH Deputy Director Health Information and Strategic.

Incentives for Medical Practice Transformation: The Bridges to Excellence Initiatives A. O’tayo Lalude, MD Louisville, Kentucky at The Third Annual HIT.

Developing Interoperable EHR: Maximizing Quality of Care Gregory J Downing, DO, PhD Office of the Secretary Department of Health and Human Services July.

SWEA1 CSE 5810 HIEx TM : Health Link Information Exchange  Review the elements of, and differences between health information technology and health information.

A First Look at Meaningful Use Stage 2 John D. Halamka MD.

Alkhudhair Dr. Basema Kh. MOH))Consultant & Trainer in Family Medicine Clinical Assistant Professor KSU

Physician Performance and Reporting Commentary David W. Bates, MD, MSc Medical Director of Clinical and Quality Analysis, Partners Healthcare Chief, Division.

Electronic Health Records and Clinical Decision Support Systems Impact on National Ambulatory Care Quality Max J. Romano, BA; Randall S. Stafford, MD,

HealthCare Information Technology Blackford Middleton, MD, MPH, MSc Director, Clinical Informatics Research & Development Chairman, Center for IT Leadership.

Affordable Healthcare IT Solutions. MU RX Compliance with Meaningful Use Stage 2.

So You Want to Do CDS A C-Level Introduction to Clinical Decision Support.

Use of Computerized Clinical Decision Support System and Registry Functions to Track and Improve Clinical Outcomes Pamela Ferrari RN Director of Performance.

Evidence-Based Public Health Nancy Allee, MLS, MPH University of Michigan November 6, 2004.

MEDIQ EuroRec’s First Draft List of EHR Certification Criteria Knut Bernstein MEDIQ

Diabetes Mellitus Primary Care QI Project – Year III Mary Altier, RN, Bonnie Fiala-Bayser, Ph.D., William Cannon, MD, David Goldberg, MD, Jan Jandrisits,

HITECH/MEANINGFUL USE Danielle Smith Trends and Issues in Healthcare December 2, 2014 Power Point Project.

Using the Electronic Health Record to Encourage Evidence-Based Practice Jonathan S. Einbinder, MD, MPH Partners HealthCare

Component 3-Terminology in Healthcare and Public Health Settings Unit 15-Overview/ Introduction to the EHR This material was developed by The University.

Confidential All Rights Reserved Patients Complain About Access Doctors Complain About Compliance.

The First Clinical Insight Engine Find out how ClinicalKey delivers comprehensive, trusted content for unrivaled speed to answer.

Clinical Decision Support Consortium Blackford Middleton, MD, MPH, MSc Clinical Informatics Research & Development Partners Healthcare Brigham & Women’s.

Mary Gardner, RN, MA, CCM, CDE Program Manager, High Risk Diabetes and COPD XLHealth Member Management Using The Med-eXpert System and Med-eMonitor Patient.

Terminology in Health Care and Public Health Settings Unit 15 Overview / Introduction to the EHR.

Leveraging Social Science and Technology to Harness the Power of Information Democratization Joshua Seidman, Ph.D. President Bethesda, MD.

Chapter 19 Manager of Information Systems. Defining Informatics Process of using cognitive skills and computers to manage information.

What Lies Ahead for ONC Meaningful Use and Beyond Farzad Mostashari, MD ScM National Coordinator for Health Information Technology.

Design of Patient-Centered Care Health IT Patient Advisor involvement in ePHR Design and Outcomes Research Patricia Sodomka, FACHE Senior Vice President,

Configuring axiUm for Meaningful Use

SAGE Nick Beard Vice President, IDX Systems Corp..

The Role of Health Information Technology in Implementing Disease Management Programs Donald F. Wilson, MD Medical Director Quality Insights of Pennsylvania.

Complex Medical Patients Wayne Katon, MD.  Definition: Illnesses with high prevalence, high comorbidity and bidirectional adverse interactions Examples:

Use of EHR & Quality Based on Zhou, et al. The Relationship between Electronic Health Record Use and Quality of Care over Time. J Am Med Inform Assoc.

1 Michaela Frazier, LMSW Director of Community Benefit Programs Institute for Family Health Care Coordination and Technology to Support Physical and Behavioral.

UNIVERSITY OF MISSOURI Family & Community Medicine EMR Dashboards & Registries Helping the Team Take Action in the Patient-Centered Medical Home.

Presentation Developed for the Academy of Managed Care Pharmacy

Improving Patient Outcomes in Diabetes Matt Petersen Managing Director, Medical Information & Professional Engagement American Diabetes Association.

N ORTHWEST AIDS E DUCATION AND T RAINING C ENTER HIV Prevention in Clinical Care Settings Jeanne Marrazzo, MD, MPH Professor, Division of Allergy and Infectious.

Cheryl Schraeder, RN, PhD, FAAN Health Systems Research Center

Objectives of behavioral health integration in the Family Care Center

Using Technology to Support Evidence Based Practice

1st International Online BioMedical Conference (IOBMC 2015)

Expert Medical Opinion Program

CPOE Medication errors resulting in preventable ADEs most commonly occur at the prescribing stage. Bobb A, et al. The epidemiology of prescribing errors:

Expert Medical Opinion Program

Presentation transcript:

Clinical Decision Support at Partners Healthcare Blackford Middleton, MD, MPH, MSc Corporate Director, Clinical Informatics R&D Chairman, Center for IT Leadership Partners Healthcare System Harvard Medical School Harvard School of Public Health

Overview: CDS Dimensions Provider workflow Provider workflow – Lookup – Alert – Interrupt – Actionable – Documentation- centric – Population (Cohort) Patient Relevance Patient Relevance – Non-specific – Specific/tailored Consumer Consumer – Lookup – Alert – Population (Cohort) Methods Methods – Inference methods (rules, etc.) – Temporal reasoning (protocols/pathways) – Values/Utilities (preferences: pt/provider) 5*2*3*3 = a minimum of 90 different approaches to CDS!

Partners CDS CPOE CPOE Alerts & Reminders Alerts & Reminders Actionable CDS Actionable CDS Documentation-centric CDS Documentation-centric CDS Population/cohort Population/cohort Patient-directed CDS Patient-directed CDS

Medication ordering -- main screen

KnowledgeLink in the Workflow

Secure Messaging Task Management Population Management Clinical Alerts Schedule Patient Lists Knowledge Links

CAD/DM Smart Form Smart View: Data Display Smart Assessment, Orders, and Plan Assessment and recommendations generated from rules engine Smart Documentation Lipids Anti-platelet therapy Blood pressure Glucose control Microalbuminuria Immunizations Smoking Weight Eye and foot examinations Lipids Anti-platelet therapy Blood pressure Glucose control Microalbuminuria Immunizations Smoking Weight Eye and foot examinations

CAD/DM Smart Form Medication Orders Lab Orders Referrals Handouts/Education

CAD Quality Dashboard Targets are 90 th percentile for HEDIS or for Partners providers Zero defect care: Aspirin Beta-blockers Blood pressure Lipids Zero defect care: Aspirin Beta-blockers Blood pressure Lipids Red, yellow, and green indicators show adherence with targets

Discrepancy Details

Serious Medication Error Rates Before and After CPOE Bates et. al. JAMA 1998.

Preliminary Results: Smart Form On Treatment Analysis <

Patient Journal Causes Provider Activation Grant RW et al. Practice-linked Online Personal Health Records for Type 2 Diabetes: A Randomized Controlled Trial. Arch Intern Med Sep 8;168(16): Arch Intern Med. More medication changes in visits after diabetes journal submission:

An external repository of clinical content with web-based viewer Search Criteria Content Type… Specialty

Community (”Crowd”)Medical Professional Personal Health Information Network Science Rule builder Knowledge respository Rule engine Clin. Inf. System Petter K. Risøe HSPH HPM ’Crowdsourcing’ Knowledge Engineering Patient

“I conclude that though the individual physician is not perfectible, the system of care is, and that the computer will play a major part in the perfection of future care systems.” Clem McDonald, MD NEJM 1976 Thank you! Blackford Middleton, MD Where are we?