1. Truven or Consequences How we Augmented Centricity to Meet the MU Patient Education Requirement Dr. Paul Snyder Dr. Mike McLeod Concord Hospital, Concord, NH

2. Concord Hospital Concord, NH 295 licensed beds Concord Hospital Medical Group: 13 primary care sites 13 specialty care sites ~220 providers ~125 Eligible Providers Single server, shared chart Centricity 9.8 2

3. CHMG EP Meaningful Use Attested for Stage 1 in 2011 Initially aiming for Stage 2 in 2014 Decision to attest for Stage 2 using 2014 Stage 1 criteria 100% of CHMG EP’s successfully attested in Q4 2014 3

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5. Patient-specific Education in Centricity 9.8 Truven via InfoButton Workflow is cumbersome Content is often lacking Rx info when prescribing OK if you are prescribing a new medication Duplicative of pharmacy-provided info 5

6. The Consequence: Provider Discontent The Truth: Providers were already doing plenty of education –But it doesn’t count for MU Suggested workflow provides poor or duplicative content What we heard: “Busy-work just so the Hospital can get some money” “Meaningless Abuse”  Provider morale suffers, undermines entire MU effort 6

7. How do we make MU Patient Education Meaningful? Suggest content based on Diagnoses actually addressed during the encounter Give MU credit for existing educational materials in use Add more options for 3 rd -Party educational materials Make it easier to use during a patient encounter *(need to self-report to be able to count measure this way) 7

8. How do we make MU Patient Education Meaningful? Suggest content based on Diagnoses actually addressed during the encounter –Diagnoses used for orders placed through Orders module –Problems selected on CPOE Assessment & Plan Form –Problems designated on the End of Visit Summary 8

9. How do we make MU Patient Education Meaningful? Give MU credit for existing educational materials in use –Solicited content from Primary Care and all specialties What educational materials are you already using? What diagnoses do you use each for? –Currently > 1200 Dx-Handout combinations –Manual, labor-intensive process – but worth it if it adds value 9

10. How do we make MU Patient Education Meaningful? Add more options for 3 rd -Party educational materials –Up to Date –PERC (Patient Education Resource Center) 10

11. How do we make MU Patient Education Meaningful? Make it easier to use during a patient encounter –Put the functionality in a place that Providers are already using in their current encounter workflow * Existing Smoking and Weight Loss Handout Buttons * End of Visit Summary Form 11

12. 12 End of Visit Summary: Patient Education is embedded in current workflow

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14. What Happens When I Hit the Print Button? 14 Custom Handouts: Print, MU credit recorded to OBS term Pre-printed Materials: Nothing prints (duh), but MU credit is recorded to OBS term, & chart note records which handout was given UpToDate & PERC: Launches Internet Explorer window to a search on that diagnosis at the respective site On closing the window the user is asked via Yes/No button whether they actually printed a handout – choosing Yes writes MU credit to OBS term

15. CHMG Patient Education - Form Rollout 15 Initial engagement through soliciting content Form developed & content added through reporting period Practice-by-practice Demo to providers Weekly Dashboards add sense of urgency Feedback generally good – using the content they want (Why do I have to check a box and hit a button for something I was doing anyway?)

16. 16 Rapid adoption Increasing use per provider during the reporting period

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21. Take-aways and Impressions 21 Centricity can be modified to enhance Patient Education options “Home-grown” options preferred, but not exclusively Providers appreciated credit for education already being used Easier workflow helped with more rapid adoption Patients like being given educational material Bring on MU2!