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

2. Last Next Ten Years Improved Technology Government Support Receptivity of Healthcare Professionals Receptivity of Patients = Use of Electronic Records = Amount of Data Health IT Workforce Curriculum Version 1.0/Fall 2010 2Component 3/Unit 15a

3. Health IT Workforce Curriculum Version 1.0/Fall 2010 3Component 3/Unit 15a

4. The Electronic Health Record Common acronyms for electronic records for patient data –EHR: electronic health record (across the lifespan) –CBMR: computer based medical record –CPR: computerized patient record –EMR: electronic medical record –EPR: electronic patient record –PHR: personal health record Health IT Workforce Curriculum Version 1.0/Fall 2010 4Component 3/Unit 15a

5. Functions of the Health Record Document patient care Provide communication among healthcare team members Financial and legal record Research and continuous quality improvement Repository of the clinical thought processes recording ideas and impressions over the period of care Single point at which all clinical data are archived for long-term use Health IT Workforce Curriculum Version 1.0/Fall 2010 5Component 3/Unit 15a

6. Attributes of the EHR Enormous capabilities of data storage in a small space Accessible from remote sites to multiple people at the same time Information retrieval can be almost instantaneous Provide clinical alerts, expert systems, and reminders Health IT Workforce Curriculum Version 1.0/Fall 2010 6Component 3/Unit 15a

7. Attributes of the EHR Can link the clinician to protocols Create customized views Improve risk management Provide outcomes assessment More accurate capture of financial charges and billing efficiency Increases patient satisfaction Health IT Workforce Curriculum Version 1.0/Fall 2010 7Component 3/Unit 15a

8. Health IT Workforce Curriculum Version 1.0/Fall 2010 8 Data rich and information poor? Component 3/Unit 15a

9. Rights of Information  Right information: must be accurate, free from error, and meaningful  Right person: communicated to the person who will respond to them  Right time: crucial to the health of an individual, give to the decision-maker within a few minutes or hours  Right place: must be accessible at the point of care  Right amount: decisions can be made faster when only the information desired is available Health IT Workforce Curriculum Version 1.0/Fall 2010 9Component 3/Unit 15a

10. American Recovery and Reinvestment Act (ARRA) $ 19B for HITECH –Health Information Technology for Economic and Clinical Health Center for Medicaid and Medicare Services (CMS) –Incentive Payment, Meaningful Use Office of the National Coordinator for Health Information Technology (ONC) –Certification Standards Health IT Workforce Curriculum Version 1.0/Fall 2010 10Component 3/Unit 15a

11. Meaningful Use “The effective use of information to support better decision-making and more effective care processes that improve health outcomes and reduce cost growth” 1.Data Capture and Sharing 2.Advanced Clinical Processes 3.Improved Outcomes Health IT Workforce Curriculum Version 1.0/Fall 2010 11 The Markel Foundation: Connecting for Health, “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009 Component 3/Unit 15a

12. Data Capture and Sharing Improve Quality, Safety and Efficiency Engage Patients and Families Improve Care Coordination Improve Population and Public Health Ensure Privacy and Security Protections Health IT Workforce Curriculum Version 1.0/Fall 2010 12Component 3/Unit 15a

13. Improve Quality Use CPOE Formulary Checks Problem List e ‐ Prescribe Rx List Rx Allergy List Record Demographics Record physiological data Growth charts for children between 2 and 20 Record Smoking (> 13 Yrs) Structured Lab Results List Patient by Condition Report Quality Measures Patient Reminders (50 Yrs or >) Clinical Decision Support ("Relevant to Clin Quality Measures“) Check Eligibility Submit Electronic Claims Health IT Workforce Curriculum Version 1.0/Fall 2010 13Component 3/Unit 15a

14. Engage Patients and Families Patient e ‐ Access on Request (Including Discharge Summary/ Instructions from hospital) Patient e ‐ Access to Record (Patient Portal) Clinical Summaries each Visit (Portal, email, CD, USB, Paper) Health IT Workforce Curriculum Version 1.0/Fall 2010 14Component 3/Unit 15a

15. Improve Care Coordination Exchange Health Info with other Provider Medication Reconciliation Summary Care Record for each Transition/Referral: Transfers w/Summary Health IT Workforce Curriculum Version 1.0/Fall 2010 15Component 3/Unit 15a

16. e ‐ Submit to Immunization Registries (Hospital also submits to Department of Public Health) Syndromic Surveillance to Department of Public Health Health IT Workforce Curriculum Version 1.0/Fall 2010 16Component 3/Unit 15a Improve Population and Public Health

17. Final Revisions to the ARRA Meaningful Use Rule Final revisions to the rule July 13, 2010 http://www.ofr.gov/OF RUpload/OFRData/20 10-17210_PI.pdf Health IT Workforce Curriculum Version 1.0/Fall 2010 17Component 3/Unit 15a

18. Summary of Objectives The “Meaningful Use” Regulation for Electronic Health Records. NEJM, July 13 th, 2010 http://healthcarereform.nejm.org/?p=3732 Health IT Workforce Curriculum Version 1.0/Fall 2010 18Component 3/Unit 15a