NWH Transition of Care document for MU Stage 2

1. NWH Transition of Care document for MU Stage 2 June 6, 2014

2. What is the definition of Meaningful Use (MU)? MU is using certified electronic health record (EHR) technology to: • Improve quality, safety, efficiency, and reduce health disparities • Engage patients and family • Improve care coordination, and population and public health • Maintain privacy and security of patient health information DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

3. What are the objectives of Meaningful Use Ultimately CMS hopes that MU will result in • Better clinical Outcomes • Increased transparency and efficiency • Empowered individuals • More robust research data on health systems DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

4. Stages of Meaningful Use • 2011-2012 • Stage 1 • Data capture and sharing • 2016 • Stage 3 • Improve outcomes • 2014 • Stage 2 • Advance clinical processes • NWH is preparing to begin MU Stage 2 reporting on July 1st2014 DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

5. Overview – MU 2 Objectives DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

6. Overview – MU 2 Objectives cont. DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

7. Overview – MU 2 Objectives cont. DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

8. MU Initiatives CPOE Med Reconciliation Drug-Drug/ Drug-Allergy Alerts Plans of Care – Problem Management Patient and Clinical Portals Data Standards LOINC Codes/ ELR Interfaces Ethnicity Race Smoking Status Immunizations Discharge Process • Discharge Assessment • Discharge Clinical Letter • Patient Specific Education Transition of Care Document Krames Patient Education ePrescribing DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

9. USES for Transition of CARE Document One Document leveraged to address the needs of 2 MU measures. 50 % of patients able to View online Download and Transmit info related to their hospital visit w/in 36 hours 50% of patients transfers or referrals include a Summary of Care doc; 10% of these sent electronically DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

10. Transition of Care Sections Extracted from Data Sources • Document Header • Allergies (RxNorm) • Problems and Encounter Diagnosis (SNOMED-CT) • Configured Results (LOINC for Laboratory) • Discharge Medications (RxNorm) • Immunizations (CVX) • Procedures (SNOMED-CT) • Chief Complaint Customer Configurable • Detailed instructions • Social History • Functional Status • Vital Signs (HT, WT, BP, BMI) and other configured Observations • Reason for Visit • Treatment Plan • Hospital Course DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

11. Transition of Care Document header • Auto-populated with data when the CCDA has been generated. • STAR is the data source • The Header includes: • Date range that the document summarizes • Location of Care, Entity, Service, Caregivers • Race and Ethnicity • Patient’s sex and date of birth • Patient’s preferred language • Account number, medical record number, visit identifier • Patient’s masked Social Security number – Last 4 digits DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

12. Challenges Not being able to limit results Vendor limitations Capturing Medical Problems Capturing Procedures DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

13. Challenges (con’t) Auto Generation of ToC Communication to staff/patients Patient Provisioning DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

14. Discharge Process Discharge Assessment • Timing of Discharge Orders • Appropriate Roles/ Scope of Practice in completion of assessment • Moving from paper to electronic (Soarian) Discharge Instructions Report • Creating a patient friendly, readable report • Supplemented by patient education materials from Krames Patient Specific Education ( Krames) UW Medicine Standard for patient education • Using “infobutton” in Soarian DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist

15. Our MU2 reporting period starts on July 1st, we’ll collect data to prove that we’re meeting our objectives and making it all work Q: The recognition and incentive reward will be nice, but what’s our real, big-picture goal? A: We have amazing technology & want to use it in the best possible way to benefit our patients!

16. The Patient Portal Secure online website that gives patients convenient 24-hour access to personal health information and other health tools from anywhere with an Internet connection

17. Questions? DeJuan Skelton IMS Project Manager; Mary Pat O'Donnell CIT Specialist