Based on healthit

1. Introduction to Health IT and Electronic Health Records Based on www.healthit.gov

2. Government and Health IT • Health Information Technology for Economic and Clinical Health (HITECH) Act 2009: Encouraging Use, Protecting Privacy, Supporting Research • Gives hospitals and doctors estimated $20 billion to support their installing and using EHRs. • Hospitals and doctors must demonstrate they are using EHR systems to actually improve care in specific ways per strict guidelines established by Office of the National Coordinator (ONC) for Health Information Technology. • ONC also promotes use of health IT in ways that improve care. Source: http://www.healthit.gov/patients-families/government-health-it

3. What Are Electronic Health Records? • Digital (computerized) versions of patients‘ paper charts with benefits of digitization. • Real-time, patient-centered records • “Whenever and wherever it is needed” • Everything about a patient's health in one place • Contains information about a patient's medical history, diagnoses, medications, immunization dates, allergies, radiology images, and lab and test results Source: http://www.healthit.gov/providers-professionals/learn-basics-ehrs

4. Features of EHRs • Access to evidence-based tools that helps providers make decisions about patient's care • Automates and streamlines providers' workflow • Provides single resource created, managed and consulted by authorized providers and staff across more than one health care organization. Authorized providers include: • Current and past doctors, emergency facilities, school and workplace clinics, pharmacies, laboratories, and medical imaging facilities. Source: http://www.healthit.gov/providers-professionals/learn-basics-ehrs

5. Benefits of EHRs and Health IT • Reduces patient and provider paperwork • Places PHI accurately into the hands of people who need it • Helps physicians coordinate care and protect safety • Reduces unnecessary tests and procedures. • Provides patients with direct access to health records Source: http://www.healthit.gov/patients-families/health-it-and-health-care-quality

6. Patient Story: Lilianne Wright My Type-1 Diabetes Could Be Managed More Effectively with EHRs Lilianne Wright is a mother of two from Tucson, AZ. After she survived a near-fatal diagnosis of Type-1 Diabetes in 2002, she found that one of the obstacles to managing her disease was an inaccessibility to her paper medical records. Today, her two children are benefiting from a new generation of medical tools: electronic health records (EHRs), technology she hopes her own providers will adopt. Read more about this story at: http://www.healthit.gov/patients-families/lilianne-wright Source: http://www.healthit.gov/patients-families/lilianne-wright

7. Physician Story: Dr. Jennifer Brull I Found Cancer in Patients Earlier Jennifer Brull, M.D., is a family physician in the rural town of Plainville, KS. Her EHR has allowed Dr. Brull to track quality measures to make sure that patients are getting the right screenings when they need it. “…we put a reminder in the EHR that automatically notifies me [if someone has not had the colon cancer screening test]. I am not perfect now, but I’m at about 81 percent, which is a lot better than 37 percent. “ Read more at: http://www.healthit.gov/patients-families/dr-jennifer-brull --Jennifer Brull, M.D. Source: http://www.healthit.gov/patients-families/dr-jennifer-brull

8. EHRs: Privacy and Security • Same Federal health information privacy protections that apply to paper records also apply to EHRs • Health Insurance Portability and Accountability Act of 1996 (HIPAA) • U.S. Department of Health and Human Services established standards for protecting privacy and security of certain health information, whether it is stored on paper or electronically. Source: http://www.healthit.gov/providers-professionals/privacy-security

9. EHRs: Privacy and Security • HIPAA Privacy Rule and HIPAA Security Rule provide Federal protections for individually identifiable health information called “protected health information” (PHI). • Privacy Rule protects paper, electronic, and oral information. • Security Rule applies only to information maintained in electronic form, sometimes referred to as e-PHI. This includes information in EHRs. Source: http://www.healthit.gov/providers-professionals/privacy-security

10. Health IT and Health Care Quality • Two studies support HIT goal to improve quality of care • Texas: More advanced health IT led to fewer deaths and fewer problems with care Texas Hospitals Study found hospitals with advanced health IT produced better patient results than hospitals with less advanced health IT. • Cleveland: EHRs led to more recommended care Better Health Greater Cleveland: Facilities using EHRs: 51% of patients with diabetes received all recommended care vs. facilities using paper-only records—7%. Source: http://www.healthit.gov/patients-families/health-it-and-health-care-quality

11. Health IT in New Jersey

12. Health IT in New Jersey • Helping Healthcare Providers Transition to EHRs • Establishing Health Information Organizations • Connecting through a Statewide/Nationwide Exchange

13. 1. Helping Healthcare Providers Transition to EHRs • Providing all New Jerseyans with electronic health records is the core mission of the New Jersey Health IT Program. • The New Jersey Health Information Technology Extension Center (NJ-HITEC), which was granted Federal funds to establish a statewide regional extension center, assists physician offices of ten physicians or less with the adoption and us of EHRs. • NJ-HITEC: www.njhitec.org • NJ-HITEC

14. 2. Establishing Health Information Organizations (HIOs)

15. 3. Connecting through a Statewide/Nationwide Exchange • New Jersey Health Information Network (NJHIN) will exchange health information to authorized physicians and hospitals across HIOs and with state databases such as Immunization. • The Network of networks within the state will also share information with authorized providers in other states across the country.

16. Federal and New Jersey State Resources on EHRs and Health IT

17. ONC/Federal Health IT Program Resources Talking to Your Patients About EHRs Health IT: Advancing America’s Health Care www.healthit.gov Protecting Your Privacy and Security Note: All four documents are available at www.nj.gov/njhit What Patients Need to Know About EHRs -- Trifold

18. NJ Health IT Program Resources www.njhitec.org www.nj.gov/njhit New Jersey Health IT Program Overview www.nj.gov/njhit/ehr

19. Glossary of Terms About EHRs and Health IT

20. Important Health IT Terminology • Health information technology (IT) is the use of computer hardware and software to privately and securely store, retrieve, and share patient health and medical information. • Electronic health record (EHR) is a digital record of a patient’s health information (formerly kept in a paper format or “chart”) that can provide the patient’s health care team with comprehensive health information about the patient. More than just a computerized version of a paper medical chart, over time, it can allow a patient’s providers to share important information, across different health care settings, while maintaining EHR patient confidentiality in accordance with federal and state privacy and security requirements. The patient health information in an EHR includes allergies, radiology images, lab and test results, medical history, diagnoses, medications, and immunization dates. Today, a small but growing number of doctors and hospitals use EHRs—and more are converting to these systems every day. EHRs are growing in popularity in the health care industry, in part because they can be safer and easier to use than paper, and in part because the Federal government is giving doctors and hospitals incentives to use them to improve care. • Electronic medical record (EMR) refers to a digital version of a patient’s health information that is only located in one hospital or physician practice. • Health Information Exchange (HIE) is the movement of health information electronically across multiple organizations. Exchanging health information is important in order to make sure that a patient’s health care providers have access to the most up to date information about the patient so they can make more informed decisions about the patient’s care. HIE can improve the coordination of care for a person who is seeing multiple providers by enabling providers to share important health information. • Health Information Organization (HIO) is an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized and state standards. • Personal Health Record (PHR) is like an EHR, except a patient sets up and controls their information. The patient does not have to wait for their doctor to build an electronic system into his or her practice. Some health care or health insurance providers may already offer a PHR for patient use. A patient can also create a PHR through other software and online services. Much like the EHR, the PHR can be an electronic storage center for a patient’s most important health information, such as: emergency contacts, allergies, illnesses or conditions, medications, immunization dates, lab and test results. A PHR may also have its own "apps" – programs that are used on smartphones – that can help a patient monitor or improve their health by linking with other devices such as a web-enabled digital scale or pedometer. Ideally, a patient should be able to link their PHR with their doctor's EHR, making it a personal health care "hub," although most doctors may not be technologically ready for this quite yet. PHRs can be maintained in a variety of formats, such as a USB "memory stick" or on a password-protected Internet site.

21. Important Health IT Terminology (cont.) • Electronic PrescribingE-prescribing enables a doctor to enter a patient’s prescription into a computer database. The order for the medication is then sent over a network to the patient’s pharmacy, which can fill it immediately. Some larger hospitals already have e-prescribing. Many large drug store chains are getting ready to install systems or already have systems in place with this capability. E- prescribing requires that the doctor and pharmacy be linked electronically. Some doctors may not be able to do this today—but it is becoming increasingly common. • HIPAAPrivacy Rule, short forThe Health Insurance Portability and Accountability Act of 1996 Privacy Rule, provides patients with health information privacy rights. These rights are important for every patient to know. Patients can exercise these rights, ask questions about them, and file a complaint if a patient thinks their rights are being denied or their health information isn't being protected. A patient’s health information rights include:Right to access your health informationRight to an accounting of disclosures of your health informationRight to correct or amend your health informationRight to notice of privacy practicesRight to file a complaintThe HIPAA Privacy Rule gives every patient the right to inspect, review, and receive a copy of their health and billing records that are held by health plans and health care providers covered under HIPAA.The HIPAA Security Rule, short forThe Health Insurance Portability and Accountability Act of 1996 Security Rule, details the steps a patient’s health care providers and others must take to keep a patient’s electronic protected health information secure.