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Cuyahoga County Board of Health (CCBH) and Regional Extension Center (REC)

Discover the benefits and strategies of implementing Electronic Health Records at Cuyahoga County Board of Health, Ohio. Learn how to improve productivity, efficiency, and quality of care while ensuring regulatory compliance. Gain insights on securing leadership support, fostering buy-in, and maintaining effective communication throughout the process.

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Cuyahoga County Board of Health (CCBH) and Regional Extension Center (REC)

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  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><AllAnswers /> Cuyahoga County Board of Health (CCBH) and Regional Extension Center (REC) James W Coates, MS, RS Researcher, Epidemiology, Surveillance and Informatics

  2. Cuyahoga County Board of Health • Serves ~845,000 residents in Cuyahoga County, Ohio excluding the City of Cleveland and Shaker Heights.

  3. Why EHR at LHD? • Participate in the Health Information Exchange • Provide Patient Data • Get Population Data • Increase Revenue • Improve Productivity and Efficiency • Improve Customer Service and Quality of Care • Improve Regulatory Compliance

  4. Keys to Success • Senior-level Management Support • Funding, priority setting, and executive attention • Physician and Nurse/Staff buy-in • Identify Champions • Abandon inefficient processes • Leave the “we’ve always done it that way” behind • Maintain Constant Communication • Understand Technology alone will not transform nursing practice Liang, L. Connected for Health Using Electronic Health Records to Transform Care Delivery. 2010. Jossey-Bass A Wiley Imprint.

  5. Goal To record all patient interactions, migrate historical data from current practice management (PM) system, track and generate claims, achieve stage 1 meaningful use, participate in the State health information exchange, and comply with HIPAA 5010 and ICD-10 requirements.

  6. CMS Incentive Flow Chart Centers for Medicare & Medicaid Services. ICN# 905343 (September 2010) https://www.cms.gov/MLNProducts/Downloads/Eligibility_Flow_Chart-ICN905343.pdf

  7. History of Events • October 2010 • REC Kick-off Meeting • Not Eligible for REC Services • November 2010 • Title X Letter • December 2010 • Signed REC Agreements

  8. Golden Ticket *Additionally CCBH contracts with Certified Nurse Midwife with prescriptive authority and a M.D.

  9. REC Experiences • Case Western Reserve University (CWRU) • Assigned Consultant • Welch Allyn • Preparation Questions • Personnel • Budget • Work flows

  10. Welch Allyn • Preparation Questions • Personnel • Budget • Work flows

  11. CCBH Direct Services • Immunizations • Child • Adult • Travel • Title X Family Planning • School Based Dental Sealant

  12. Work Flows • Documents sequence of events between actor and the system. • Excellent learning experience for all • Communicates needs to developers • Essential for developers

  13. Example Work Flow Orlova, A., Johns Hopkins University, Health Information Technology Standards and Systems Interoperability Course, Spring 2011. http://ocw.jhsph.edu/courses/infstandards/PDF/infStandards_lec5c_orlova.pdf

  14. Fork in the Road • System Type • Integrated • Include Case Management • Interfaced • Could Include Case Management

  15. Case Management • Things to consider • Include in build out of EHR • Comprehensive System • Reporting • Maintenance • Cost

  16. Next Steps • Case Management? • Develop RFP • Evaluate Vendors • Vendor Selection

  17. Welch AllynProcess{Deliverable: Requirement Analysis Document} |----------------------------| Send out RFP{Deliverable: Receive at least 3 proposals} |----------| Vendor Selection{Deliverable: Choose 1 certified vendor} |----------| Sys. Development  {Deliverable 1:  Sys. Development Specifications} |----------------------------|{Deliverable 2:  Working prototype / pilot} Pilot testing & retesting    {D:  Pilot Testing Protocol/Report} |---|        |-----| Modification |------|     |---|     Implementation {D: Sys. Documentation} |-------------------------| Evaluation & Operation  {D:  Ops. Manual} |-------------------------------> _______________________________________________________________________________   Jun-11            Aug-11            Apr-12            May-12            Jul-12            Sept-12            Nov-12    Timeline

  18. Contact Information James Coates, MS, RS Researcher Epidemiology, Surveillance and Informatics Cuyahoga County Board Of Health 5550 Venture Drive Parma, OH 44130 Phone: 216-201-2001 ext: 1617 Email: jcoates@ccbh.net

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