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Learn about HITPAC project benefits, EHR adoption in Minnesota nursing homes, care coordination, and next steps for improved health information exchange.
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Health Information Technology for Post Acute Care (HITPAC): Minnesota Project Overview Candy Hanson Program Manager Julie Jacobs HIT Consultant June 13, 2013
Objectives • Understand the purpose of the HITPAC project • Identify benefits of the HITPAC project to Minnesota health care communities and its patient populations • Learn about Minnesota’s adoption and use of electronic health records and health information exchange in its skilled nursing facilities
Stratis Health • Independent, nonprofit, Minnesota-based organization founded in 1971 • Mission: Lead collaboration and innovation in health care quality and safety, and serve as a trusted expert in facilitating improvement for people and communities • Working at the intersection of research, policy, and practice
The Six Goals of the CMS Quality Strategy 1 2 3 4 5 6
Minnesota Environmental Scan • Provides a broad brush stroke of the state of Minnesota skilled nursing facilities adoption and use of EHRs • Describes EHR Functionality • Informs about Health Information Exchange (HIE) possibilities • Recommendations for moving forward Link to Minnesota Environmental Scan: http://intranet/c1/10sow/siphitpac/es/MN%20Environmental%20Scan%20for%20HIT%20PAC%20%20-%20Final%2001_08_13%20(2).pdf
Minnesota EHR Adoption & Use • 69% Minnesota nursing homes report adopting/using EHR • 99% report using EHR to document activities such as MDS assessment • 98% report using EHR to document resident demographics • 96% report using EHR to document diagnosis or condition list Ref 2011 MDH Nursing home Survey Data
Minnesota Nursing Homes with EHRsMedication Management Activities • 14% used EHRs for medication reconciliation • 62% used alerts for medications • 36% used an electronic medication activity record (e-Mar) • 3% used e-Prescribing Ref: 2011 MDH Nursing Home Survey Data
Care Coordination Toolkit http://www.stratishealth.org/expertise/healthit/caretransitions
Findings: • Limited Long Term Post Acute Care (LTPAC) EHR functionality • Interoperability • CCD • Medication Reconciliation and e-Prescribing • Laws and rules that pre-date EHR use contribute to problematic work flows • Hybrid health records (paper/electronic mix)
Findings: • LTPAC and Acute Care Facilities: • Understanding the needs of each • Inconsistent expectations of EHR users • Potential points for improving medication administration in current medication reconciliation workflows • Privacy and security practices in an electronic health record environment will continue to need attention • View-only access to hospitals’ EHR does not solve interoperability issues
Next Steps: • Early Recommendations • All EHR Vendors should design software that can both generate and consume a Continuity of Care Document (CCD) • 225 Data points • MDS, OASIS, Interact, other proprietary formats • Configuration and training related to Clinical Decision Support and e-Prescribing tools • Medication Libraries • Predictive text • Electronically generated reports • Work flow re-designs to advocate for Computer Physician Order Entry (CPOE) • Best practice around Medication Reconciliation • Pharmacy consults • EHR CDS
Next Steps (continued): • Earlyrecommendations -LTPAC facilities consider investing in a “super-user” environment -Financial assistance to help non-EHR LTPAC settings prepare for EHR adoption and use -Financial assistance made available to help LTPAC settings who have EHR in place assess adoption and use and workflow issues
Questions? For more information contact: Candy Hanson Program Manager Health Information Technology for Post Acute Care (HITPAC) Stratis Health chanson@stratishealth.org