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

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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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