EHR Meaningful Use & System Development Life Cycle

1. EHR Meaningful Use & System Development Life Cycle Camille Infante, Heather dos Remedios & Safiah Mamoon HCA 626- Health Information Technology

2. The Problem:Paper-based Health Records • Legibility problems • Issues with patient safety • Fragmentation of information • Lack of flexibility • Space and storage issues • Difficulty in conducting research • Difficulty in dispersion and reporting • Difficulty in measuring quality • Inability to exchange information seamlessly • Not available to multiple users • More time needed to write chart notes • Back-up problems • Fragile and susceptible to physical destruction

3. How will we overcome these issues with EHR/Meaningful Use? • Improved quality, efficiency and safety of health care, • Engage patients in their health care, • Improved communication • Improve care coordination • Improved workflow • Improve population and public health • Save time through structured data entry • Maintain privacy and security THE SOLUTION: Adopt a government-certified EHR for meaningful use

4. So What Happens When… • … the health management executives or Chief Information Officer (CIO) of a health organization wants to adopt electronic health records (EHR)? • If they are eligible providers, they must acknowledge the rules and regulations of EHR Meaningful Use to gain incentives and adapt to the growing field of health information technology

5. What is Electronic Health Records (EHR)? • According to Health Information Management Systems Society (HIMSS), “The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports,” (2014).

6. Health Information Technology for Economic and Clinical Health Act (HITECH) • Component of the American Recovery and Reinvestment Act (ARRA) of 2009 signed into law by President Barack Obama on February 17, 2009 • Seeks to improve health care delivery and patient care through the use of health information technology • Under Title IV, Division B of HITECH, incentive programs are established under the Medicare and Medicaid programs for eligible professionals and eligible hospitals that meaningfully use EHR Technology that is certified through Certification Commission for Health Information Technology (CCHIT) • The Centers for Medicare and Medicaid Services (CMS) is charged with managing the Medicare and Medicaid Incentives Program, also known as EHR Meaningful Use

7. What is EHR Meaningful Use? • The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology • To receive an EHR incentive payment, eligible providers and hospitals have to show that they are “meaningfully using” their certified EHR technology by meeting certain measurements that range from recording patient information as structured data to exchanging summary care records • Stage 1 requires two years of meaningful use; Data capture and sharing • Stage 2 is proceeded when Stage 1 is completed; Advanced clinical processes • http://youtu.be/dUiARwgKzi0

8. EHR Meaningful Use Criteria • Eligible professionals must complete fifteen core objectives, five menu set objectives, and six Clinical Quality Measures (CQM) • Eligible hospitals must complete fourteen core objectives, five menu set objectives and fifteen Clinical Quality Measures (CQM) • http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1vsStage2CompTablesforEP.pdf

9. Workflow Goals Functions Design Implementation Organization THINGS A CIO SHOULD TAKE INTO CONSIDERATION

10. System Development Life Cycle

11. Why Would the CIO Need to Initiate a System Development Life Cycle? To correct problem in existing system To improve existing system Outside group may mandate change Competition can lead to change

12. SDLC Challenges of EHR Systems and EHR Meaningful Use… • Lack of an evaluation process • Inability to understand the requirements • Privacy and security issues • One-size-fits all approach • User utilization • Not consistent • Cost

13. Issues and Challenges with Meaningful Use Implementation

14. Issues to Consider With Meaningful Use Implementation • Data capture abilities of software • Workflow redesign • Understanding of requirements • Selection of product • Assigning roles • Training and skills

15. Benefits of EHR Meaningful Use • For Patients • Play an active role in their health care • Receive efficient care by the accessibility and organization of EHR • Receive safer care due to reduction in medical errors that are usually provided by human error, unorganized information, missing information, and lack of readability of handwritten notes • There is also the means of health care convenience for patients who need a printout of the medical records where in this case all documents and images are stored in the system • Communicate with provider without making appointments for minor problems

16. Benefits of EHR Meaningful Use • For Providers • Supportive in creating a safer and efficient environment • Provides efficiency and organization in the workplace • Complete documentation • Legible prescribing and documentation • Reduction in medical errors • Work-life balance • Incentives • Interoperability can be achieved at more advanced stages by connecting systems between hospitals, physician offices, pharmacies and imaging departments

17. Benefits of EHR Meaningful Use • For the Community • Early identification of trends • Identify safety problems in their area • Detect epidemics • Prevention • Share information and resources • Early intervention • Education • Improve overall healthcare