PowerPoint Presentation IHM Presentation

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Denni McColm, CIO, Citizens Memorial Healthcare
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• 74 acute care beds
• Emergency Services
• Home Health, Hospice, Home Medical Equipment,
  Health Transit Services
• Long Term Care Facilities (5)
• Residential Care Facility (1)
• Physician Clinics (16 locations, 60 providers)
• Outpatient Services

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• EMR that crosses continuum
• 100 use of CPOE
• No paper charts

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Ambulatory Quality and Safety Project

• Standardize and integrate data capture for
  quality measurement into the normal documentation
  of care within the ambulatory EMR
• Implementation of an automated system for data
  extraction including valid, reliable reports that
  provide actionable insight for the measurement,
  analysis and improvement of care

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Broad Approach All PQRI measures applicable

• First period, July 1, 2007 December 31, 2007
• Renewed for 2008, January 1 December 31
• 1 ½ bonus for Medicare fee schedule services for
  reporting at least 80 of the time on 3 or more
  measures during the period
• 47 measures proposed initially
• 74 measures actually used in 2007
• 119 measures in use for 2008
• 175 proposed for 2009 (bonus 2 plus ePrescribing
  bonus 2

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Where are the answers?

• Demographics
• Billing Data
• Test Results
• Orders
• Health Maintenance
• Vital Signs
• Medication List
• Queries

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Template Redesign
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PQRI Exclusions Exceptions
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• The Institute for Health Metrics (IHM) is
• A non-profit that helps hospitals leverage
  electronic systems for quality improvement
• Assists hospitals in extracting data from the
  MEDITECH system for use in
• Physician Departmental Profiling
• Quality of Care Reporting JCAHO Core Measures,
  IHI, AHRQ, etc.
• Performance Improvement
• Benchmarking

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Data Extraction Process

• Nightly data extracts
• Monthly reports delivered within hours of
  discharge codes completed

Web Based Reports
Clean Normalize Map Report
IHM

• NO Software to Install and maintain
• No IT resources outside initial VPN set up
• All CMS, JCAHO requirement updates performed by
  IHM
• All new indicators added by IHM

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• AIES (Automated Indicated Extraction System)
  Automatically delivers quality performance
  indicators for over 300 quality measures to
  expedite hospital reporting and improve care.
• PQMS (Physician Quality Management System)
  Provides hospital management with on-going
  department and physician information for reviews
  and credentialing across 102 procedures and 26
  diagnoses.
• CPMV (Core Measures Patient View) Preps data for
  submission to core measures vendor.
• Daily Infection Alert This new daily report
  alerts the hospital staff to identify patients at
  risk for hospital acquired infections and to
  proactively intervene.

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Challenges

• Designing to be time neutral for providers
• Speech recognition
• Medication reconciliation / updating
• Nurse support training
• MUSE
• Make a personal connection
• Understand the patients concerns and priorities
• Sit, see, and show the screen
• Engage the patient as a partner in healthcare
• Patient Portal
• Hospital based providers measures
• Sharing templates