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Session Descriptions
Meeting Provider HITECH Needs: The Vendor Perspective
The panel will: Describe the process by which NC vendors are getting organized for EHR deployment, including the support of the vendor selection and group purchasing assistance specified in Section 3012 of the ARRA HITECT stimulus funding FOA; Discuss vendor commitment to supporting NC installations; Describe how providers can best engage the vendors to make sure they are selecting the appropriate system for the business/clinical needs and stimulus goals; and Discuss how vendors can support the regional extension centers.
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NC's Plans for An ARRA HITECH Regional Extension Program
The presenter will describe NC’s provider assistance plans specified in Section 3012 of the ARRA HITECH funding FOA.
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Bringing ARRA Home to NC: Plans for Applying for & Managing Stimulus Funding
Presenters will discuss NCHICA’s commitment to NC’s success; How the State has organized the efforts; HWTFC’s responsibilities for the Section 3013 application and management of the funds; The role of the HIT Collaborative in providing advice, guidance and support for the application development and coordination with other ARRA efforts (3012 and Broadband); and the application for a Regional Extension Center to support EHR adoption and meaningful use. There will be time for Q&A as well.
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Why CPOE?.....and
Its Unintended Consequences
As technology becomes more and more prevalent in the healthcare
arena, many hospitals are asking the question, "Is this
the time to invest in CPOE?" Many articles speak about
the benefits of implementing CPOE. The obvious benefits of a
CPOE implementation are reducing medication errors and reducing
turn-around time, but at what cost? Can CPOE actually have a
dollar value besides the actual cost of the project? What other
benefits will come from such an expansive project? What about
the unintended consequences of implementing CPOE? Are they good
or bad or both? CPOE creates many eye-opening impacts. Each
consequence must be addressed to determine how to use beneficially
or mitigate the impact.
Presenters will address the question of "Why CPOE?"
The benefits of implementing CPOE are many and the project
can be successful with careful and detailed planning. Once
CPOE is live the question becomes what next? Addressing the
unintended consequences of implementing CPOE becomes the next
generation of challenges that will be addressed in our presentation.
Session Objectives:
- List the reasons and benefits to moving forward with a
CPOE implementation.
- Describe the potential unintended consequences of implementing
CPOE, both good and bad.
- Discuss how good project planning and paying attention
to detail can help mitigate negative consequences and promote
positive ones.
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The Future of HIE:
Meeting Unmet Needs
Health Information Exchange (HIE) is currently at a crossroad.
Even the most successful of the current health information
organizations (HIOs) are facing numerous daily challenges
including sustainability and multiplying regulations. Fresh
ideas and money, however, are making their way into the system,
giving new possibilities and challenges. This presentation
will summarize current and previous efforts at broad HIEs,
including functionality, participation and sustainability
models, and present ideas on possible future developments
with the assumption that HIE will develop to address current
and future unmet needs. The presentation will address specific
issues such as sustainability, functionality, governance,
organizational structure, IT models (e.g., federated and repository
models) as well as likely developments in the law that may
help or hinder electronic exchanges of health information.
The talk will also delve deeply into the failure of current
HIEs to consistently and uniformly meet some of the needs
of end-users. Looking at those needs, the presenter will make
some broad estimations of where HIE may be directed in the
next few years and ways to create and sustain HIOs.
Session Objectives:
- List current regulations affecting the electronic exchange
of health information.
- Discuss the impact of any ultimate stimulus package on
the creation of HIOs.
- Describe the various legal structures from which HIEs
may take place.
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Understanding Government
EHR Incentives - What's In It for Me?
As 2011 draws closer, physicians and administrators
are being bombarded with marketing initiatives from vendors
and advice from consultants, urging them to move quickly to
adopt an EHR, or to buy one EHR in particular. In order to
make the right decision, practices need to arm themselves
with a complete and accurate understanding of the facts related
to the legislation, and must keep up-to-date on the moving
targets of "meaningful use" and EHR certification-a
daunting proposition given the speed and frequency at which
regulations are being proposed and modified. Misinformation
and misconceptions abound. This session will clarify the legislation-detail
its components, explore its implications, and relate it to
your practice.
Session Objectives:
- Analyze the latest proposals on "meaningful use"
and certification
- Understand how to evaluate the impact on your practice
- Develop a framework for making the right decision
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The Implications
of HIE on Healthcare Consumers: The Case of Consumer Empowerment
Emerging technological innovations such as personal health
records, electronic health records and the Nationwide Health
Information Network provide the ability to increase the sharing
of medical records among healthcare stakeholders. Although
there are concerns with the electronic sharing of medical
records, such as the security of the records, these technologies
have the potential to improve the quality of healthcare. Recent
studies show that patients want more control over their medical
records, which health information exchange (HIE) can allow.
Does this notion of consumer control create consumer empowerment?
In their discussions on HIE initiatives and technological
adoption, many healthcare stakeholders have emphasized the
need for consumer empowerment.
The purpose of this examination is to learn more about the
implications of HIE on healthcare consumers and how consumer
empowerment is discussed by three groups: an AHIC Consumer
Empowerment Group, the NCHICA NC Consumer Advisory Council
on Health Information, and a group of everyday consumers.
This examination revealed that there is no solid definition
of consumer empowerment in HIE; therefore it is difficult
to understand how and if consumer empowerment will be achieved
in HIE. One commonly discussed component of consumer empowerment
is literacy, which includes functional literacy, health literacy,
and a new concept of HIE literacy. Also, the idea of trust
was found to be important in a way that may not be anticipated.
The findings from this analysis have implications for consumers,
providers, vendors, policy-makers, patient advocates and other
healthcare stakeholders.
Session Objectives:
- Describe the implications of HIE technology on consumers.
- Explain how consumer empowerment has been discussed in
HIE initiatives.
- State the types of literacy levels needed to for consumers
to understand HIE.
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Nurse-Driven Clinical
IT Solutions: Improving Communication, Efficiency and Outcomes
Nurses empowered to integrate technology with workflow create
improved communication, efficiency and clinical outcomes.
This session will demonstrate how nursing utilized IT to solve
four different clinical initiatives:
- Ensuring influenza and pneumovac vaccines are given appropriately
following CDC guidelines (HQI Indicator)
- Automation of the IV Titration process
- Interdisciplinary communication of isolation indicators/active
surveillence
- Making sure provider-nurse communication is not lost with
the implementation of CPOE
Nursing involvement in clinical IT assures nursing is implementing
care based on best practices, consistent documentation and
the safe use of computer applications.
Session Objectives:
- Describe how technology imbedded vaccination protocols
improve compliance, audit and reporting.
- Describe the Nursing/Pharmacy communication facilitated
by an integrated IV Titration pathway.
- List two improved outcomes from the integrated isolation
pathway.
- Describe the impact of "Airport Monitors" on
CPOE Units.
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How 21st Century
Technology May Affect Informed Consent for HIE
Health IT is quickly transforming the 20th century paper-based,
fragmented and siloed healthcare delivery system into an electronic
exchange system that provides streamlined, coordinated and
comprehensive data to support more timely and effective care
delivery. Health IT offers exciting possibilities for improving
care, lowering administrative and healthcare delivery costs,
preparing for pandemics and disasters, and even new treatment
discoveries. However, adoption of health IT and participation
in health information exchange (HIE) networks fundamentally
changes the scope and dynamics of communications between healthcare
providers and consumers and created new challenges to consumer
and provider trust in the accuracy, security and privacy of
the health information exchanged.
Where applicable law does not require advance consumer consent
to exchange personal health information, it is a policy decision
as to whether, and for what purposes, consumer consent will
be required for that exchange. Consent policies that were
developed before an organization's adoption of health IT and
participation in an HIE network should be reviewed and updated,
as necessary, to verify that the policies are relevant and
adequate to ensure both that consumer health information is
readily available through HIE for authorized purposes, and
that the consumer's health information privacy and security
is not compromised.
Updating consumer consent policies to enhance their relevance
and applicability to a networked HIE environment is challenging.
The Health Information Security and Privacy Collaboration
multistate Consent Policy Options Collaborative determined
that consent policy decisions require careful consideration
of the risks and benefits of a new and promising, yet still
unfamiliar, HIE paradigm. The legitimate, yet often competing,
interests of all participants in the HIE network must be identified,
understood and ultimately balanced in order for the HIE networks
to succeed.
Session Objectives:
- Explain the issues that will affect policy decisions about
consumer consent to exchange health information through
HIE.
- Describe the interests that providers, consumers and HIE
administrators have regarding consumer consent to exchange
health information through HIE.
- Describe the legal and policy support for differing levels
of consumer consent to exchange health information.
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What Did
We Really Accomplish? Improving Compliance & Documentation
of Core Measures for JCAHO
Every healthcare provider is challenged with improving the compliance
and documentation of core measures to meet the requirements
of the Joint Commission. A case study of how the Carondelet
Health Network in Tucson, AZ utilized the electronic medical
record to guide compliance and its ultimate achievements will
be presented. Carondelet's implementation of the Cerner Millennium
Suite of applications required the local team to expend a great
amount of time, energy and resources in order to complete the
implementation on time and on budget. One of the questions that
confronted the team was: How will implementing Cerner help Carondelet
improve compliance and documentation to meet the core measurement
requirements of the Joint Commission?
This presentation will provide both a retrospective as well
as a current compliance review to share Carondelet's progress
in meeting these requirements including:
- Identification of the specific data elements needed;
- Identification of interdisciplinary processes that support
modifications to ongoing documentation in response to requirement
changes or workflow needs;
- Identification of educational needs and training processes;
and
- Determining what worked well and what did not.
Session Objectives:
- Discuss the need for interdisciplinary review of clinical
documentation.
- Identify needs for and use of required data entry fields
and their implications in compliance.
- Explain "Conditional Logic" use within clinical
documentation systems to assist in compliance.
- Explain the use of reference text within clinical documentation
systems to assure compliance.
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Consumer Empowerment
and Privacy: What Do Healthcare Consumers Really Know and
What Do They Really Want?
RTI International conducted a series of 12 focus groups and
a short survey of consumers at six sites across the country
asking about general knowledge of EHR, PHR and health information
exchange (HIE). The questions probed concerns about consent
and privacy related to multiple purposes for HIE such as treatment
and health research. Nine of the group discussions were conducted
in English, and two were in Spanish and one in Chinese Mandarin.
The groups were varied based on regional and residence, educational
attainment, age, sex, income, chronic illness and English
proficiency skills.
Highlights include:
- Concerns about security of EHRs were more common than
concerns about privacy.
- Privacy concerns focused mostly on access to information
by health plans and employers (concerns about discrimination).
- Groups suggested a system of role-based access to information
(minimum necessary to accomplish tasks and with providers
having the highest level of access) would protect privacy.
- Spanish-speaking and Chinese-speaking groups struggled
with the term "healthcare provider."
- Spanish-speaking and Chinese-speaking groups would permit
access to all types of health data to doctors, including
specially protected data such as HIV, STD, Mental health,
drug and alcohol and genetic data.
- Spanish-speaking groups split on whether paper or electronic
records are safer or more accurate.
- Chinese-speaking group felt paper records are more accurate.
Session Objectives:
- Describe how the participants in these groups understood
the purpose and functions of PHR, EHR and HIE.
- Describe how the participants viewed access to their health
information for various purposes and their beliefs about
the need for consent.
- Describe the differences in beliefs and concerns that
exist between the English-speaking and non-English speaking
groups.
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The Future 'Ain't
What It Used To Be' - Applying Yogi Berra's Wisdom to Hospital-Physician
Partnerships
Yogi Berra, the great Hall of Fame Catcher, once said: "You
got to be careful if you don't know where you're going, because
you might not get there." This prophetic statement can
easily be applied to the growing importance of developing ambulatory
strategies between hospitals and physician practices.
Healthcare organizations recognize the need to link physicians
to the hospital to both improve patient care and strengthen
ties with referring and employed physicians. With the relaxation
of the Stark regulations, hospitals continue to develop ambulatory
strategies to support physician practices including:
- Offering direct financial subsidies
- Extending the hospital's ambulatory EMR vendor discounts
- Identifying several third-party vendors of choice which
will eventually be integrated to the hospital's HIS
- Evaluating health information exchange opportunities (e.g.,
NOVO; RelayHealth) to link practices to the hospital
- Providing only technical support
This presentation will examine the varying ambulatory strategies
-- including success factors, issues and risks -- that exist
across the country (e.g., ThedaCare, Piedmont Health and Memorial
University Medical Center-Savannah), as well as within North
Carolina (e.g., Carolina's HealthCare System, University Health
Systems of Eastern Carolina, Novant Health and Moses Cone).
This presentation will also provide a case study of New Hanover
Regional Medical Center's (NHRMC) ambulatory strategy and
deployment. NHRMC will detail its plans and experience supporting
multiple practices - including cost, benefit, opportunity
and risk, as well as lessons learned.
Session Objectives:
- Discuss the varying ambulatory strategies that have been
successfully deployed across the country and within North
Carolina.
- Examine the cost, benefit, opportunities and risk for
the varying strategies.
- Describe the success measures of NHRMC's proven ambulatory
strategy.
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Determining
ROI for Public Health IT
Very few studies of the costs and benefits of public health
IT have been conducted. Quantifying the benefits of minimizing
the effects of a disease outbreak, for example, can be challenging.
Public health IT, furthermore, is a public good. In other words,
it benefits everyone and not just those who have paid for the
systems. Evaluating the return on investment for public health
IT is imperative, however, in order to define the best practices
of cost effective systems and to encourage investment and sustainability
in public health IT on a global scale. As data integration needs
continue to grow, stakeholders across all spectrums of healthcare
from the World Health Organization (WHO) to the local provider
play crucial roles in the development of disease surveillance
and response systems that aim to reduce morbidity and mortality.
This presentation will provide a review of the value of public
health IT systems as documented by several different localized
systems, including the Cherokee Indian Health Authority, the
NY Institute for Family Health, the NJ Electronic Disease
Surveillance System and NC DETECT. US policy regarding investment
in public health IT and the requirements of the WHO's International
Health Regulations regarding global disease surveillance will
also be discussed.
Session Objectives:
- Describe the primary functions of IT for public health.
- Describe the value of several different public health
IT exemplar systems.
- Understand US policy as it relates to investment in public
health IT.
- Understand the guidelines from the WHO regarding global
disease surveillance and reporting requirements and the
implications of these guidelines on local disease surveillance
systems.
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PCIX:
A Real Approach to P4P
Patients with chronic disease frequently have co-morbidities
that complicate their treatment. Failure to recognize illness
severity can lead to improper treatment that impacts cost and
health outcomes. To date there has been no commonly accepted
way to measure the complexity of patient illness nor track the
treatment outcomes. Current reimbursement models favor capitation
or pricing by procedure and are often misaligned with the severity
of illness.
To support pay-for-performance (P4P), we need to measure
treatment outcomes in terms independent of claims data. Such
evaluation and tracking tools would support fair compensation
according to illness complexity, facilitate clinical outcomes
improvement, and thereby achieve value-based outcomes for
patients.
The Patient Complexity Index (PCIX) methodology is based
on serum chemistry values used by physicians to diagnose specific
medical conditions to evaluate the severity of illness by
the deviation of those values from the normal range. By displaying
the serum chemistry values on uniquely constructed color-coded
radar charts, patients can readily visualize improvement over
time and payers can better compensate treatment according
to health outcomes. End Stage Renal Disease (ESRD) will be
used to demonstrate how PCIX complexity scores do not correlate
with current reimbursement methods as revealed in our study.
The discrepancy between reimbursement and PCIX complexity
scores may result from the inability of capitation reimbursement
models to account for varying levels of complexity that providers
face. Our presentation will demonstrate the need to measure
quality based on a value-based outcome of treatment results
over time in a P4P future.
Session Objectives:
- Discuss the complexities of measuring the health of a
patient over an episode of care and how one approach to
P4P put an organization ahead of the curve
- Explain how a data-based model to measure the health of
a group of individuals over time was approached, delivered,
measured, and the results that the project was able to achieve
in the treatment of ESRD patients.
- Describe how an approach like this could be utilized to
provide valuable metrics as your organization looks at the
impact of P4P and the tools needed to quantify clinical
outcomes and disease complexities to support realigned reimbursement.
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NC Public Health
IT Advances in 2009 to Improve Public Health Services
High-quality, cost-effective public health services depend
on good information. NC public health leaders have been pursuing
multi-year projects to improve the services that critically
depend on better information services. The work has been pursued
by local, regional and state public health officials supported
by grants from private foundations and the state. The initiatives
consist of a mix of health IT projects, new public health
services that critically depend on health IT, and public health
staff training needed to manage public health services more
cost-effectively using health IT. Among the projects is an
HIE planning process for the southern piedmont (SoPHIE), a
statewide broadband provision project for public health (the
NCTN) to support HIE, a standards-based environmental health
services support system, a statewide training program for
business process management (Common Ground), and a statewide
EHR implementation.
In 2009, these projects have matured. Many are ending their
planning phase and are poised to start implementation. Some
projects have first generation implementations working and
are considering second generation updates. The work of assessing,
planning and piloting with these projects has positioned NC's
public health enterprise to make good use of funding opportunities
for large implementations -- as anticipated in the "health
IT stimulus" legislation. This session will focus on
the progress that these initiatives have made in 2009 towards
the larger goal of improving the cost-effectiveness of public
health services using health IT, lessons learned, and prospects
for the next phase of work in this area.
Session Objectives:
- List at least three projects that contribute to improving
public health IT capabilities in NC.
- List at least one way in which each of these projects
improves the cost-effectiveness of public health services.
- Describe the top three priorities in pursuing the next
phase of work in this area.
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Applying
Business Process Analysis to Define EMR Requirements
It is very hard to get what you want from a software application
without determining what your needs are up front. Business process
analysis defines the way tasks are conducted, highlights opportunities
for improvement, and ultimately helps to develop requirements
for the optimal information system solution.
Local public health departments are exploring how to transition
their clinics from a system of paper medical charts to an
EMR system. This session will give an overview of the steps
taken by the Southern Piedmont Partnership for Public Health
in analyzing public health business processes to define software
requirements, evaluate and select an EMR system.
Step one of the transition to an EMR system entailed approximately
60 subject matter experts from eight health departments working
together to collaboratively analyze areas of the health department
that would be affected by a new information system - Family
Planning, Child Health, Maternal Health, Communicable Disease,
Lab, Family Care Coordination, Billing and Registration/Checkout.
Workgroup meetings were held to analyze and refine over 50
business processes. The next step consisted of defining features
and functionality requirements determined by the analysis.
By defining the requirements, well-informed strategic decisions
were much easier to make in selecting a software application
that best met the need of each health department.
By evaluating public health business processes and working
collaboratively, public health agencies can make improvements
in service delivery, quality and performance, and the goal
of doing more with less can be reached.
Session Objectives:
- Describe the benefits of business process analysis collaboration.
- List the steps taken in the development of EMR system
requirements.
- List the steps taken in the evaluation and selection of
an EMR system for public health departments.
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Using ICD-10 as
a Technology Driver
The conversion from ICD-9 to ICD-10 is a massive undertaking
that must not be taken lightly by payers and providers of
care. There will be payer organizations that will fail to
act quickly enough and cease to remain viable, and there will
be providers that will face severe revenue cycle difficulties
due to a lack of complete preparation. The use of IT as part
of a well developed strategy and implementation plan will
be key for the survival of payers and providers. With the
enhanced detail provided by ICD-10 code sets, ICD-10-compliant
systems will enable a level of patient management and outcomes
management not previously available. The presenters will explain
the approach that payers and providers must take for completely
implementing ICD-10. Using specific case study examples, the
presenters will describe a Change Leadership/Business Process
Reengineering methodology and compliance process that will
transform a payer's or provider's compliance effort into an
effort for improving outcomes and achieving a short- and long-term
competitive advantage.
Session Objectives:
- Explain how to follow a Change Leadership/Business Process
Reengineering methodology in a compliance effort.
- Explain how a well developed strategy and implementation
plan for ICD-10 can lead to a short- and long-term competitive
advantage.
- Describe how the use of ICD-10-compliant systems will
lead to improved levels of patient management and outcomes
management.
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WebCIS & CDW-H
at UNC Health Care System
UNC Health Care System's (UNCHCS) web-based clinical information
system (WebCIS) consolidates data across 40 different feeding
systems, such as radiology, labs and cardiology. Last fall
they created a module called "Rounds Report" that
pulls current medications from CPOE, recent vitals and fluid
Input Outputs from eChart, and recent labs from WebCIS for
any list of patients. The system presents them in a user friendly
manner that enables providers to scan the current status of
all patients across a unit online, document treatment plans
in one screen without a single click, and print a concise
paper report that they can carry with them during rounds.
This presentation will demo and discuss the conceptualization,
design, development and rollout of the rounds report across
UNCHCS.
In 2007 UNCHCS initiated development of an enterprise-wide
data warehouse, the Carolina Data Warehouse for Health (CDW-H).
The warehouse incorporates all inpatient and outpatient clinical
data, plus administrative data such as billing codes and appointment
schedules. CDW-H became operational in the first quarter of
2009 with the extraction of data elements from the two major
operational sources of information in UNCHCS: the webCIS EMR
and the Siemens Decision Support System which stores transactions
from registration, billing, scheduling and inpatient hospital
physician order entry systems. The presentation will describe
the theory of data warehousing, the process of governance
and implementation of the CDW-H, security concerns in the
development of a data warehouse, the outcomes of the diabetes
and hospital inpatient data marts, and the use of the research
web portal of the data warehouse.
Session Objectives:
- Describe how data from multiple systems, and from multiple
provider sources, can be compiled and presented in a concise
manner for optimal and efficient patient care.
- Discuss the importance of governance structure in the
implementation process of a data warehouse.
- Describe the pitfalls in development of security and provisioning
for an enterprise data warehouse.
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Grant & Project
Proposal Readiness: Improving Your Odds of Securing Grants
or Project Funding
The American Recovery and Reinvestment Act (ARRA) signed into
law on February 17, 2009, allocated a total of $19 billion
to implement health information technology (HIT). Funding
to develop HIT infrastructure, health information exchange
(HIE) demonstration projects, capital projects, EMR adoption
and HIT related academic programs are being published faster
than some stakeholders can put a project idea together. Depending
on the scope of the project, grant or proposal preparation
and writing is a project unto itself.
This presentation is designed to educate and foster creative
solutions for healthcare stakeholders who wish to leverage
their orphaned or current HIT strategy, project plan, PCMH,
clinical care coordination concepts, and community relationships
to create a robust grant package for EMR adoption or HIE funding.
Session Objectives:
- Identify potential project funding opportunities
- Describe the difference between project planning and grant
writing
- List the steps from grant preparation to submission
- Set the foundation for a coordinated response to funding
opportunities
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Building on 15 Years of Collaboration: NCHICA's Contributions to NC's Success
Presenters will discuss: The expectations at the founding of NCHICA in 1994; The activities of the NC Consumer Advisory Council on Health Information and consumer expectations of NCHICA’s work; The activities of the NC HIE Council and Committees in support of NCHICA’s efforts; NHIN activities and their importance to NC in the ARRRA HITECH stimulus funding and other initiatives; and the activities undertaken in the HISPC Project and the importance of policy efforts to enable HIE and HIT.
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Improving Patient
Flow at the Hospital's Front Door - Your Emergency Department
Albert Einstein Medical Center (AEMC), a 509-bed teaching facility
located in Philadelphia, is one of the first trauma centers
in the nation to have integrated a patient and asset tracking
system that is based on a real-time location network. Originally
implemented in 2003 to manage the increased communication challenges
and workflow complexities associated with a significant increase
in the size of the emergency department, AEMC has now used the
system to coordinate the care of more than 350,000 patient visits.
Today, staff uses the tracking software as a centralized workflow
and communication portal in managing over 76,000 visits annually
over which time they have reduced average length of stay, ambulance
diversions and patient walkouts. In the initial year, increased
reimbursements from fewer patient walkouts were valued at over
$1 million.
When patients enter the department, they are given an ultrasonic
tag, which the staff also wears, which communicates their
location and movement to a network of sensors positioned throughout
the department. Tags are also placed on movable medical equipment
for quick location identification. The tracking software provided
receives the location data and uses ED workflow algorithms
to interpret interactions between patients, staff and equipment
in the context of patient care milestones. As milestones are
recognized, the web-based software updates the patient information
in map and status view screens sending notifications to staff
members who need to know in order to keep patient care progressing
with a minimum of delays. The software also interfaces with
lab, radiology and ADT systems to integrate the status of
orders. As a teaching facility, the emergency department has
used the granular tracking of patient movement to extensively
analyze patient flow, profile caregivers and support their
resident training program.
Session Objectives:
- Describe the impact of real-time location enabled patient
and asset tracking on the operations of an emergency department.
- Identify the technology components of a real-time location
enabled tracking system.
- Discuss the patient, staff and technology implications
of introducing a real-time location system.
- Identify the role of the emergency department in impacting
facility-wide patient flow.
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IEEE-USA Medical
Technology Policy Committee & Interoperability for the
NHIN
This presentation describes the work of the Institute of Electrical
and Electronics Engineers - USA (IEEE-USA) Medical Technology
Policy Committee in addressing national policy issues relating
to health and wellness. Specifically, it addresses our support
of the work that has been done by NCHICA and other groups
that are working to implement a Nationwide Health Information
Network (NHIN). In our white paper on Interoperability for
the NHIN, we describe the various types of interoperability
- semantic and functional - that are required to provide seamless
interchange of medical information among healthcare providers,
healthcare consumers, insurers and public health agencies.
We discuss the standards that are being developed by various
standards development organizations to address interoperability
issues. We will also present an overview of our current work
on using health IT to improve the quality of healthcare delivery
while constraining the rising cost of healthcare in the US.
Session Objectives:
- Describe the role of the IEEE-USA Medical Technology Policy
Committee in formulating medical technology legislation,
regulation and policy.
- Explain the different types of interoperability required
for the seamless interchange of medical information in NHIN/HIE/RHIO
health information networks.
- List the major standards (e.g. SNOMED, ICD9/10, HL7) required
to support interoperability.
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HIT and
the Patient-Centered Medical Home
The Patient-Centered Medical Home (PCMH) has been identified
as one of the key strategies in the new Administration for tackling
the myriad issues with our current healthcare system. PCMH is
a model of healthcare that is focused on the patient's needs;
it draws from existing chronic care models by emphasizing continuous,
comprehensive care. Many of the objectives of the PCMH support
the principles put forth in the IOM seminal report on quality
of care by promoting safe, timely, effective, efficient, equitable
and patient-centered care.
This presentation will review the PCMH model as currently
defined through the work of the Patient Centered Primary Care
Collaborative (PCPCC) with emphasis on the CMS Medical Home
model. This model draws largely from the CMS version of the
NCQA's PPC-PCMH quality improvement program which will be
implemented in CMS Medical Home Demonstration project.
Session Objectives:
- Describe the patient-centered medical home - its components
and objectives in relationship to medical practice and the
national healthcare agenda
- Develop a plan to transform a medical practice into a
medical home
- Use HIT to enable the medical home
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Sutter's
Mill 2009: Meeting the RAC Challenge
Millions of healthcare dollars are lost annually due to fraud,
waste and abuse (FWA). In 2006, Centers for Medicare and Medicaid
Services made the Recovery Audit Contractor (RAC) process permanent
through Section 302 of the Tax Relief and Health Care Act. While
the initial impact only affects 16 states, there is an aggressive
schedule to bring the rest of the county into the program through
2009 and 2010. FWA schemes and errors are complicated, detailed,
medical specialty-specific, difficult to identify, and expensive
for provider organizations to monitor and manage. Traditional
data mining approaches are often not user friendly, only detect
a small portion of FWA, and are inadequate to meet the pace
and demands of the organizations that they serve.
The time is right for provider organizations to take a proactive
approach to monitoring FWA - an approach that identifies ways
to avoid penalties associated with FWA and mitigate legal
risk, but also identifies ways to optimize claims submittals
and identify opportunities for lost revenue for under-submitted
claims. This presentation will identify new strategies and
methodologies for leveraging logic-based approaches to mitigate
FWA risk and financial exposure while simultaneously identifying
opportunities to increase revenue lost due to inaccurate under-coding
of claims data.
Session Objectives:
- Explain the need to address FWA in the RAC environment.
- Describe the criteria and drivers required for a successful
FWA program and how that program can drive revenue for your
organization.
- Identify weaknesses inherent in your existing FWA and
RAC activities and strategies to address them.
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Physician Incentives
to Adopt EHR/EMR Systems
This presentation will address the following:
- the Impact of the 2009 CMS changes as they relate to the
physician quality reporting initiative (PQRI) and e-Prescribing
and how these items relate to physician incentives for implementing
EMR/EHR systems.
- the proposed impact and disincentives in the government's
push to promote e-Prescribing adoption and their current
enactment status.
- the direction of President Barak Obama's Healthcare Strategy
as it relates to EMR/EHR systems and the Stark guidelines
in Hospital-Physician Alignment in supporting EHR/EMR implementations
in physician practices.
- the calculation for a return-on-investment if implementing
a PQRI software package in the physician practices.
Session Objectives:
- Discuss current CMS initiaties to encourage physicians
to adopt EHR/EMR systems.
- Explain the Stark initiatives.
- Describe PQRI implementations and ROI calculations.
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HITECH Compliance:
Strategies for Addressing the New Legal and Technical Challenges
for Mobile Information Security
The goal of the Health Information Technology for Economic
and Clinical Health (HITECH) Act, embedded within the American
Recovery and Reinvestment Act (ARRA) signed earlier this year,
was to promote the adoption of health information technologies
(HIT) to improve the quality, safety and efficiency of America's
health care system. The provisions of HITECH recognized that
the current level of security and privacy protections would
be a deterrent to adoption and implemented strong standards.
As a requirement of HITECH, HHS issued draft Guidance in April
2009 addressing the security of mobile devices and proposed
an encryption standard as the only safe-harbor. HITECH contains
provisions for HHS to issue the final Guidance regarding mobile
devices and other regulations by August 15, 2009. This presentation
will address the legal and regulatory framework within HITECH
and explore the compliance issues with the HHS Guidance. It
will also dive into the governance-risk-compliance challenges
of mobile devices and examine how HHS' Guidance impacts healthcare
organizations. We also will cover device encryption and how
it affects regulatory compliance, and provide a brief technical
overview of some of the leading implementations available
to all enteriprse and healthcare organizations.
Session Objectives:
- Discuss the foundations of the HITECH Act as well as the
HHS Guidance statements.
- Describe the legal and regulatory compliance mandates,
as well as practical solutions on how to communicate these
requirements to the Information Technology staff.
- Identify and implement an HHS compliant mobile device
program to meet the regulatory requirements as documented
in HITECH.
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Federal to Private Sector: Building Connections in NC to Serve Military & Tribal Members
Presenters will discuss the importance of exchanging information with the private sector to serve Wounded Warriors, dependants and veterans; plans for ARRA HITECH Stimulus funding to drive the meaningful use of electronic health records and health information exchange to improve the quality of care; and provide examples of how connections with the WNC DataLink project has benefited tribal members.
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