10- Fundamentals of Health Workflow Process Analysis and Redesign- Unit 6- Process Redesign- Lecture...

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Fundamentals of Health Workflow

Process Analysis and Redesign

Process Redesign

Lecture e

This material Comp10_Unit6e was developed by Duke University, funded by the Department of Health and Human Services,

Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.



Process RedesignLearning Objectives

1. Identify the factors that optimize workflow processes in health caresettings (Lecture a)

2. Describe how information technology can be used to increase theefficiency of workflow in health care settings (Lectures a, b)

3. Identify aspects of clinical workflow that are improved by EHR(Lecture b)

4. Propose ways in which the workflow processes in health caresettings can be re-designed to ensure patient safety and increaseefficiency in such settings (Lecture c)

5. Use knowledge of common software functionality and meaningfuluse objectives to inform a process redesign for a given clinicscenario (Lectures c, d, e)

2Health IT Workforce Curriculum

Version 3.0/Spring 2012

Fundamentals of Health Workflow Process Analysis & Redesign

Process Redesign

Lecture e



Process RedesignTopics – Lecture e

• Eligible Provider and Hospital/Critical

access Hospital objectives

•Using the Table of Contents andspecification sheets for objectives

• Understand Meaningful Use CPOE 10-15

• Process redesign for Meaningful Use




Process Redesign

Lecture e



Meaningful Use

“The Medicare and Medicaid EHR IncentivePrograms provide a financial incentive for the

"meaningful use" of certified EHR technology to

achieve health and efficiency goals. By putting into

action and meaningfully using an EHR system,

providers will reap benefits beyond financial

incentives –such as reduction in errors, availability

of records and data, reminders and alerts, clinicaldecision support, and e-prescribing/refill

automation.” (CMS EHR Meaningful Use Overview , n.d., para. 1)




Process Redesign

Lecture e



Meaningful Use Stages



Fundamentals of Health Workflow Process Analysis & RedesignProcess Redesign

Lecture e

Stage 1 – 2011

Stage 2 – 2013

Stage 3 – 2015



Handouts for this unit

• The Stage 1 EHR Meaningful Use

Table of Contents and Specification

Sheets for the following are required

for this unit. – Eligible Professionals and for

– Hospitals/Critical Access Hospitals (CAH)

• These are the criteria for a facility to

make a Meaningful Use claim.

•They are available at the following link:

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use

.asp#BOOKMARK4




Lecture e

Eligible ProfessionalMeaningful Use Table of Contents

Core and Menu Set Objectives

Eligible Professional Core Objectives

(1) Use CPOE for medication orders directly entered by any licensed healthcare professional

who can enter orders into the medical record per state, local and professional guidelines.AVAILABLE

(2) Implement drug-drug and drug-allergy interaction checks.

AVAILABLE

(3)

Maintain an up-to-date problem list of current and active diagnoses.

AVAILABLE

(4) Generate and transmit permissible prescriptions electronically (eRx). AVAILABLE

(5) Maintain active medication list. AVAILABLE

(6)

Maintain active medication allergy list. AVAILABLE

(7)

Record all of the following demographics :

(A) Preferred language.

(B) Gender.

(C)

Race.

(D)

Ethnicity.

(E) Date of birth.

AVAILABLE

(8) Record and chart changes in the following vital signs:

(A) Height.

(B) Weight.

(C)

Blood pressure.

(D) Calculate and display body mass index (BMI).

AVAILABLE

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp


















Links Provide More Information

The links on theMeaningful Use

Table of Contents

Core and Menu

Objectives allow

you to view the

detailed specification

sheet for eachobjective.

http://www.cms.gov/EHRIncentivePrograms/Downloads/1_CPOE_for_Medication_Orders.pdf




Lecture e








Stage 1 Meaningful Use Objectives

• Two sets of objectives, a set for – Eligible Professionals (15 core and 10 menu),

• and a set for – Hospitals/Critical Access Hospitals (CAH) (14 core

and 10 menu)

The criteria impact workflow!




Lecture e



EP CO 10

Clinical quality measures

“Report ambulatory clinical quality measures

to CMS or, in the case of Medicaid EPs, the

States.”

Workflow Impact:

•Changes to an existing administrative task




Lecture e

Requirements and electronic specifications for ambulatory clinical quality measures can be found at:

http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp#TopOfPage

http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp

http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp



EP CO 11

Clinical decision support

“Implement one clinical decision support rule

relevant to specialty or high clinical priority alongwith the ability to track compliance with that rule.”

Workflow Impact:

• Possible new task

• Changes to an existing leadership and technical

task10Health IT Workforce Curriculum

Version 3.0/Spring 2012Fundamentals of Health Workflow Process Analysis & Redesign

Process Redesign

Lecture e



EP CO 12

Providing patients an electronic copy of their healthinformation

“Provide patients with an electronic copy of theirhealth information (including diagnostics test results,

problem list, medication lists, medication allergies)

upon request.”

Workflow Impact:

• Changes to an existing administrative task

11Health IT Workforce CurriculumVersion 3.0/Spring 2012


Lecture e



EP CO 13

Clinical summaries

“Provide clinical summaries for patients for each

office visit.”

Workflow Impact:

• Probable new task



Lecture e



EP CO 14

Exchange key clinical information

“Capability to exchange key clinical information (for

example, problem list, medication list, allergies, anddiagnostic test results), among providers of care

and patient authorized entities electronically.”

Workflow Impact:

• Probable new task



Lecture e



EP CO 15

Protect electronic health information

“Protect electronic health information created or

maintained by the certified EHR technology throughthe implementation of appropriate technical

capabilities.”

Workflow Impact:

• Probable new tasks, and

• New workflow for existing tasks



Lecture e



Process RedesignSummary – Lecture e

• Eligible Provider and Hospital/Critical

access Hospital objectives

• Using the Table of Contents andspecification sheets for objectives

• Understand Meaningful Use EP CO 10 -

15



Lecture e



Process RedesignSummary

1. Identify the factors that optimize workflow processes in health caresettings

2. Describe how information technology can be used to increase the

efficiency of workflow in health care settings

3. Identify aspects of clinical workflow that are improved by EHR4. Propose ways in which the workflow processes in health care

settings can be re-designed to ensure patient safety and increase

efficiency in such settings

5. Use knowledge of common software functionality and meaningful

use objectives to inform a process redesign for a given clinic

scenario



Lecture e



Process RedesignReferences – Lecture e

References

• CMS EHR Meaningful Use Overview . (n.d.). Retrieved February 29, 2012, from Centers for Medicare & Medicaid

Services website: https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp

• Electronic Specifications, Eligible Professionals (EPs). (n.d.). Retrieved February 29, 2012, from Centers for

Medicare & Medicaid Services website: https://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp

• Eligible Professional Meaningful Use Core Measures Measure 10 of 15, Clinical Quality Measures (CQMs). (2010,

November 7). Retrieved from Centers for Medicare & Medicaid Services website:

http://www.cms.gov/EHRIncentivePrograms/Downloads/10_Clinical_Quality_Measures.pdf

• Eligible Professional Meaningful Use Core Measures Measure 11 of 15, Clinical Decision Support Rule. (2010,

November 7). Retrieved from Centers for Medicare & Medicaid Services website:http://www.cms.gov/EHRIncentivePrograms/Downloads/11_Clinical_Decision_Support_Rule.pdf

• Eligible Professional Meaningful Use Core Measures Measure 12 of 15, Electronic Copy of Health Information.

(2010, November 7). Retrieved from Centers for Medicare & Medicaid Services website:

http://www.cms.gov/EHRIncentivePrograms/Downloads/12_Electronic_Copy_of_Health_Information.pdf

• Eligible Professional Meaningful Use Core Measures Measure 13 of 15, Clinical Summaries. (2011, April 18).

Retrieved from Centers for Medicare & Medicaid Services website:

http://www.cms.gov/EHRIncentivePrograms/Downloads/13_Clinical_Summaries.pdf



Lecture e



http://www.cms.gov/EHRIncentivePrograms/Downloads/11_Clinical_Decision_Support_Rule.pdf














Process RedesignReferences – Lecture e

References

• Eligible Professional Meaningful Use Core Measures Measure 14 of 15, Electronic Exchange of Clinical Information.

(2010, November 7). Retrieved from Centers for Medicare & Medicaid Services website:http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf

• Eligible Professional Meaningful Use Core Measures Measure 15 of 15, Protect Electronic Health Information. (2010,

November 7). Retrieved from Centers for Medicare & Medicaid Services website:

http://www.cms.gov/EHRIncentivePrograms/Downloads/15_Core_ProtectElectronicHealthInformation.pdf

• What are the requirements for Stage 1 of Meaningful Use (2011 and 2012)? CMS EHR Meaningful Use Overview .

(n.d.a). Retrieved February 29, 2012, from Centers for Medicare & Medicaid Services website:

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK4

Images

Slide 5: Meaningful Use Stages. Available at http://www.cms.gov/ehrincentiveprograms/

Slide 6: What are the requirements for Stage 1 of Meaningful Use (2011 and 2012)? CMS EHR Meaningful Use

Overview . (n.d.). Retrieved February 29, 2012, from Centers for Medicare & Medicaid Services website:

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK4

Slide 7: Image adapted from Centers for Medicare & Medicaid Services (2010). Medicare & Medicaid EHR Incentive

Program Meaningful Use Stage 1 Requirements Overview [PowerPoint slides] Retrieved fromhttps://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf



http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf




https://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf

https://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf






http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf

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