In this assignment you will imagine yourself in the role of a recently hired Practice Manager for a physician office called Welby-Eichman healthCare (WeCare). The practice is located in a small urban
Week 9 Lab- Assignment, Rubric, & Lesson Content Assignment: In this assignment you will imagine yourself in the role of a recently hired Practice Manager for a physician office called Welby-Eichman healthCare (WeCare). The practice is located in a small urban area. Three of the physicians are Internal Medicine Physicians and the other two are Family Practice physicians. You previously worked at LiveWell Medical Center as the HIM Manager and were on the front line there as they adopted and deployed EPIC at LiveWell South Physician Clinic, and this gave you a hiring advantage at WeCare. For this assignment, you will need to download and complete the worksheet below: Worksheet: Module 09 Lab – Worksheet If you cannot open the above link. Please copy & paste the link below to a browser to open. https://content.learntoday.info/Learn/HIM3202_Summer_17/Media/HIM3202-Mod_09-Lab_Worksheet%20rev%20090718.docx Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates. Save your assignment as a Microsoft Word document Rubric: None for this week Lesson:
In this assignment you will imagine yourself in the role of a recently hired Practice Manager for a physician office called Welby-Eichman healthCare (WeCare). The practice is located in a small urban
Dermatology Times AUGUST 2 0 1 5 / D E R M A T 0 L 0 G Y T I M E S .com OF DERMATOLOGY From the pages of M e d i c a l . Economics M ining EHR data for quality im provem ent KEN TERRY | STAFF CORRESPONDENT Ma n y p h y s i c i a n s d o u b t th a t electronic h e a lth re c o rd s (EHRs) im p ro v e q u a lity of ca re. But relatively few p ra c tic e s a re m in in g t h e ir EHR d a ta to see h o w well th e y ’re d o in g or to u p d a te t h e ir c a re d e ­ livery processes. M ost are collecting data m a in ly for e x te r n a l re p o rtin g p u rp o s e s, u s u a lly w ith th e h elp of a u to m a te d EHR fe atu res. A ccording to a re c e n t s tu d y in Health Affairs, b e tw e e n 2007 a n d 2013 th e p e r­ ce n ta g e of large p ra c tic e s t h a t collected d a t a o n q u a lity m e a s u r e s n e a r ly d o u ­ bled; t h a t a c tiv ity in c re a s e d ev e n m o re in sm all a n d m e d iu m -s iz e d practices b e ­ tw e e n 2009 a n d 2013. But th e u s e of elec­ tro n ic re g istrie s to identify p a tie n t care gaps a n d t h e fe e d b a c k of p e r fo rm a n c e d a ta to p h y sician s re m a in e d co n fin e d to a sm all p erc e n ta g e of practices. T h e re a re several possible re a so n s for th e low in te re st in m in in g d a ta for q u a l­ ity im p ro v e m e n t. M ost p h y s ic ia n s b e ­ lieve t h e y ‘r e a lre a d y d o in g a g o o d job, a n d th e y m a y feel th e y ’re to o b u s y to d e ­ vote t im e to r u n n i n g r e p o r ts a n d look­ in g a t d a ta . E s p e c ia lly if t h e y ‘r e w o rk ­ in g in s m a ll p r a c tic e s , t h e y m a y feel i n t im i d a t e d by t h e t e c h n i c a l r e q u i r e ­ m e n ts of d a ta m in in g . It’s also d ifficult for p ro v id e rs to e n te r d a ta c o n siste n tly in th e r ig h t EHR fields so t h a t th e y h a v e e n o u g h d a ta to y ield so lid in fo rm a tio n on in d iv id u a l p a tie n ts or p o p u la tio n s . W ith t h e g ro w in g u s e of v a lu e – b a s e d re im b u rse m e n t, however, p ra ctices find th e m s e lv e s u n d e r i n c r e a s e d p r e s s u r e to p ro v e t h a t t h e y a r e p r o v id in g h ig h – q u a l i t y c a r e to p a t i e n t s . At t h e s a m e tim e , p a y e r s ’ a r e e m p h a s i z in g p o p u ­ la tio n h e a l t h m a n a g e m e n t, w h ic h r e ­ q u i r e s p r a c tic e s to id e n tif y c a r e g a p s a n d r e a c h o u t to th o s e w h o n e e d care, re g a rd le ss of w h e th e r th e y ’ve b e e n see n recently. E x p e rts a n d d o c to rs in te rv ie w e d by Medical Economics say d a ta m in in g is v ita l to h e lp in g p r a c t i c e s m e e t th o s e o bjectives. Each p ra c tic e m u s t fin d a n a p p r o a c h t h a t fits its n e e d s a n d goals; b u t w h a te v e r t h a t is, th e s o o n e r y o u get s t a r t e d , t h e b e t t e r off y o u ’ll b e in t h e long ru n .DATA M I N I N G O P T IO N S H e alth IT experts advise practices to take a close look a t th e i r EHR’s c a p a b ilitie s b efore th in k in g a b o u t u s in g o u tsid e s o ­ lu tio n s or o u ts o u rc in g . In m a n y p r o d ­ u cts, th e s e c a p a b ilitie s in c lu d e h e a lth m a in te n a n c e a le rts a n d r e p o r t w riters. H e a lth m a i n t e n a n c e a le r ts , w h ic h a r e r e m i n d e r s a b o u t p r e v e n t i v e o r c h r o n ic c a r e se r v ic e s t h a t a r e r e c o m ­ m e n d e d for a p a r tic u la r p a tie n t, p o p u p w h e n e v e r a n e lec tro n ic c h a rt is open e d . W h ile th e i r u s e m a y n o t b e c o n s id e re d d a t a m i n in g , w h e n y o u c r e a te a n e w h e a lt h m a in te n a n c e alert, you a r e m i n ­ in g y o u r EHR d a ta for a p u rp o s e . I t’s d iffic u lt to p r o g r a m n e w h e a lt h m a in te n a n c e a le rts in m o s t EHRs, says E rn ie H o o d , s e n io r d ire c to r, r e s e a r c h a n d insights, for th e A dvisory B o ard Co. B ut Jen Brull, M.D., says t h a t h e r n in e – p r o v id e r f a m ily p r a c tic e in P la in v ille , K an., c u s to m iz e d s e v e ra l a le r ts w i t h ­ o u t a n y tro u b le. T h e re a l p ro b le m w ith p ro m p ts , s h e says, is t h a t th e y c a n be o v e r w h e lm in g . “If y o u t u r n o n e v e ry ­ t h i n g a ll a t o n ce , y o u d o n ’t p a y a t t e n ­ tio n to a n y th in g .” A n o th e r m e th o d of d a ta m in in g is to r u n th e re p o r ts av a ila b le in t h e EHR or to w rite t h e re p o rts you w a n t a n d th e n r u n th e m . T h is is a n a r e a w h e re EHRs d iffe r w id ely . Dr. B ru ll, for e x a m p le , “But there’s still a lot of setup that you have to do, and many people never get to it. So even though a lot of EHRs offer this functionality, it’s underutilized.” Michelle Holmes, M.B.A. ECG Management Consultants, Seattlesays t h a t h e r EHR in c lu d e s p r e b u ilt r e ­ p o r ts for all of th e q u a lity m e a s u r e s in t h e M e a n in g f u l Use in c e n tiv e p ro g r a m a n d t h e P h y s ic ia n Q u a lity R e p o rtin g S ystem (PQRS). H ow ever, h e r p ra c tic e c a n n o t m o d ify t h e s e r e p o r t s b e c a u s e t h e y ’re w r i t t e n to m e e t EHR c e r tif ic a ­ tio n re q u ir e m e n ts . To p ro d u c e c u sto m r e p o r ts , t h e p r a c t i c e ’s IT s t a f f d e v e l­ o p e d a s p e c ia l w e b – b a s e d a p p lic a tio n t h a t q u e rie s t h e EHR d a ta b a se . In co n tra st, M ichelle Holm es, M.B.A., a S e a t t l e – b a s e d p r i n c i p a l w i t h ECG M a n a g e m e n t C o n s u l t a n t s , s a y s t h e p ro b le m w ith m a n y EHRs is t h a t th e y d o n ’t offer e n o u g h p r e b u ilt re p o rts . I n ­ stead, th e y su p p ly a “sa n d b o x ” a n d a v a – rie ty of to o ls t h a t p r a c tic e s c a n u s e to w rite t h e ir o w n re p o rts. T h e v e n d o rs do th is, sh e n o tes, so ev­ eryone c a n c reate th e re p o rts th e y w ant. “But t h e r e ’s still a lot of s e tu p t h a t you h av e to do, a n d m a n y p e o p le n e v e r get to it. So ev e n th o u g h a lot of EHRs offer th is fu n c tio n a lity , it ’s u n d e r u tiliz e d .” D R A W B A C K S O F E H R R E P O R T S Ify o u r EHR p ro v id es p re b u ilt re p o rts r e ­ la te d to M e a n in g f u l U se a n d / o r PQRS m e a s u r e s , th e y m ig h t b e p r o g r a m m e d for a p a r tic u la r r e p o r tin g p e rio d . W h e n you r u n th o se reports, th e y will om it d ata o n p a tie n ts w h o h av e n o t so u g h t c a re or h av e m is s e d a p p o in tm e n ts d u r in g t h a t p e rio d . You c a n l e n g th e n t h e p e r io d for w h ic h th e re p o rt se a rch e s th e EHR d a ta ­ b a se to a y e a r or two, Dr. Brull notes. But so m e p a tie n ts o n y o u r p a n e l w ill still b e left o u t—a sig n ifican t ch a lle n g e ifyou’re tr y in g to m a n a g e th e h e a lth of y o u r e n ­ tire p a tie n t p o p u la tio n . A n o t h e r p r o b l e m is t h a t s o m e o n e h a s to r u n EHR r e p o r ts —w h e th e r p r e ­ b u ilt o r c u s to m iz e d —to e x tra c t th e lat­ est d a ta from th e m . T h e y ’re n o t r u n n in g in t h e b a c k g r o u n d a n d u p d a t e d every ti m e y o u se e a p a t i e n t o r w a n t to s e e h o w y o u ’re d o in g o n a p a r ti c u la r q u a l­ ity m e a s u r e . C on seq u en tly , t h e y ’re n o t in te g ra te d in to th e workflow a t th e p o in t of care, n o te s B ruce Bagley, M.D., p re s i­ d e n t a n d CEO of TransforM ED, th e p a ­ tie n t – c e n te r e d m e d ic a l h o m e s u b s id ­ ia ry of th e A m e ric a n A c ad em y of Fam – EHR D A T A MINING s e e p a g e 5 2 D e O F D E R M A T O L O G Y AUGUST 2015 / DERMAT0L0GYTIIV1ES.comDermatology Times E H R D A T A M I N I N G : Identify patient care gaps, get performance feedback from page 5 1 ily P h y s ic ia n s (AAFP). He s e e s t h i s as a s e r io u s d e fic ie n c y of E H R -b a sed r e ­ p o rts, b e c a u s e th e re p o rts c a n ’t b e u s e d to in fo rm m e d ic a l decisions. T h e c u r r e n t w ay of g a th e r in g in fo r­ m a tio n for m e d ic a l d e c is io n -m a k in g , h e says, is to scro ll t h r o u g h t h e c h a r t u n til you h ave w h a t you n ee d . “The new way w o u ld b e to have it all p re s e n te d on a single sc re e n t h a t show s you th e ca re gap s y o u c a n fo c u s o n ,” h e says. “T h a t c a n m a k e th e visit m o re efficient a n d ef­ fective.” STANDALONE REGISTRIES T h i r d p a r t y r e g i s t r y s o f t w a r e i n t e r ­ faced w ith E H R s c a n provide a u to m a te d re p o rts t h a t a re available to p h y sician s w h e n th e y ’re providing care. In addition, a good registry ca n give you up-to-date in ­ form ation on all ofyour patients, w h e th e r or n o t y o u ’ve see n th e m recently. T h e p u r p o s e of re g is trie s is to m a n ­ ag e c h r o n ic a n d p r e v e n tiv e c a r e a n d k e e p t r a c k o f h i g h – r i s k p a t i e n t s , Dr. B ag ley say s. T h e m o r e s o p h i s ti c a t e d re g istrie s a r e d e s ig n e d to: > p ro v id e lists of s u b p o p u la tio n s , su ch as p a tie n ts w ith h y p e rte n s io n a n d d i­ abetes, > i d e n t i f y p a t i e n t s w i t h c a r e g a p s , b a s e d o n ev id e n c e -b a se d guidelines, I s u p p o r t o u t r e a c h to p a t i e n t s w h o h av e c a re gaps, > p ro v id e fe e d b a c k o n h o w e a c h p h y ­ sic ia n is d o in g o n p a r ti c u la r ty p e s of care, su c h as th e p e r c e n ta g e of th e ir d i a b e t i c p a t i e n t s w h o h a v e t h e i r H b a lc levels or blood p re s su re u n d e r control, a n d I g e n e r a t e q u a l i t y r e p o r t s f o r t h e p ra c tic e Dr. B rull’s p ra c tic e u se s outside re g is­ tr y so ftw a re w ith its EHR. T h e p ro g r a m in c lu d e s a d a s h b o a r d t h a t sh e looks at w h e n she sees p a tie n ts. T h is d a s h b o a rd sh o w s d a ta fro m six c h r o n ic c a re su ites a n d 11 p re v e n tiv e c a r e s u ite s t h a t a r e a p p lie d to e a c h p a t i e n t for w h o m th e y a r e a p p ro p ria te . REGISTRIES IN ACTION Dr. B rull a n d h e r co lle a g u e s look at th e r e g is tr y d a ta for t h e w h o le g ro u p a n d use itto design q u ality im p ro v em en t in i­ tiatives. Recently, th e y e x a m in e d t h e ir d a ta o n p a tie n ts w ith h y p e r te n s io n a n d m e ta b o lic sy n d ro m e . A fter c o m p a r in gth e d a ta w ith p a s t in fo rm a tio n o n th e s e p a tie n ts , th e y d e c id e d to fo c u s o n p a ­ tie n ts w h o h a d h y p e r te n s io n a n d m o d ­ e ra te re n a l in su ffic ie n c y a n d w e re n o t ta k in g a n ACE inhibitor. Lists of p a tie n ts in t h a t c a te g o ry w e re p ro v id e d to p h y si­ cian s, w h o co u ld d e c id e if th is m e d ic a ­ tio n w a s a p p ro p ria te . Yul E jn e s , M .D ., MACP, a f o r m e r A m e ric a n College of P h y sic ian s b o a r d c h a ir m a n w h o p ra c tic e s in Providence, RI, sa y s h is p r a c t i c e u s e s t h i r d – p a r t y so ftw a re a tta c h e d to its EHR. T he g ro u p h a s a n IT d e p a r t m e n t t h a t m in e s a n d a n a ly z e s th e d a ta a n d s e n d s re p o r ts on p a tie n t c a re gaps to p h y sician s. W hile Dr. Ejnes finds th is in fo rm atio n helpful, h e n o tes t h a t h e receives th e re ­ p o r ts o n ly o n c e a m o n t h or q u a rte rly . T h a t c a n m a k e t h e m less u s e f u l w h e n h e sees p a tie n ts to w a rd th e e n d of a r e ­ p o rtin g p eriod. But th e d a ta is far m ore tim ely t h a n h e a lth p la n claim s data. HIGH COST FOR SMALL PRACTICES E x p erts a g re e t h a t s o p h is tic a te d re g is ­ try so ftw a re c a n b e cost-prohibitive, e s ­ p e c ia lly for s m a lle r p ra c tic e s. An in s u r ­ a n c e c o m p a n y p a id for th e a p p lic a tio n t h a t Dr. B rull’s g ro u p u s e s as p a r t of a statewide patient-centered m edical hom e p ro g ra m . O th erw ise, it w o u ld h av e cost h e r p ra c tic e a lot, sh e says. But sh e a d d s th a t it’s so valuable to th e group th a t th e y p ro b a b ly w o u ld h av e b o u g h t it anyw ay. Very basic registry applications, w hich a re available o n lin e, c a n b e fairly inex­ p en siv e a n d ea sy to im plem ent, says Ms. H olm es. But Mr. H o o d n o tes t h a t th e s e p r o g r a m s r e q u ir e s o m e t e c h n i c a l ex­ p e r tis e to g e n e ra te u s e f u l re p o rts . T h e less co stly th e tool, th e m o re te c h n ic a l know ledge n e e d e d to m a k e it work. S m a ll p r a c t i c e s c a n c o n s i d e r o u t ­ s o u r c in g d a t a m i n in g a n d a n a ly s is to t h e ir EHR v e n d o r or o n e of its t e c h n o l­ ogy p a r t n e r s . S om e v e n d o r s , s u c h as Epic, C e rn e r, M e d ite c h , a n d a t h e n a – h e a lth , a r e in c o rp o r a tin g a n a ly tic s in to th e i r EHRs a n d w ill do t h e w o rk for y o u in t h e cloud, Mr. H o o d says. R o se m a rie N elson, a S yracuse, N ew Y ork-based c o n s u l t a n t w ith th e M e d ­ ic a l G ro u p M a n a g e m e n t A s s o c ia tio n (MGMA), says t h i s c a n b e a ffo rd a b le for p ra c tic e s of a n y size, d e p e n d in g on t h e co st-b e n e fit ratio. If a g ro u p c o n s id ­ ers b u y in g a less costly p ro d u c t, its le a d ­ers s h o u ld a sk th e m s e lv e s w h e th e r th e p ra c tic e h a s t h e te c h n ic a l e x p e rtise to b u ild it out. “You’re going to p ay on e w ay or th e o th e r,” sh e says. You s h o u l d a ls o lo o k a t h o w d a t a m i n in g fits i n to y o u r b u s in e s s p la n . If y o u ’re c re a tin g a p a tie n t-c e n te re d m e d ­ ical h o m e or a re p a r tic ip a tin g in a n a c ­ c o u n ta b le c a r e o r g a n iz a tio n , it m ig h t m a k e s e n s e to in v e s t in r e g is tr y s o ft­ w a re or o u tso u rc in g , b e c a u s e y o u h av e f in a n c ia l in c e n tiv e s t h a t c o u ld r e c o u p y o u r in v e s tm e n t in tim e . Dr. Bagley b e ­ liev es t h a t t h e u s e of r e g is tr ie s to c o l­ lect a n d a n a ly z e d a ta c a n h e lp p ra c tic e s r e a p c a r e m a n a g e m e n t fees a n d o th e r in c e n tiv e s . E ven a s im p le d o -it- y o u r ­ s e lf r e g i s t r y b a s e d o n a s p r e a d s h e e t c a n s p u r a p ra c tic e “to b u ild t h e work- flow s t h a t a r e r e q u ir e d to e n s u r e t h a t d a ta is u s e d a t t h e p o in t of c a re . E ven­ tually, y o u ’ll h av e it in te g ra te d in to th e EHR. B ut y o u ’ll h a v e t h e w o rk f lo w in p la c e already.” GETTING THE DATA YOU NEED Good d a ta gets you actionable results. To s ta r t w ith , lab re s u lts m a y n o t b e a v a il­ able in s tr u c tu r e d form , d e p e n d in g on w h e th e r th e EHR in te rfa c e s w ith a p a r ­ t i c u l a r lab. Dr. E jn es’ p ra c tic e , fo r ex­ am ple, d o e s n ‘t h a v e in te rfa c e s w ith all o f t h e la b s it u s e s , so e m p lo y e e s m u s t e n te r so m e faxed lab r e s u lts m a n u a lly in to th e EHR. Dr. Ejnes a lso u n d e r li n e s th e p r o b ­ lem of g e ttin g all of t h e g ro u p ‘s p h y s i­ c ia n s a n d n u r s e p r a c titio n e r s to e n te r d a ta in s t r u c t u r e d fields, r a th e r t h a n as free text. T h e g ro u p h a s m e d ic a l a s s is ­ ta n ts in p u ttin g so m e of th is d a ta so m i n ­ ers h a v e s o m e th in g to m in e , h e says. Even w h e n p ro v id e r s e n te r t h e d a ta in s tru c tu re d fields, Dr. Ejnes notes, th e EHR allows th e m to p u t it in a n y of sev­ e ra l p la c e s —a f e a tu r e t h a t m a n y v e n ­ dors h ave b u ilt in to th e ir p ro d u c ts, says Nelson. M s. N e ls o n sa y s t h e s o lu t io n is to t r a i n s t a f f m e m b e r s to e n t e r d a t a in a g r e e d – u p o n fields. But th a t ‘s d ifficu lt if a p ra c tic e tack le s 15 or 20 q u a lity im ­ p ro v e m e n t a re a s all at once. Ms. H olm es s u g g e s t s f o c u s in g o n j u s t o n e a r e a , s u c h as b r e a s t c a n c e r s c r e e n in g . T h is e n s u r e s th e o rg a n iz a tio n receives a c c u ­ ra te d a ta to c h a n g e p ro v id er a n d p a tie n t b ehavior. D T Copyright ofDermatology Timesisthe property ofAdvanstar Communications Inc.andits content maynotbecopied oremailed tomultiple sitesorposted toalistserv without the copyright holder’sexpresswrittenpermission. 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