Cuyahoga County Board of Health (CCBH) and Regional Extension Center (REC) James W Coates, MS, RS Researcher, Epidemiology, Surveillance and Informatics
Cuyahoga County Board of Health • Serves ~845,000 residents in Cuyahoga County, Ohio excluding the City of Cleveland and Shaker Heights.
Why EHR at LHD? • Participate in the Health Information Exchange • Provide Patient Data • Get Population Data
• • • •
Increase Revenue Improve Productivity and Efficiency Improve Customer Service and Quality of Care Improve Regulatory Compliance
Keys to Success • Senior-level Management Support • Funding, priority setting, and executive attention
• Physician and Nurse/Staff buy-in • Identify Champions • Abandon inefficient processes • Leave the “we’ve always done it that way” behind
• Maintain Constant Communication • Understand Technology alone will not transform nursing practice
Liang, L. Connected for Health Using Electronic Health Records to Transform Care Delivery. 2010. Jossey-Bass A Wiley Imprint.
Goal To record all patient interactions, migrate historical data from current practice management (PM) system, track and generate claims, achieve stage 1 meaningful use, participate in the State health information exchange, and comply with HIPAA 5010 and ICD-10 requirements.
CMS Incentive Flow Chart
Centers for Medicare & Medicaid Services. ICN# 905343 (September 2010) https://www.cms.gov/MLNProducts/Downloads/Eligibility_Flow_Chart-ICN905343.pdf
History of Events • October 2010 • REC Kick-off Meeting • Not Eligible for REC Services
• November 2010 • Title X Letter
• December 2010 • Signed REC Agreements
Golden Ticket
*Additionally CCBH contracts with Certified Nurse Midwife with prescriptive authority and a M.D.
REC Experiences • Case Western Reserve University (CWRU) • Assigned Consultant • Welch Allyn • • • •
Preparation Questions Personnel Budget Work flows
Welch Allyn • Preparation Questions • Personnel • Budget • Work flows
CCBH Direct Services • Immunizations • Child • Adult • Travel
• Title X Family Planning • School Based Dental Sealant
Work Flows • Documents sequence of events between actor and the system. • Excellent learning experience for all • Communicates needs to developers • Essential for developers
Example Work Flow
Orlova, A., Johns Hopkins University, Health Information Technology Standards and Systems Interoperability Course, Spring 2011. http://ocw.jhsph.edu/courses/infstandards/PDF/infStandards_lec5c_orlova.pdf
Fork in the Road • System Type • Integrated • Include Case Management
• Interfaced • Could Include Case Management
Case Management • Things to consider • Include in build out of EHR • Comprehensive System • Reporting • Maintenance
• Cost
Next Steps • • • •
Case Management? Develop RFP Evaluate Vendors Vendor Selection
Timeline Welch Allyn Process |----------------------------|
{Deliverable: Requirement Analysis Document} Send out RFP |----------|
{Deliverable: Receive at least 3 proposals}
Vendor Selection |----------|
{Deliverable: Choose 1 certified vendor}
Sys. Development |----------------------------|
{Deliverable 1: Sys. Development Specifications} {Deliverable 2: Working prototype / pilot}
Pilot testing & retesting |---| |-----| Modification |------| |---|
{D: Pilot Testing Protocol/Report}
Implementation {D: Sys. Documentation} |-------------------------| Evaluation & Operation {D: Ops. Manual} |------------------------------->
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Sept-12
Nov-12
Contact Information James Coates, MS, RS Researcher Epidemiology, Surveillance and Informatics Cuyahoga County Board Of Health 5550 Venture Drive Parma, OH 44130 Phone: 216-201-2001 ext: 1617 Email:
[email protected]
