EHM-520_WEEK (7) منيف.pdf

EHM-520 ELECTRONIC HEALTH RECORDS WEEK 7 Prof. Bakheet Aldosari Presented by Dr. Muneef AlMokhlef 9/29/2022 1 Today Session # WEEK 7 Topic Reading Specialty-specific EHRs MARGRET’S CH 17 Due in Class 2 Learning Objectives • Describe the overall need for EHR products that address special...

EHM-520 ELECTRONIC HEALTH RECORDS WEEK 7 Prof. Bakheet Aldosari Presented by Dr. Muneef AlMokhlef 9/29/2022 1 Today Session # WEEK 7 Topic Reading Specialty-specific EHRs MARGRET’S CH 17 Due in Class 2 Learning Objectives • Describe the overall need for EHR products that address specialty functions or special needs of certain provider types • Identify what efforts are being undertaken to address specialty EHR needs • Review functions of EHRs for behavioral health • Review functions of EHRs for nursing homes and home health agencies • Discuss the pros and cons of specialty EHR vs. general, or multispecialty, EHR in the broader context of health information technology and health information exchange. Focus on Specialty-Specific EHRs • Focus (and M.U. incentives) for EHR has primarily been on hospitals and physician practices • But specialty providers of all types also benefit from EHR: – – – – – Integrated delivery networks Nursing homes Home health agencies Behavioral health facilities Specialists (e.g., chiropractics, dentists, optometrists, and podiatrists eligible for M.U. incentives) of all types – Others Other Provider Settings • • • • • • • • • • Emergency departments Public health departments Clinical research facilities Human service agencies Assisted living centers Durable medical equipment providers Correctional facilities Retail clinics Planned parenthood organizations Community health centers and federally qualified health centers • Pharmacies • Occupational health services • Emergency medical services Addressing Specialty Needs • Specialty medical societies often develop clinical practice guidelines • Associations of specialty providers often exhibit products and collect adoption statistics, but do not address clinical content • Standards development organizations – HL7 maintains a registry of Functional Profiles • CCHIT addresses functionality for specialists who have sought specialty certification EHR in LTPAC • Reports vary widely in reporting rates of adoption • “Electronic information systems for medical records” are not the same as EHR • EHR functionality – Similar to hospitals, but with somewhat less “deep” clinical functionality EHR Functionality for LTPAC • Financial/Administrative • Clinical – – – – – – – – – – – – – – – MDS or OASIS Care and service plans Resident assessment profiles Patient records* Electronic health records* ADL documentation Vital signs Therapy management E-prescribing E-MAR Computerized pharmacy administration (drug dispensing) Pharmacy interfaces Rehabilitation Transfer records Advance directives – General ledger, accounts payable, and payroll – Admissions planning – Discharge planning – Training – Policies and procedures – Compliance surveys – Resident satisfaction surveys – Marketing – Case management – Flags for LUPA or PEP – Executive dashboard • Resident services • Facilities management *Inclusion of these terms suggest that this list is all HIT, not just EHR, though some functions are EHR Benefits & Challenges in LTPAC • Time spent on required data collection reduced • Medication cost decreased through waste avoidance • Improved reporting leads to better data for appropriation forecasting • Reduced time to complete notes • Less personal contact • System issues • Desire more training • Time to chart • More explanation of information • Learning curve EHR in Behavioral Health • It is reported that EHRs in behavioral health are not as prevalent as in LTPAC, despite that a few vendors have been (CCHIT) certified for some time • E-Rx is not often used – Psychiatrists are often contracted by the facility and order controlled substances which have only recently been permitted • More interest in EHR to track care and progress over a long period of time – SAMHSA supporting research Behavioral Health Services • Variety of types of – Professionals – Therapies • Individual • Group • Family – Settings • Many state laws and requirements for data collection • Controversy surrounding nomenclature and categorization of types of “behavioral health” care (e.g., “mental health,” substance abuse records) Behavioral Health EHR Functionality • Call processing • Referral and waiting list management; access to community service directories • Patient registration and demographics • Insurance eligibility and prior authorization management • Client scheduling, including recurring appointments, group appointments, linked appointments, transportation, administrative, and cancellation management • Provider scheduling and caseload management • Provider desktop, schedule, and task list • Standardized diagnostic assessments, based on DSM IV differential diagnosis • Standardized treatment plan • Prompts for additional assessments • Assignment of providers to specific interventions • Association of clinical notes with treatment plan • Normative scaling of outcomes • Support for home monitoring, PHRs, telepsychiatry • Complex billing Benefits & Challenges in BH • Few implementations and low level of maturity – in both products and expectations • Benefits expectations focused on financial ROI, especially staff productivity, rather than quality improvement Specialty vs. General in HIT & HIE • “Two sizes” do not fit all, but all need technology to help health information exchange • Confidentiality pressures are great, but many individuals believe basic behavioral health information is essential for primary care providers Conclusion • Achieving coordination of care across the continuum will depend on specialty “gaps” being filled • Specialists have different needs, but agree that EHRs are not “IT projects,” everyone needs to be engaged in planning, training is vital, and users need to be process and content experts For Next Session # WEEK 8 Topic Reading Personal Health Records MARGRET’S CH 18 Due in Class 16 9/29/2022 17