Health Information Technology to Support the Patient-Centered Primary Care Medical Home: UNC Experience Sam Weir, MD UNC Family Medicine Center Director.

Slides:

Advertisements

Similar presentations

Team/Organization Name Background and structure Location Brief system information (type, size) Pilot population.

Advertisements

Mary Campos, RN, CDE EKLMC Diabetes Case Manager.

CDM Registry Project Dr. Richard Lewanczuk Regional Medical Director Chronic Disease Management Capital Health.

SC PA Best Practice Sharing. Practice 1 PDSA’s Included:  Identifying DM patients prior to and/or at time of visits  Identify who needs Urine Micro.

The Chronic Care Model.

What is an asthma registry? n A list of patients with asthma n A source of data for asthma management  individual patient level  individual provider.

Care Coordination in the Patient-Centered Medical Home New York Academy of Medicine May 24, 2011.

Sutter Medical Foundation Diabetes Management Program Kimberly Buss, MD, MPH Medical Director of Diabetes Education, SMF Medical Advisor of Diabetes.

Importance of a Registry Amy Belisle, MD Laura Brann, Program Manager, CIR Eric Anderson, Dir. Quality Data Management Chapter Quality Network (CQN) Asthma.

The Long and Winding Road to PCMH Presenters Laurel Domanski Diaz, MNO, Director of Business Operations Dan Gauntner, CNP, Director of Clinical Operations.

Population Management & Reporting. Federally-designated Regional Extension Center for the State of Missouri  University of Missouri:  Department of.

Care Continuity and Patient Care Transitions Kari DiCianni, Director of Innovations & Research.

Jackie Gianunzio CDEMS Support Specialist Intro to CDEMS.

A Patient-Centered Approach with P.R.I.D.E.

Elizabeth I. Molina Ortiz Diabetes Medical Director Institute for Family Health.

Paul Kaye, MD VP for Practice Transformation Hudson River HealthCare October 1, 2010.

1 Open Door Family Medical Centers Care Coordination and Information Exchange Presentation October 2010.

August 9, 2013 Patient Engagement: The Time is Now Weekly Webinar Series Overcoming Meaningful Use Barriers: Solutions from the Field.

Patient-Centered Medical Home.

Patient Centered Medical Home What it means for Duffy Health Center Board Presentation September 10 th 2012.

USING HEALTH INFORMATION TECHNOLOGY TO IMPROVE CARE OUTCOMES HCN BOARD RETREAT TONY AMOFAH, MD, MBA, FACP, CMO, COMMUNITY HEALTH OF SOUTH FLORIDA, INC.

Designing and Using Cloud – Based Interactive Patient Experience Surveys to Assess the Effectiveness of Accessible Telecare Strategies for People with.

Bangor Beacon Community Health Data Capture October 26, 2010 Barbara Sorondo, MD MBA.

KIDS & TEENS MEDICAL GROUP L.A. Care: HIT conference October 27, 2009.

Alliance for Health Reform Briefing: Medicaid and Health IT Community Health Centers and HIT Driving Innovation in the Patient-Centered Medical Home Presented.

HIT Policy Committee Quality Measures Workgroup October 28, 2010 Fred D Rachman, MD.

Introduction to Healthcare and Public Health in the US The Evolution and Reform of Healthcare in the US Lecture d This material (Comp1_Unit9d) was developed.

Patient-Centered Medical Home Overview October 15, 2013.

A NEW APPROACH TO PATIENT- CENTERED CARE Family Health & Sports Medicine Albert Puerini, MD.

Weston Willet, CIO Institute for Family Health x3054 September

Exploring Challenges and Potentials of Personal Health Records in Diabetes Self-Management: Implementation and Initial Assessment Telemedicine journal.

California Chronic Care Learning Communities Initiative Collaborative Final Outcomes Congress December 9, 2005.

Iowa’s Section 2703 Health Home Development October 04, 2011 Presentation to: 24 th Annual State Health Policy Conference Show Me…New Directions in State.

UMHS Dominos Family Medicine Pam Szymanski, RN, Complex Care Nurse Navigator.

1. Overview This talk will focus on how Bristol Park Medical Group has improved Clinical Quality Scores over a 4 year period by using an integrated approach—integration.

Pawtucket Medical Central Falls Medical Pawtucket Dental Blackstone Valley Community Health Care FQHC serving 15,000 patients 30 providers, including 18.

The Patient-Centered Medical Home: A Work in Progress Alliance for Health Reform Briefing Washington D.C. September 22, 2008 Diane R. Rittenhouse, MD,

David Gorchoff, MD MPH Medical Director, Redwood Community Health Coalition California Healthcare Foundation November 2005, San Francisco Using Technology.

Component 1: Introduction to Health Care and Public Health in the U.S. 1.9: Unit 9: The evolution and reform of healthcare in the US 1.9d: The Patient.

The Business Case for P4P Douglas Allen MD., MMM. Chief Medical Officer Greater Newport Physicians IPA.

The National Medical Home Summit March 2 and 3, 2009.

Memorial Hospital Quarterly Meeting – What to look for in an EMR Tips used at Dr. John Dormois’ Practice.

The Electronic Personal Health Record (ePHR) Beth Friedmann CS Spring 2007.

Transforming Care in Patient Centered Medical Home and Accountable Care Organization Hae Mi Choe, PharmD Director, Pharmacy Innovations & Partnerships.

1 Michaela Frazier, LMSW Director of Community Benefit Programs Institute for Family Health Care Coordination and Technology to Support Physical and Behavioral.

Care Management: The Transition to Meeting NCQA Standards for PCMH Clyde H. Satterly, MD, MBA SUNY Upstate Medical University, Dept of Family Medicine.

The Medical Home in Residency: Comparison with a Non-Residency Setting Group Health Family Medicine Residency Seattle Sara Thompson, MD - Program Director.

Chronic Pain Management Project at the Underwood-Memorial Hospital Family Medicine Residency Program Gina Gill Glass, MD John R. Armando, LCSW 2006 STFM:

Training Medical Assistants to Participate in the Patient-Centered Medical Home TMAP Dana Neutze, MD, PhD; Mark Gwynne, DO; Julea Steiner, MPH; Lindsay.

Bronx Health Access: IT Requirements Gathering IT REQUIREMENTS GATHERING 1.

A Comprehensive Training Strategy to Implement Self Management Support in a PCMH Kyle Knierim, MD Corey Lyon, DO, FAAFP Kimberly Breidenbach, MD, MPH Aimee.

Join the conversation! Our Twitter hashtag is #CPI2011. Garbage in, garbage out: Barriers to Efficient Data Capture and Review A case study in maximizing.

Group Health’s experience September 24, 2015| Kathryn Ramos Implementing CDSME in an integrated health care system.

Beyond the Medical Home: Teaching and Interdisciplinary Care Conferences Group Health Family Medicine Residency Seattle Sara Thompson, MD - Program Director.

The Patient Centered Medical Home. Learning Objectives Identify the attributes of a patient centered medical home Describe some processes that facilitate.

How to measure quality and improvement of panel manager’s work in the Patient Centered Medical Home in a residency practice Daisuke Yamashita, MD Joe Skariah,

Disease Management Colloquium Using Registries to Manage Patient Care Art Sprenkle, MD Medical Director: McKesson Health Solutions; Washington State Medical.

The Colorado Family Medicine Residency PCMH Project North Colorado Family Medicine, Greeley, CO Sarah DeMoor, MD, Emily Lieder, DO, Paul Lobitz, MD (and.

Establishing a Primary Care Medical Home

The Long and Winding Road to PCMH

CMHI - for CHI Pilot, Dec 2009.

Objectives of behavioral health integration in the Family Care Center

The use of EMR tools in IFH’s Diabetes Initiative

Electronic Health Records (EHR)

Ann Intern Med. 2014;160(11): doi: /M Figure Legend:

ANNIE RUTTER, MD, MS & ELIZABETH MEZA, MD UNC-CHAPEL HILL

Jessica Lobban, PGY-3 CCLP Family Medicine Residency Program

16 Personal Health Records.

23 November 2018.

Gene Burwell CIO, Jamestown Health Department

Presentation transcript:

Health Information Technology to Support the Patient-Centered Primary Care Medical Home: UNC Experience Sam Weir, MD UNC Family Medicine Center Director

Objectives Illustrate our current use of HIT to support PCMH »EMR » portal »Chronic disease registry Discuss our hopes for future use of HIT to support PCMH »Patient portal (for results, messages, scheduling appointments) »Expanded registry function »Patient entered histories Summarize with lessons learned

UNC Webcis: Patient Record

UNC Webcis: Problem List Tab

UNC Webcis: Allergy Tab

UNC Webcis: Patient Record

UNC Webcis: Activity List Function

UNC FMC Portal

UNC FMC Chronic Disease Registry Diabetes, CHF »Based on freeware from Washington State »DEMS, CVDEMS, CDEMS Home :: Improving Chronic Illness Care cdems.com: Chronic Disease Electronic Management System information & user discussioncdems.com: Chronic Disease Electronic Management System information & user discussion Key functions: »Point of service decision support for care team Pre-visit planning Standing orders »Outreach (ex: mailing to encourage flu shots) »Quality reporting and targeted outreach Phone calls to those with A1c>9.0

CHF Registry Encounter Form Decision Support Trends of weight, bp, bnp, ejection fraction Lab download from EMR Clinical Data from Chart Audit

Quality reports from CVDEMS, Excel

Plans for further development: Patient Portal/Referring MD Portal Patient Portal Plans Access for patients to portions of their own records »Lab Results »Radiology Results Improved portal Improved ability to schedule appointments Referring MD Portal Access for outside referring MD’s to initiate referrals, review their patient’s charts Barrier: Resources

Plans for further development: Expanded Registry Function Migrate from CVDEMS to CDEMS »Improved ability to do tailored patient action plans in support of self management »Improved ability to tailor registry encounter forms Switch from weekly downloads from Webcis to feed from UNC’s data warehouse »Expanded ability to pull data into the registry »Expand registry to include preventive services »Barrier: institutional reluctance to share data

Plans for further development: Patient entered histories An expanded patient portal »Instant Medical History - Patient Interviewing Software and EMR Productivity ToolInstant Medical History - Patient Interviewing Software and EMR Productivity Tool Barriers »Interfaces with Webcis

Lessons Learned Progress is slow (two steps forward, one back) »Example: Who is the patient’s doctor? Persistence is a virtue Solutions can come from a variety of sources »Institutional »Departmental »Freeware from foundations »Vendors