1. Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a – Introduction to the EHR This material Comp3_Unit15 was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023

2. Introduction to the EHR Learning Objectives Identify the functions of the health record Describe the American Recovery and Reinvestment Act of 2009 (ARRA) including the portion of the bill called the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 Define meaningful use 2 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

3. Functions of the Health Record Document patient care Provide communication among healthcare team members Establish financial and legal record Support research and continuous quality improvement Create repository of the clinical thought processes recording ideas and impressions over the period of care Archive (at a single point) all clinical data for long-term use 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

4. Electronic Health Record “an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person’s care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations laboratory data and radiology reports” Source:(Centers for Medicare and Medicaid Services, 2012) (Office of the National Coordinator, 2012) (Latour & Maki, 2010). 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

5. Past and Future Improved Technology Government Support Receptivity of Healthcare Professionals Receptivity of Patients = Use of Electronic Records = Amount of Data 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

6. Data Rich? Data rich and information poor? Source: (LaTour & Maki, 2010) 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

7. Rights of Information Right information: accurate, free from error, and meaningful Right person: communicated to the person who should respond Right time: given to the decision-maker within a few minutes or hours Right place: accessible at the point of care Right amount: decisions can be made faster when appropriately-selective information is available Source: (HIMSS, 2010) 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

8. American Recovery and Reinvestment Act (ARRA) $ 19B for Health Information Technology for Economic and Clinical Health (HITECH) Centers for Medicare and Medicaid Services (CMS) –Incentive Payment, Meaningful Use Office of the National Coordinator for Health Information Technology (ONC) –Oversees Certification Standards Source:(ONC) 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

9. HIT Regulations American Recovery and Reinvestment Act of 2009 (ARRA) –Create and save jobs –Invest in education and training –Promoting energy efficiency –Invest in healthcare 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

10. HIT Regulations Health Information Technology for Economic and Clinical Health Act (HITECH) –Promotes adoption of EHR by healthcare providers –Offers financial incentives for demonstrating meaningful use of EHR Source: (ONC) 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

11. Meaningful Use “The effective use of information to support better decision-making and more effective care processes that improve health outcomes and reduce cost growth” Enhance data capture and sharing Advance clinical processes Improve outcomes Source:(The Marke Foundation, 2009) 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

12. Regional Extension Centers (RECs) Offer technical assistance and guidance on meaningful use Over 60 RECs serving a defined area Promote nationwide health information exchange Source: (ONC) 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

13. Data Capture and Sharing Improving quality, safety and efficiency of care Engaging patients and families Improving care coordination Improving population and public health Ensuring privacy and security protections Source: (CDC) 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

14. Improve Quality 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a Use CPOERecord Smoking (> 13 yrs) Formulary ChecksStructured Lab Results Problem ListList Patient by Condition ePrescribeReport Quality Measures Rx ListPatient Reminders (50 yrs or older) Rx Allergy ListClinical Decision Support ("Relevant to Clinical Quality Measures“) Record DemographicsCheck Eligibility Record Physiological DataSubmit Electronic Claims Growth charts for children between 2 and 20 Source: (Blumenthal & Tavenner, 2010)

15. Engage Patients and Families Patient eAccess on Request (including discharge summary/ instructions from hospital) Patient eAccess to Record (Patient portal) Clinical Summaries each Visit (Portal, email, CD, USB, paper) 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

16. Improve Care Coordination Exchange health information with other providers Medication reconciliation Summary care record for each transition or referral: transfers with summary Source:(Latour & Maki, 2010) 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

17. Improve Population and Public Health eSubmit to immunization registries (hospitals also submit to Department of Public Health) eSubmit Syndromic Surveillance to Department of Public Health 17 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

18. Meaningful Use Rule Final revisions to Phase 1 criteria made on July 13, 2010 Later phases planned 18 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a Source: (Blumenthal & Tavenner, 2010)

19. Electronic Health Records Lecture A – Summary Identify the functions of the health record Describe the American Recovery and Reinvestment Act of 2009 (ARRA) including the portion of the bill called the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 Define meaningful use 19 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a

20. Electronic Health Records References – Lecture a 20 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a References CDC. Meaningful Use. Introduction. Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/ehrmeaningfuluse/introduction.html http://www.cdc.gov/ehrmeaningfuluse/introduction.html Centers for Medicare & Medicaid Services. Electronic health records overview. [Internet]. Available from: https://www.cms.gov/EHealthRecords/https://www.cms.gov/EHealthRecords/ Blumenthal D, Tavenner R. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010 Jul 13. Available from: http://healthcarereform.nejm.org/?p=3732&query=homehttp://healthcarereform.nejm.org/?p=3732&query=home HIMSS. CDS Five Rights. Clinical Decision Support Wiki. Available from: http://himssclinicaldecisionsupportwiki.pbworks.com/w/page/18288541/CDS%205%20Rights http://himssclinicaldecisionsupportwiki.pbworks.com/w/page/18288541/CDS%205%20Rights ONC. HITECH Programs. The Office of the National Coordinator for Health Information Technology. Available from: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__hitech_programs/1487 http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__hitech_programs/1487 LaTour KM, Maki SE. Health information management concepts, principles and practice. Chicago: AHIMA, 2010. Office of the National Coordinator for Health IT. Health IT terms. [Internet] Available from: http://healthit.hhs.gov/portal/server.pt/community/health_it_hhs_gov__glossary/1256 http://healthit.hhs.gov/portal/server.pt/community/health_it_hhs_gov__glossary/1256

21. Electronic Health Records References – Lecture a 21 Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a References ONC. About ONC. The Office of the National Coordinator for Health Information Technology. Available from: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200 ONC. Health Information Technology Extension Program. Office of the National Coordinator for Health Information Technology. Available from: http://www.healthit.hhs.gov/portal/server.pt?open=512&objID=1335&mode=2 http://www.healthit.hhs.gov/portal/server.pt?open=512&objID=1335&mode=2 The Markle Foundation. Achieving the Health IT Objectives of the American Recovery and Reinvestment Act. The Markle Foundation: Connecting for Health, [Internet] 2009 April. Available from: http://www.markle.org/publications/403-achieving-health-it-objectives-american-recovery- and-reinvestment-acthttp://www.markle.org/publications/403-achieving-health-it-objectives-american-recovery- and-reinvestment-act Images Slides 6, 15, 16, 17, 18: Clip Art. Available from: Microsoft clips online. Used with permission from Microsoft.