1. Meaningful Use Case Study
Telana Fairchild, MSN, FNP
10/14/2014
N707 Biomedical Informatics
University of Massachusetts- Worcester
Graduate School of Nursing

2. Small Practice Monitors Clinical Quality through EHR System Templates
Middlebury Family Health (MFH)
Middlebury, Vermont

3. Medent 19.5 MFH Details March 2010 January 2011 June 2011
About 4,500 active patients
4 Providers
Worked with the Vermont Information Technology Leaders (VITL)
Provided with various tools and resources
Began
Implemented EHR
Attested MU
Medent 19.5
Started March 2010
Implemented Medent in January 2011
Version 19.5
Attesting to Meaningful Use in June 2011
March 2010
January 2011
June 2011

4. EHR Selection Implementation PCMH VITL and State collaborative
Achieve NCQA-PCMH Level 3
Vermont HER collaborative educational programs
5 different vendors
Polled other medical practices
AAFP Practice Management Journal
VITL and State collaborative
Created flow charts of workflow
Allowed a member from each department to be a part of process
Chose month of lower volume
100 hrs in-house training

5. Templates and Packages
Created templates for chronic conditions
Asthma, Diabetes, Hyperlipidemia
Evidence based research
Guidelines
Enables to collect quality measures
“Plan Package”
Checklist
Ordering system for common diagnoses
Labs, procedures, referrals
Within patient’s progress note

6. Meaningful Use Stg 1, Step 5
3 Core CQMs & 3 Menu CQMs
HTN: Blood pressure measurement
Preventive Care and Screening: Tobacco Use Assessment and Invervention
Adult Weight Screening and F/U
DM: HgA1C poor control
DM: Blood pressure management
CAD: Oral antiplatelet therapy
Ex: Poor A1C- lists patients >8 and actions taken
Objective: Report ambulatory clinical quality measures to CMS
Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS
Their report on Diabetes Hemoglobin A1c Poor Control, for instance, returns a list of patients whose A1c is greater than 8 percent and what actions have been taken to follow up with the patient (such as scheduling a follow up appointment or requesting additional laboratory tests). This also allows MFH to generate a list of patients for whom follow is needed.

7. Conclusion Process- 9 months Medent Pleased Lost productivity
Productive
Monthly fee- support
Has MU department
Medent
Lost productivity
Fewer patients
Hired additional staff
Longer appointments
Overtime