SLIDE 1
MEANINGFUL TECHNOLOGY TOOL-KIT TO
IMPROVING PATIENT HEALTH
Fall 2016
SLIDE 2 FEDERAL HEALTH INITIATIVE: MEANINGFUL USE
The Medicaid EHR Incentive Program provides incentive
payments for eligible healthcare providers to adopt and use electronic health record (EHR) technology in ways that can positively affect patient care
Objectives are established by the Centers for Medicare and
Medicaid Services (CMS) using a certified EHR; program is run by individual States
SLIDE 3
10 OBJECTIVES: MEDICAID AND MEDICARE STANDARDS
1 Protect Patient Health Information 2 Clinical Decision Support (CDS) 3 Computerized Provider Order Entry (CPOE) 4 Electronic Prescribing (eRx) 5 Health Information Exchange 6 Patient Specific Education 7 Medication Reconciliation 8 Patient Electronic Access 9 Secure Electronic Messaging 10 Public Health Reporting
SLIDE 4 GOAL: USE EHR TO IMPROVE HEALTH
Improve quality, safety and reduce health disparities Achieve better clinical outcomes Engage and empower patients Improve care delivery, coordination and public health Build more robust research data on health systems
SLIDE 5
A VISION FOR UCSF
Adopt clinic workflow to align with federal (CMS)
standards
Be at the forefront of the intersection of technology
and human health
Prepare to become integrated with UCSF Health
System
SLIDE 6
THE KEY TO OUR EXCELLENCE IS OUR….
Students Faculty Staff Everyone has a role What is YOUR role?
SLIDE 7
FACULTY START CHECKS
Students are proxy providers Chart documentation is tracked by faculty and
by student
No start check = no tracking for faculty, so
please obtain a start check at every session!!!
SLIDE 8
MEDICAL HISTORY
Update allergies Update problem list eRx query and manage Medications Hx Review meds in “medications” tab by clicking
“reviewed button”
SLIDE 9
VIDEO DEMO
1. Alerts/Allergies 2. Patient problem list 3. eRx managing medication history 4. Reviewing medications
SLIDE 10
MU TAB: THIS IS NEW!
@ every visit! Key to track continuous quality metrics related to
diabetes, hypertension, BMI, referral pattern, etc.
In EHR, select “forms”, click Select “MU tab form” from pull down menu Fill out MU2 Measures Form THIS IS A KEY FORM FOR TRACKING VARIOUS
INTERVENTIONS!
SLIDE 11
VIDEO DEMO
5. How to fill out the MU form
SLIDE 12
NEED RX? – IT’S ALL IN ERX
Prescribe under faculty log-in in eRx Print and have faculty sign
If Schedule II drugs (ex: Vicodin, Norco, etc.), then
ask faculty to take the printed eRx to the dispensary and request the secure Rx pad
SLIDE 13 UC PROTOCOL FOR DISPENSING MEDS
Available medications: Amoxicillin 500mg Clindamycin 150mg Acetaminophen 500mg and 325mg Ibuprofen 200mg Enter code Q0203 in AxiUm as “complete” in the patient’s EHR Enter a progress note and indicate a). Medication name, b). Dose, c).
Primary reason for administration.
The attending faculty must provide an electronic signature Enter the medication prescription into eRx, have the faculty sign it
electronically and print it
At the dispensary window, provide the staff member with the patient’s
EHR number, printed eRx prescription, and ask a staff member for the requested medication
SLIDE 14 VIDEO DEMO
6. Prescribing medications in eRx
Remember: your faculty must have an eRx password!!!
See a Clinic Director if faculty doesn’t have one
SLIDE 15 CLINICAL DECISION SUPPORT (CDS)
5 programmed prompts Follow the prompts when they pop up
This is an example
SLIDE 16
PATIENT EDUCATION
CAMBRA: In CRA click “yes, recommendations
given” and print the correct info for patient
New: tobacco cessation New: BMI (letter for patients with BMI <17.8 or
>25)
Go to “patient attachments” Click under “letters and general letters” Select from a list of letters relevant to your patient
SLIDE 17
VIDEO DEMO
7. Patient education letters
Smoking cessation Metabolic health (obesity)
SLIDE 18
SOCIAL COGNITIVE THEORY
Reciprocal determinism: behavior is a result of
and part of a continual interaction between individuals and their social and physical environment.
What role does UCSF School of Dentistry have
in creating an influential environment for our patients?
SLIDE 19
SMOKING IS ONE OF THE LEADING CAUSES OF STATISTICS
From January- December 2015:
We saw 10,700 patients in predoc 1,763 said “yes” to smoking 225 clinic instruction days 16.5% of our patients smoke 12% of people smoke in CA Oppor
Opportunity: 7-8 patients/da unity: 7-8 patients/day
SLIDE 20
5 DETERMINANTS OF HEALTH
Medical Care – 10% Genetics – 20% Health behaviors – 40% Social circumstances – 20% Physical environment – 10% 70% of what influences health is rooted in broader
social conditions that structure individual’s risk of being at risk – need social justice approaches
Remedial Approach
SLIDE 21
MESSAGING WITH PATIENTS: NEW
Send a “welcome message” All in axiUm email Green name color = patient Can also use Exan DoctorAccess to view these
emails remotely
SLIDE 22
PATIENT ONLINE ACCESS TO EHR
High level information Medication list Problem list Notes and details are not viewable to patients Patients go to: https://dentalhealth.ucsf.edu/ Patients log in with access code provided at the
front desk
Please engage your patients in this process FA and ACC staff maybe of help to patients
SLIDE 23
VIDEO DEMO
8. Patient online access 9. Patient messaging
SLIDE 24 SO, WHAT DO I NEED TO DO STARTING OCTOBER 3RD?
At Every Visit:
Get a start check from your faculty Ensure MU Tab form is filled out/updated Ensure Medications are “reviewed” and stamped with
”today’s” date
In General, when appropriate:
Update allergy and problem list Use eRx for every prescription you write Provide relevant patient education materials
Engage your patients in online experience:
Help patients log-in to their EHR online Send the patient a “welcome” email
SLIDE 25
THANK YOU!
Acknowledgements:
Dr. Mark Kirkland and the Dean’s office Lenh Tsan – Project Manager Tom Ferris and NIS team Maria Guerra Dr. Sean Mong Dr. Nakahara and Dr. Singh
