# Presentation: 579891

## Denni McColm, CIO, Citizens Memorial Healthcare

## 74 acute care beds
Emergency Services
Home Health, Hospice, Home Medical Equipment, Health Transit Services
Long Term Care Facilities (5)
Residential Care Facility (1)
Physician Clinics (16 locations, 60 providers)
Outpatient Services

- 74 acute care beds
- Emergency Services
- Home Health, Hospice, Home Medical Equipment, Health Transit Services
- Long Term Care Facilities (5)
- Residential Care Facility (1)
- Physician Clinics (16 locations, 60 providers)
- Outpatient Services

## EMR that crosses continuum
100% use of CPOE
No paper charts

- 100% use of CPOE
- No paper charts

## Ambulatory Quality and Safety Project

- Standardize and integrate data capture for quality measurement into the normal documentation of care within the ambulatory EMR
- Implementation of an automated system for data extraction including valid, reliable reports that provide actionable insight for the measurement, analysis and improvement of care

**Notes:**
Build it into workflow of typical visit (byproduct prompting for answers – reminding)
Extract it
Report both to CMS and back to us

## Broad Approach – All PQRI measures applicable

- First period, July 1, 2007 – December 31, 2007
- Renewed for 2008, January 1 – December 31
- 1 1⁄2% bonus for Medicare fee schedule services for reporting at least 80% of the time on 3 or more measures during the period
- 47 measures proposed initially
- 74 measures actually used in 2007
- 119 measures in use for 2008
- 175 proposed for 2009 (bonus 2% plus ePrescribing bonus 2%

**Notes:**
16% of physicians reporting in 2008

## Slide 6

## Where are the answers?

- Demographics
- Billing Data
- Test Results
- Orders
- Health Maintenance
- Vital Signs
- Medication List
- Queries

## Template Redesign

## PQRI Exclusions & Exceptions

## The Institute for Health Metrics (IHM) is:

A non-profit that helps hospitals leverage electronic systems for quality improvement

Assists hospitals in extracting data from the MEDITECH system for use in:
Physician & Departmental Profiling
Quality of Care Reporting: JCAHO Core Measures, IHI, AHRQ, etc.
Performance Improvement
Benchmarking

- A non-profit that helps hospitals leverage electronic systems for quality improvement
- Assists hospitals in extracting data from the MEDITECH system for use in:
- Physician & Departmental Profiling
- Quality of Care Reporting: JCAHO Core Measures, IHI, AHRQ, etc.
- Performance Improvement
- Benchmarking

##      Data Extraction Process

-      Data Extraction Process

**Web Based Reports**

**IHM**

**NO Software to Install and maintain**
**No IT resources outside initial VPN set up**
**All CMS, JCAHO requirement updates performed by IHM**
**All new indicators added by IHM**

**Nightly data extracts**
**Monthly reports delivered within hours of discharge codes completed**

**Clean**
**Normalize**
**Map**
**Report**

## AIES: (Automated Indicated Extraction System) Automatically delivers quality performance indicators for over 300 quality measures to expedite hospital reporting and improve care. 
PQMS: (Physician Quality Management System) Provides hospital management with on-going department and physician information for reviews and credentialing across 102 procedures and 26 diagnoses.
CPMV: (Core Measures Patient View) Preps data for submission to core measures vendor. 
Daily Infection Alert:  This new daily report alerts the hospital staff to identify patients at risk for hospital acquired infections and to proactively intervene.

**AIES****:** (Automated Indicated Extraction System) Automatically delivers quality performance indicators for over 300 quality measures to expedite hospital reporting and improve care.
**PQMS****:** (Physician Quality Management System) Provides hospital management with on-going department and physician information for reviews and credentialing across 102 procedures and 26 diagnoses.
**CPMV****:** (Core Measures Patient View) Preps data for submission to core measures vendor.
**Daily Infection Alert**:  This new daily report alerts the hospital staff to identify patients at risk for hospital acquired infections and to proactively intervene.

## Slide 13

## Challenges

- Designing to be time neutral for providers
- Speech recognition
- Medication reconciliation / updating
- Nurse support training
- MUSE
**M**ake a personal connection
**U**nderstand the patient’s concerns and priorities
**S**it, see, and show the screen
**E**ngage the patient as a partner in healthcare
- Patient Portal
- Hospital based providers & measures
- Sharing templates