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A Stimulus Story

A Stimulus Story. The ARRA Stimulus Reimbursement from a Patient Workflow Perspective. Devising a Plan Getting Organized (Requirements Inventory) Examining Workflow Devising the Workflow (Examples) Exclusions and Pitfalls. Requirements Inventory 15 Core Requirements

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A Stimulus Story

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  1. A Stimulus Story

  2. The ARRA Stimulus Reimbursement from a Patient Workflow Perspective

  3. Devising a Plan • Getting Organized (Requirements Inventory) • Examining Workflow • Devising the Workflow (Examples) • Exclusions and Pitfalls

  4. Requirements Inventory • 15 Core Requirements • 5 of 10 Menu Requirements • Where do they fit into the Clinical Workflow?

  5. Core Requirements

  6. Menu Requirements (5 of 10)

  7. Check In • History • Examination • eRx • Check Out • (Attestation Only) Workflow Proposal

  8. Check in: • Core 7, Record Demographics • Core 8 (option), Record Vital Signs • Core 9 (option), Record Smoking Status Divide and Conquer

  9. History: • Core 8 (option), Record Vital Signs • Core 9 (option), Record Smoking Status • Menu Set 2, Clinical Lab Test Results Divide and Conquer

  10. Examination: • Core 3, Maintain Problem List • Menu Set 7, Medication Reconciliation Divide and Conquer

  11. eRx: • Core 1, CPOE • Core 4, Generate and Transmit Permissible Prescriptions Electronically • Core 5, Active Medication List • Core 6, Medication Allergy List Divide and Conquer

  12. Checkout: • Core 12, Electronic Copy of Health Information • Core 13, Clinical Summaries • Menu Set 4; Patient Reminders • Menu Set 5, Patient Electronic Access (Timely Electronic Access) • Menu Set 6, Patient Specific Education • Menu Set 8, Transition of Care Summary (Patient Summary Record) Divide and Conquer

  13. Divide and Conquer • Attestation Only (no measurement): • Core 2, Drug Interaction Checks • Core 10, Clinical Quality Measures • Core 11, Clinical Decision Support Rule • Core 14, Electronic Exchange of Clinical Information • Core 15, Protect Electronic Health Information • Menu Set 1, Drug Formulary Checks • Menu Set 3, Patient Lists • Menu Set 9, Immunization Registries Data Submission • Menu Set 10, Syndromic Surveillance Data Submission

  14. Most Suitable? • Drug Formulary Checks (M1) • Patient Lists (M3) • Patient or Timely Electronic Access (M5) • Patient Specific Education (M6) • Medication Reconciliation (M7) Selecting Menu Requirements

  15. Selecting Menu Requirements • Immunization Registries Data Submission (M9) • Syndromic Surveillance Data Submission (M10) Exclusions?

  16. Immunization Registries Data Submission 10. Syndromic Surveillance Data Submission • Clinical Lab Test Results (M2) • Patient Reminders (M4) • Transition of Care Summary (Patient Summary Record) (M8) Selecting Menu Requirements Problematic?

  17. Last name • First name • Date of Birth • Gender Workflow – Check In

  18. Race (select one of the following): • White • Asian • Black or African American • Native Hawaiian or Other Pacific Islander • American Indian or Alaska Native Workflow – Check In

  19. Ethnicity (select one of the following) • Hispanic or Latino • Non-Hispanic or Latino • Preferred Language • English • Japanese • French • Italian • Portuguese • Spanish • Russian Workflow – Check In

  20. Smoking Status (Can alsobecollected in Social History) • Currenteverydaysmoker • Currentsomedaysmoker • Formersmoker • Neversmoker • Smoker • Current status unknown • Unknownifeversmoked Workflow – Check In

  21. Vital signs (Can alsobecollectedduringHistory) • Height • Weight • BloodPressure Workflow – Check In

  22. Stimulus/Non-Stimulus • Provider Number Workflow – Encounter Type

  23. Workflow – History • Vital signs • Height • Weight • BloodPressure • Smoking status (use theabbreviations as noted). • SMED: current every day smoker • SMSMD: current some day smoker • SMFS: former smoker • SMNS: never smoker • SMOKE: smoker • SMCSU: current status unknown • SMUNK: unknown if ever smoked • Clinical Lab Tests Results (if applicable)

  24. Workflow – Exam • “Problem List,” Dx or ICD-9 • Medication Reconciliation

  25. Workflow – eRx • Core 1, CPOE • Core 4, Generate and Transmit Permissible Prescriptions Electronically • Core 5, Active Medication List • Core 6, Medication Allergy List • Attestation: • Drug Formulary • Drug-drug/drug-allergy interactions

  26. Workflow – Check Out • Core 12, Electronic Copy of Health Information • Core 13, Clinical Summaries • Menu Set 4, Patient Reminders • Menu Set 5, Patient/Timely Electronic Access • Menu Set 6, Patient Specific Education • Menu Set 8, Transition of Care Summary (Patient Summary Record)

  27. Thanks for your kind attention.

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