HIT in the Patient-Centered Medical Home

An E-Quality Update from Kaiser Permanente
by Ted Epperly, MD, and Dana Hamilton, RHIT

All of us in the medical community face challenges as we implement more integrated and coordinated patient-centered care for our patients, but perhaps none more than primary care physicians. The Patient-Centered Medical Home — coupled with health information technology — is proving to be a successful model that allows physicians to provide comprehensive primary care in communities across the country. Similar to Kaiser Permanente's care model, PCHMs facilitate partnerships between individual patients and their personal physicians and their teams, and when appropriate, the patient's family.

In our PCHM, a large integrated family medicine residency practice in Idaho, there are three essential points that have helped HIT revolutionize our operation. These points have not only helped us grow, but have enabled us to thrive:

1. Do not skimp on IT resources. Having the right equipment is crucial. This includes enough computing power to not only run your practice management and electronic health record software, but to also allow for immediate growth. Growth starts before you even get the new server out of the box, so be sure to include capacity for extra users, storage, and add-on software when calculating for hardware needs.

2. Hire qualified IT support staff. Historically, IT support has been a place of bare-bones staffing in the health care arena. That has changed in the last few years, and having IT staff with health care knowledge will move you light years ahead. There are a number of teaching institutions that graduate-qualified health information management folks — including the Office of the National Coordinator for HIT, which now has its own program to educate HIT staff. Ensuring that your IT staff "gets" what is happening in the clinic will foster great working relationships with end users.

3. Training! Too often, we start the provider workforce with too little training to get started successfully. Technology is made to look easy, but operating the huge number of applications requires, at least, basic training. This has been, in our opinion, the greatest downfall for health information technology working for the masses. Too many times we give just barely enough training to get teams started, but we don't give enough to make the end user successful. By improving training, we can set up users to be knowledgeable enough to not just squeak by, but to be efficient and more independent of IT support for daily tasks.

Bringing the PCMH to Idaho and other parts of rural America poses challenges of its own, including fragmented care and lack of communication for follow-up. With few providers going into these rural areas, patients are shunted throughout communities to get the care they need for preventive services, chronic diseases, and specialty care. The PCMH model addresses these challenges directly by creating a broad-based team, which can include multiple providers, community services, and specialists. The PCMH model and the associated IT services can create a well-formed home for high-risk patients and integrates the rural community as one team.

Access, quality, management, continuity and integration of care, test and referral tracking, and registry creation are all enhanced by HIT. When implemented well, they can start working for the practice to reduce costs, improve quality, and increase patient and team satisfaction.

It is an exciting time to be a primary care provider, and to start to see what the promise of HIT and the Information Age will bring to the practice of medicine.

Ted Epperly, MD, is a primary care physician, CEO of the Family Medicine Residency of Idaho, co-chair of the Patient-Centered Primary Care Collaborative Center on Accountable Care, and Past President and Past Chairman of the Board American Academy of Family Physicians.

Dana Hamilton is Director of Clinical Informatics Family Medicine Residency of Idaho.

Heart of the Rockies Regional Medical Center 2nd CAH in Colorado to Attest to Meaningful Use!

Heart of the Rockies Regional Medical Center successfully attested for Stage 1 Meaningful Use of their Electronic Health Records on October 25th making them the second Critical Access Hospital in Colorado to attest and apply for Medicare EHR Incentive Funds. During the last year, they overcame many obstacles on their journey to Meaningful Use and could not have reached their goal without strong leadership and perseverance. CRHC is delighted to have had the opportunity to work with Heart of the Rockies as it's CO-REC partner to help guide and council them along the way.


Congratulations Heart of the Rockies Regional Medical Center!

Critical Considerations for CAHs Seeking EHR Payments

When I attested to our organization's ability to meaningfully use electronic health records on April 18, 2011, I thought the really hard part of Phase I was behind me. Talking to colleagues who were at prospective payment system hospitals, their payment process was simple; as soon as they attested for meaningful use, the CMS site locked them for payment, did the calculations of what they were entitled to receive, and three to four weeks later, they had a check.

For a critical-access hospital, it is "Not so fast, Grasshopper."

To read the rest of Stephen Stewart's, CIO of Henry County Health Center in Mount Pleasant, Iowa, article click here.

CENTURA Health Connects to the CORHIO Health Information Exchange Network

All Centura facilities went live on CORHIO on October 24, 2011. By connecting its current electronic health record with CORHIO’s secure network, Centura's physicians and other medical care providers from across the state are linked to important real-time health information about their patients.

Centura Health Uses Industry-Leading Technology to Improve Care Coordination For Residents in Metro Denver, Boulder, Colorado Springs, Pueblo, Summit County and Cañon City.

To read Centura Health's press release, click here.

To read CORHIO's press release, click here.

A Quick Guide to Clinical Quality Measures

August 30, 2011, CMS hosted a webinar about the Clinical Quality Measures and Meaningful Use. The following document contains questions and answers from the live Q&A portion of the webinar, and provides answers to the remaining unanswered questions that were received by CMS during the webinar and in follow-up emails.

To read the document, click here.

CRHC’s 2012 Membership Drive Now Underway!

Over the past 20 years, CRHC has become our state’s most trusted resource for rural healthcare. In the current economic landscape, it is more important than ever that we continue to support and advocate on behalf of rural healthcare and the safety net community. We remain loyally committed to ensuring our members have the resources and support they need to keep their communities healthy and vibrant. CRHC is well positioned to provide 20+ more years of support to ensure access to healthcare for all Coloradans, and we recognize that our work would be impossible without the dedication of our loyal members.

CRHC has three levels of membership to suit your organizational/individual needs:
• Investing Member
• Classic Sponsor
• Partner

Joining is easy. Click here to join today!

At the Classic Sponsor and Partner level memberships, your organization is given additional opportunities to support and reach out to rural healthcare providers. Please visit our website for more information on the benefits of each level. Feel free to contact Cari Fouts, Director of Communication & Development (cf@coruralhealth.org, or 303-565-5847) if you have questions about your membership or visit our website for more information.

With your support, we can continue to ensure all Coloradans have access to high quality healthcare services in 2012 and beyond.

CMS is Holding a Second Webinar on the CQMs and the EHR Incentive Programs for Small-Practice Providers

What: Webinar- The CMS EHR Incentive Programs: Small-Practice Providers and Clinical Quality Measures (CQMs)
When: October 25 from 1:00 – 2:30 p.m. EDT
Why: To help small-practice providers successfully report CQMs
How: Register online

The Centers for Medicare & Medicaid Services (CMS) is holding a second webinar on CQMs and their importance in attesting to meaningful use for the EHR Incentive Programs. CMS hopes to help small-practice and rural providers become more knowledgeable in the topics below:

• An overview of the CQMs
• How to report CQMs during attestation
• Why CQMs are included in the EHR Incentive Programs
• Answers to many FAQs on the CQMs and the EHR Incentive Programs

Although, small-practice providers are the intended audience of this webinar, anyone is welcome to join.

The webinar presentation, a document with over 300 questions and answers from the webinar held on August 30, and an informational CQM fact sheet will be provided to participants before the webinar as downloadable handouts.

Additionally, registrants will be given an opportunity to submit questions through the registration site before the webinar that will be answered by CMS subject matter experts and posted to the CMS EHR website a few weeks after the webinar has been completed.

Registration

Individuals can register online for the webinar. After successfully registering, they will be sent a confirmation message with a link to the webinar site. Space is limited, so interested participants should register now to secure their place.