Meaningful Use Case Study Telana Fairchild MSN FNP

Meaningful Use Case Study Telana Fairchild, MSN, FNP 10/14/2014 N 707 Biomedical Informatics University of Massachusetts- Worcester Graduate School of Nursing

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

Insurance Types MFH Details ü About 4, 500 active patients Medicaid ü 4 Providers Private ü Worked with the Vermont Information Technology Leaders (VITL) Uninsured § Provided with various tools and resources March 2010 Began Medicare Medent 19. 5 January 2011 Implemented EHR June 2011 Attested MU

EHR Selection PCMH Achieve NCQA-PCMH Level 3 Vermont HER collaborative educational programs 5 different vendors Polled other medical practices AAFP Practice Management Journal Implementation 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

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

Meaningful Use Stg 1, Step 5 • 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 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: Hg. A 1 C poor control DM: Blood pressure management CAD: Oral antiplatelet therapy Ex: Poor A 1 C- lists patients >8 and actions taken

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