The Podiatry Profile of the EHRS Functional Model

The Podiatry Profile of the EHR-S Functional Model Tuesday October 2 Q 4 WGM Baltimore Maryland

The Team • We have been able to assemble a unique team that is spearheading this effort. Many are SME’s from outside HL 7 • Barbara Bellione – Director of Risk Management at PICA the largest Malpractice Carrier in Podiatry • Alan Bass DPM – Consultant for Trak. NET one of the two largest niche EHR Vendors in Podiatry and a practicing Podiatrist • Michael Warshaw DPM – A representative from the American College of Foot and Ankle Orthopedics and a practicing Podiatrist • Dr Robert Katz – A former owner of an EHR reseller and integrator and a practicing Podiatrist • Dr Seth Rubenstein – A Podiatrist in private practice and on the board of the American Podiatric Medical Association (President Elect) • Dr Dyane Tower – A representative from the American Podiatric Medical Association • Mr John Romans – CEO of Biomedix a computerized diagnostic device used in many podiatry practices that has a HL 7 V 2 interface with many Podiatry Specific EHR Systems

As well as • Reed Gelzer MD • Gary Dickenson • Michael Brody – DPM I am a practicing podiatrist, the Medical Director for a CMS approved QRDA that serves the Podiatry Profession and the Chief Compliance officer for Sammy the other big EHR in the Podiatry Space

Back to Basics - The PSS Project Goal • The goal of this project is to develop a Podiatry Specific profile of the EHR-S functional model that addresses the specific needs of a Podiatrist. The scope of Podiatry in the United States is substantially broader than the scope of Podiatry in other countries; therefore, this is a US Realm project.

Project Need • Podiatry is the sub specialty that focuses on the treatment of the foot and lower extremity. There are specific examinations and documentation elements that are not currently supported by the current EHR-S Functional Model, in addition there are elements of the EHR-S Functional Model that do not apply to the practice of Podiatry. This project is needed to develop conformance criteria for a EHR System that is fit for use by a Podiatrist. • • Among the issues identified are: • • Improved documentation of wounds of the lower extremity for improved continuity of care and interoperability • Including the ability for an EHR system to send messages to discontinue medications, messages to indicate that OTC medications have been supplied to pharmacies and pharmacy benefit plans. • Improved ability to support Electronic Submission of Medical Documentation, Electronic Determination of Coverage, and clinical documentation with stakeholders to support both quality reporting and revenue cycle management. • Ability to support the capture of all relevant data related to joint replacements ORIF (screws and plates) and other implantable devices that have unique device identifiers and those that do not have UDI’s. • Ability to support communication of accurate data and authentic records with all appropriate stakeholders • Ability to support communication of quality measure data with all appropriate stakeholders.

Artificial Joints and Implants • Work has not yet begun on this aspect of the project.

Ability to support communication of quality measure data • Work has not yet begun on this part of the project

Improved documentation of wounds of the lower extremity • We have identified all of the data points associated with the various types of wounds that occur in the lower extremity • We have developed user stories associated with these wounds • We have reviewed the work done by CIMI on Wound care that is currently up for ballot (some excellent work) • We will leverage the work done by CIMI and hope to work with them to extend that work to support the data elements we have identified that are not currently part of that work product. • We are in the process of putting our work into a template that can be imported into the Enterprise Architect Tool (Thanks to Gary for all of his assistance with this effort)

Improved ability to support Electronic Submission of Medical Documentation • We have had communication with the Attachments workgroup on how information with wounds can be submitted to carriers to assist with ESMD for wound care • Once we have finished putting all of our work on this section into the template we will return to Attachments for input and appropriate modification of the wound documentation section

Medications • We have identified workflows where: • • • Sample Medications are dispensed to patients in the doctors office Prescription Medications are dispensed to patients in the doctors office Patients receive therapeutic injections of medications in the doctors office All of which are not currently supported in the current Functional Model. Consent for patients to be provided with medications for off label use • User stories have been developed for these events and will be imported into the spreadsheet for import into the tool. • Once all items are in the tool we will return to Pharmacy to make appropriate modifications to this section

Ability to support communication of quality measure data • Once the wound work is completed specifications for transmission to a CMS approved registry will be developed for both send and receive of this data.

Ability to support communication of accurate data and authentic records • Dr Gelzer has begun to work on the RI, TI and Reporting functions to enhance accuracy and authenticity of all data shared with EHR system that adhere to the specifications of this work product.