TOPIC OBJECTIVE. Who We Are Origin Idea Planning & Creating Curricular Integration Progress to Date Next Steps Q&A Contact Information

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Sherilyn Morrison
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2 WIN, WIN, WIN: WHEN A BUSINESS, HOSPITAL, AND COLLEGE COLLIDE

3 TOPIC How a business, hospital, and college are collaborating using an electronic health record OBJECTIVE Who We Are Origin Idea Planning & Creating Curricular Integration Progress to Date Next Steps Q&A Contact Information To prepare current graduates with a competitive edge while elevating the healthcare workforce skillset in a shortened length of time.

4 WHO WE ARE

6 KIRKWOOD COMMUNITY COLLEGE MAIN CAMPUS Cedar Rapids, Iowa

7 THE COLLEGE The Campus 885 acres 27 buildings = 1.65 million square feet of interior learning space 400-acre working farm 1.5-acre vineyard and winery Academics 115 degrees, diplomas and certificates offered 14 different parts of the world visited through Study Abroad More than 80 student-focused organized groups Students 20,398 attended class in students - the average class size 330 international students from 100 different countries

8 HEALTH PROGRAMS Patient Care Electroneurodiagnostic Technology Medical Assisting** Nursing* Occupational Therapy Assistant* Physical Therapist Assistant* Respiratory Therapist** Surgical Technology Other Health Programs Diagnostic Assistant-Radiologic Technology Medical Laboratory Technology Paramedic/EMT Pharmacy Technician** Dental Dental Assisting Dental Hygiene Dental Technology Health Informatics Health Information Technology (Includes Medical Coding)** Medical Transcription High School Health Academies Patient Care Dental

9 MERCY MEDICAL CENTER

10 MERCY MEDICAL CENTER 448 licensed beds Employees: o MMC-2,300 o MercyCare (including providers)-485 (Nearly 100 MercyCare providers) Clinics: o 5 Urgent Care locations o 14 Specialty clinics o 14 MercyCare clinics Patient Centered Medical Home (PCMH)

12 EPIC SYSTEMS CORPORATION Epic, is a privately held healthcare software company Verona, WI Also has offices in Netherlands, United Arab Emirates, Singapore, and Denmark >10,000 employees

13 HITECH ACT (2009) Stimulate the adoption of EHRs and supporting technology within healthcare organizations Workforce development programs

14 WHAT IS AN EHR? Definition An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization. Goals of Use (HITECH Act) To improve the quality, safety, and efficiency of care while reducing disparities To engage patients and families in their care To promote public and population health To improve care coordination To promote the privacy and security of EHRs US Department of Health and Human Services

15 IDEA ORIGIN

16 CURRENT OPTIONS Available by license per student: Lippincot DocuCare Cerner Academic EHR Practice Fusion VA VistA CPRS Nightingale Notes Demo or Open Source: Practice -Fusion OpenMRS isalus EHR FreeMED More are developed everyday

17 HEALTHCARE DISCIPLINE COMPETENCIES Physical Therapy Assistant Occupational Therapy Assistant Medical Assisting HIM/HIT Nursing Pharmacy Technician Respiratory Therapy

18 PHYSICAL THERAPY ASSISTANT COMPETENCIES Use of EHR 7D18 Review health records (e.g., lab values, diagnostic tests, specialty reports, narrative, consults, and physical therapy documentation) prior to carrying out the PT plan of care. 7D25 Complete accurate documentation that follows guidelines and specific documentation formats required by state practice acts, the practice setting, and other regulatory agencies. 7D27 Contribute to efforts to increase patient and healthcare provider safety. 7D29 Participate in performance improvement activities (quality assurance). Interprofessional Healthcare 7D28 Participate in the provision of patient-centered interprofessional collaborative care. Quote from PTA Director I SEE THE USE OF EPIC AS A GREAT TOOL TO INCORPORATE INTERPROFESSIONAL CARE/ COMMUNICATION Critical Thinking 7D30 Describe aspects of organizational planning and operation of the physical therapy service. 7D31 Describe accurate and timely information for billing and payment purposes.

19 OCCUPATIONAL THERAPY ASSISTANT COMPETENCIES Use of EHR A 2.25 Students must be given access to and have the opportunity to use the evaluative and treatment methodologies that reflect both current practice and practice in the geographic area served by the program. B 1.8 Demonstrate an understanding of the use of technology to support performance, participation, health and well-being. This technology may include, but is not limited to, electronic documentation systems, distance communication, virtual environments, and telehealth technology. Interprofessional Healthcare B 4.1 Gather and share data for the purpose of screening and evaluation using methods including, but not limited to, specified screening tools; assessments; skilled observations; occupational histories; consultations with other professionals; and interviews with the client, family, and significant others. Critical Thinking B Identify the role and responsibility of the practitioner to advocate for changes in service delivery policies, to effect changes in the system, and to recognize opportunities in emerging practice areas Standards-and-Interpretive-Guide.pdf

20 MEDICAL ASSISTING COMPETENCIES Use of EHR Interprofessional Healthcare Critical Thinking aspx IX.C Procedural and Diagnostic Coding IX.C.1. Describe how to use the most current procedural coding system IX.C.2. Describe how to use the most current diagnostic coding classification system IX.C.3. Describe how to use the most current HCPCS level II coding system XI.C.4. Discuss the effects of: IX.C.5. Define medical necessity as it applies to procedural and diagnostic coding X.C Legal Implications X.C.1. Differentiate between scope of practice and standards of care for medical assistants X.C.2. Compare and contrast provider and medical assistant roles in terms of standard of care X.C.3. Describe components of the Health Insurance Portability & Accountability Act (HIPAA)IX.C.5. Define medical necessity as it applies to procedural and diagnostic coding VI.C.4. Define types of information contained in the patient s medical record VI.C.5. Identify methods of organizing the patient s medical record based on: a. problem-oriented medical record (POMR) b. source-oriented medical record (SOMR) VI.C.6. Identify equipment and supplies needed for medical records in order to: VI.C.7. Describe filing indexing rules VI.C.8. Differentiate between electronic medical records (EMR) and a practice management system V.C.8. Discuss applications of electronic technology in professional communication VI.C.11. Explain the importance of data back-up VI.C.12. Explain meaningful use as it applies to EMR

21 OTHERS IN PROCESS Health Information Management and Coding AHIMA curriculum Analyze the documentation in the health records to ensure it supports the diagnosis and reflects the patient s progress, clinical findings, and discharge status. Verify the documentation in the health record is timely, complete, and accurate. Apply policies and procedures to ensure the accuracy and integrity of health data. Respiratory Therapy Pharmacy Technician

22 NURSING COMPETENCIES Use of Information Technologies Interprofessional Healthcare Critical Thinking gcorecompetencies.pdf NOF A6 Values the privacy and confidentiality of protected health information in electronic health records NOF S3b Uses sources of data that relate to contemporary standards of practice and patient care NOF S5b Accesses, enters, retrieves data used locally for patient care (e.g., uses Health Information Systems, Care Information Systems for plan of care, assessments, interventions, notes, discharge planning) Essential IV: Graduates must have basic competence in technical skills, which includes the use of computers, as well as the application of patient care technologies such as monitors, data gathering devices, and other technological supports for patient care interventions. In addition, graduates must have competence in the use of information technology systems, including decision-support systems, to gather evidence to guide practice QSEN Informatics: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making. S4c Uses standardized communication approach to transfer care responsibilities to other professionals whenever patients experience transitions in care and across settings Essential VI: Use inter and intraprofessional communication and collaborative skills to deliver evidence-based, patientcentered care. QSEN Teamwork & Collaboration: Participate in designing systems that support effective teamwork QSEN Informatics: Navigate the electronic health record; Document and plan patient care in an electronic health record; Employ communication technologies to coordinate care for patients NOF A5a Questions the rationale of supporting routine approaches to care processes and decisions Technology Informatics Guiding Educational Reform (TIGER) Initiative

23 PLANNING & CREATING

24 TIMELINES

25 LOGISTICAL TIMELINE

26 ADMINISTRATIVE

27 STAKEHOLDERS Epic Kirkwood Administration Kirkwood IT Department Mercy Medical Center Administration Mercy Medical Center IS Department Mercy Epic Education Manager Certified Epic Trainer Faculty and Students

28 FUNDING SOURCES Workforce Training and Economic Development Fund The Workforce Training and Economic Development (WTED) Fund was established in 2003 as part of the Grow Iowa Values Fund. This fund has become an important source of financing for community college new program innovation, development, and capacity building, particularly for career and technical education. The funding is allocated annually using the community college state general aid distribution formula as provided for in Section 260C.18A of the Iowa Code. The WTED fund requires application of 70 percent of appropriated funds be used to support projects, programs and initiatives that fall within Iowa s targeted industry clusters defined in statute as: o advanced manufacturing o information technology and insurance o o alternative and renewable energy life sciences which include the areas of biotechnology, health care, and nursing technology. Each community college is required to provide the Iowa Department of Education the opportunity to review and comment on proposed use of the funds and to provide an ongoing accountability process. Each year an annual progress report and plan for the next year, outlining the proposed use of the dollars appropriated, are to be submitted to the Iowa Department of Education. Unexpended funds may be carried over to the next fiscal year, however carryover must be noted in the annual progress report and annual plan s appropriate sections with a documented reason for the carryover, if applicable. The colleges have the flexibility to modify their plans as needed during the year without approval. *

29 SUSTAINABILITY Budget items >$100,000 in year one Personnel Training Equipment

30 TECHNICAL SPECIFICATIONS

31 CURRICULAR INTEGRATION Certification Basics Faculty/Student Engagement Space, Equipment, and Access What Does It Look Like?

CURRICULUM DEVELOPMENT TIMELINE Initial meeting with Kirkwood & Mercy 10/1/2014 Arrangement finalized 12/1/2014 Pilot On-Site Training 10/29/2015 Large Scale Rollout 1/11/2016 2014 Oct 2015 Apr Jul

32 CURRICULUM DEVELOPMENT TIMELINE Initial meeting with Kirkwood & Mercy 10/1/2014 Arrangement finalized 12/1/2014 Pilot On-Site Training 10/29/2015 Large Scale Rollout 1/11/ Oct 2015 Apr Jul Oct 2016 Apr Jul Oct Today 1/12/2015 Kirkwood internal tasks Certification process 6/23/2015 4/21/2015 8/21/2015 Interviews/Process development4/6/2015 6/15/2015 Build & test Pilot Clinical Training on Kirkwood's campus Implementation in Nursing curriculum Initial build for Allied Health Implementation in PTA Fundamentals Course 7/13/ /1/ /29/ /5/2015 2/6/2016 3/10/2017 9/15/ /16/2016 2/22/2017 3/18/2017

33 CERTIFICATION BASICS

34 FACULTY ENGAGEMENT Department meetings Meet one-to-one with lead faculty Review current assignments Sit in on lab and simulation experiences

35 SPACE, EQUIPMENT, AND ACCESS Shared computer labs/laptop carts/ipads Citrix installation Student permissions for remote access Software updates

36 WHAT DOES IT LOOK LIKE? Course presentations Introduction to informatics Clinical Decision Support Big Data in Healthcare

37 WHAT DOES IT LOOK LIKE? 2017 Epic Systems Corporation. Used with permission.

38 WHAT DOES IT LOOK LIKE? 2017 Epic Systems Corporation. Used with permission.

39 WHAT DOES IT LOOK LIKE? 2017 Epic Systems Corporation. Used with permission.

40 WHAT DOES IT LOOK LIKE? 2016 Epic Systems Corporation. Used with permission.

41 PROGRESS TO DATE

42 Course Instruction Use in lab and simulation

43 Test outs Documentation of clinical experiences in institutions without an EHR Course Fundamentals of PTA Pathophysiology Training or Student Experience 1 hour - How to navigate the EHR 1 hour Case Study Review Faculty Presentation plan to utilize in: PTA Modalities I and II Introduction PTA Procedures to EHR I and II Documentation Neurology Orthopedics Rehab for Medical Conditions Career Essentials OTA Methods II OTA Methods III

44 NEXT STEPS

45 VISION Assessment Actual v. perceived competence Baseline v. Post-orientation Improved interprofessional collaboration Critical thinking skills Integration More programs Utilize mobile technologies Classroom instructional modalities

46 Q & A

47 SOURCES, CITATIONS, & REFERENCES

48 American Association of Colleges of Nursing. (2008). Essentials of baccalaureate education for professional nursing programs. Retrieved from Bembridge, E., Levett-Jones, T., & Jeong, S. Y. (2011). The transferability of information and communication technology skills from university to the workplace: A qualitative descriptive study. Nurse Education Today, 31(Selected papers from the 3rd International Nurse Education Conference Nursing education in a global community April 2010, Sydney, Australia), doi: /j.nedt De Gagne, J. C., Bisanar, W. A., Makowski, J. T., & Neumann, J. L. (2012). Integrating informatics into the BSN curriculum: a review of the literature. Nurse Education Today, 32(6), doi: /j.nedt Epic Systems Corporation. (2017). Retrieved from George, N. M., Drahnak, D. M., Schroeder, D. L., & Katrancha, E. D. (2016). Enhancing prelicensure nursing students' use of an electronic health record. Clinical Simulation In Nursing, 12, doi: /j.ecns Hart, M. (2008). Informatics competency and development within the us nursing population workforce: a systematic literature review. CIN: Computers, Informatics, Nursing, 26(6), Hunter, K., McGonigle, D., & Hebda, T. (2013). The integration of informatics content in baccalaureate and graduate nursing education: a status report. Nurse Educator, 38(3), doi: /nne.0b013e31828dc292 Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from Mercy Medical Center. (2017). Retrieved from

49 Miller, L. A., Stimely, M. E., Matheny, P. M., Pope, M. F., McAtee, R. E., & Miller, K. A. (2014). Novice nurse preparedness to effectively use electronic health records in acute care settings: Critical informatics knowledge and skill gaps. Online Journal of Nursing Informatics, 18(2), 1. Norman, L., Buerhaus, P.I., Donelan, K., McCloskey, B., & Dittus, P. (2005). Nursing students assess nursing education. Journal of Professional Nursing, 21(3), Quality and Safety Education for Nurses (QSEN). (2017). QSEN competencies. Retrieved from

50 CONTACT INFORMATION

51 Nichelle L. Cline, PhD, MPA, OTR/L Jana Pownell, MEd, MSN, RN

53 CONTRACTUAL AGREEMENTS

Cheryl Anne Smith, MSN, RN Martin Methodist College Pulaski, Tennessee

Cheryl Anne Smith, MSN, RN Martin Methodist College Pulaski, Tennessee 5-31-2012 Objective At the end of this session, the learner will summarize methods that a small baccalaureate college used to incorporate