Care Everywhere Integrated Workgroup

Transcription

1 Care Everywhere Integrated Workgroup PAC 5/9/2017

2 Scope Care Everywhere Description of Group Care Everywhere is Epic s tool to allow you to exchange a patient s record electronically to other healthcare organizations whether they are using Epic or not. The groups purpose is to determine how the tool will be implemented. Topics are interdisciplinary in nature and cross several categories. Legal & Compliance Authorization Release of Information Exchange Participation Direct Messaging Trading Partners Meaningful Use Transitions of Care Membership Nareesa Mohammed-Rajput (CMIO) Mark Haas (HIM) Katherine McGrath (Compliance) Michael Sperling (IS) Anna Kalinsky (IS) Bettyann Carrol (Revenue Integrity) Lindsey Sullivan (IS) 2

3 Key Decisions Care Everywhere Decision Will we want other external locations to collect authorization for our records? Will we make an exceptions to authorizations based on locations? How long will authorization be effective? Are there any restricted departments? What is the verbiage for authorization form when collected by external organizations? What will the header for authorizations for outside records look like? (body of authorization is provided by external organization) Will we collect prospective authorization to release CCD for exceptions? Outcome No, with the exceptions of genetic testing, HIV, psychiatric visits to ED/IP We will not make exceptions based on location. Authorization will be required every time. There are no restricted departments. Verbiage provided by HIM, Legal, and compliance (see smart text). Verbiage provided by HIM, Legal, and compliance (see smart text). We will not collect prospective authorization. 3

4 Key Decisions Care Everywhere Decision Will we auto query surrounding organizations at night to see if there are outside records available for reconciliation? Will we auto-query on ED arrival? Who will be able to manually query and reconcile chart with external records? Who will collect authorizations? Outcome The query will run nightly to identify outside records for patients that have scheduled appointments the next day. Yes, we will auto-query on ED arrival so that clinical staff will be able to see if the patient has a match at any surrounding organizations. The front desk, nursing, and MDs can query. Providers can reconcile all clinical information. Clinical staff (e.g. RNs, Mas) can only reconcile Allergies, Meds, and Immunizations by policy. Only providers should reconcile problems. Ambulatory Front desk staff or clinical staff will collect authorizations. It depends on the specific department ED Clinical staff will collect authorizations. IP Clinical staff will collect on the rare occasion that it happens. 4

5 Key Decisions Care Everywhere Decision Who will scan authorizations when we collect them from the patient? Who is responsible for international queries and will have specific wording/language? Who will own manual linking when a patient can t be matched during the manual query from an outside site to SSHS? Sometimes patient is linked or merged inappropriately. Who will unlink patient? Will we enable authorization through MyChart. In addition to Mass-Hiway which exchanges will we connect to? Outcome IP HIM. ED ED staff/unit clerk. Ambulatory Front desk has e-signature pads but if necessary they will scan form as well. HIM will manage international queries. Requestor will see default language asking them to contact HIM. End users from external organizations will see contact information for South Shore HIM for assistance. HIM or the external site will notify SSHS IS that a patient needs to be unlinked. The Care Everywhere analysts will then unlink with the help of Epic if necessary. Out of scope. We will connect to E-Health and Carequality. 5

6 Key Decisions Care Everywhere Decision Will we include referral management workflows. Out of scope. Outcome Do we want to delay the transmission of inpatient summary of care documents for hospital discharges? Who will enter the follow up provider data? Yes, we will for two hours after discharge to reflect the time it takes to discontinue Nurses and Ancillary staff will enter the follow up provider data. Who will enter the referral information? Providers will enter the referral information. Will we auto send summary to the PCP? Will our providers receive direct messages through Care Everywhere? We will auto send summaries to provider organization. The receiving organization will determine if it routes to a pool or a provider. Yes, our providers will receive direct messages. 6

7 Key Change Management Opportunities Care Everywhere Opportunity Plan Owner There is inconsistency in regards to how we will collect authorizations across the enterprise. In the ED and IP floors clinical staff will collect. In the ambulatory setting the front desk or the clinical staff could be responsible based on the specific department. There is a risk that no one will collect authorization unless it is communicated on a departmental level. In order for external data to become part of the patient chart a clinician will have to reconcile it manually. Providers and clinical staff all have the ability to reconcile meds, allergies, immunizations, and problems. Clinical staff in the inpatient setting are unable to update problems. In the outpatient setting problems non clinical staff can update problems under the explicit direction or a provider. We will automatically send PCP organization a summary of care document at discharge and ADT notifications. The receiving organization will determine if it goes to a pool or a provider. Raise awareness across affected areas through departmental meetings, governance councils, and marketing. Care everywhere workflows are also included in training. Raise awareness across affected areas through departmental meetings, governance councils, and marketing. Care everywhere workflows are also included in training. We have also developed a new policy on problem list etiquette. We will work with advisory councils, HPSO, Medical Staff Office, and Provider Relations to socialize. Peg Hafkemeyer /Paula Beaulieu Nareesa Rajput/Peg Hafkemeyer/Paula Beaulieu Kathleen Powers/Luke O Connell/Brad Sampson/Lynda Aflague 7

8 Key Change Management Opportunities Care Everywhere Opportunity Plan Owner Providers from external organizations have the ability to send messages with patient and encounter level information directly to SSHS providers. HIM will have to manually link patient charts in the rare instance that a query from an external organization doesn t match automatically. They will also be responsible for manual unlinking when there are multiple links for the same patient at the same organization. We are communicating the impact of In basket on providers across the enterprise through marketing and various provider committees. In basket will also be included in Epic training. We will support the manual linking workflow during normal business hours and make sure that all HIM staff have access to perform workflow. We will also distribute tip sheets. Nareesa Rajput Ann Dooley 8