Information Technology Report to Medical Executive Committee

Transcription

1 March 10, 2015 z Information Technology Report to Medical Executive Committee Contents 1 Physician Training Opportunities for PowerChart Maternity and FetaLink Launch March 24 at Germantown Hospital 2 North Data Center Upgrade and Downtime 2 Cerner (HIE) Health Information Exchange Data Migration 2 Direct 2 Problem List Update 3 Morrisey Case Management 3 HealtheLife (Patient Portal) 4 PACS 4 Projects to Begin in Q Telehealth Advisory Committee 5 Appendix 1 Orders Update for February Appendix 2 Meaningful Use Problem List and Summary of Care Physician Training Opportunities for PowerChart Maternity and FetaLink Launch March 24 at Germantown Hospital An online module was posted in Chexweb on February 25 for PowerChart Maternity and FetaLink. The thirty-minute module provides physicians with basic instructions for using the new PowerChart Maternity application in combination with their use of Cerner PowerChart. Physicians receive.5 CME credits for completing the module. Workshops are scheduled for physicians in the Germantown Labor and Delivery Physician Lounge March 9 20 at a variety of times (see Appendix 4 for the schedule). The workshops are designed to assist physicians with accessing the module, reviewing the use of the PowerChart Maternity application and having an opportunity for hands on access to the application. During the workshops physicians will be given a ready reference pocket booklet referencing the basic steps in using the application. During the go live March 24 through 31, Physician Analysts will be available onsite 24 hours a day to assist physicians with the new application and relate PowerChart components. 7 Appendix 3 Physician Advisory Group (PAG) Key Decisions reviewed by PAG on 02/19/15 8 Appendix 4 PowerChart Maternity Germantown Physician Workshops Schedule 9 Appendix 5 HIE/Community View Counts

2 PAGE 2 North Data Center Upgrade and Downtime The Methodist North Data Center is being expanded and upgraded to accommodate the growing needs of our organization. Movement and upgrade of key network hardware requires two network downtimes that will affect a few key systems. Please note that Cerner onechart, McKesson PACS, Mainframe, and MyTime will not be affected by these downtimes. Downtime #1: Friday, April 16, 10:00 p.m. until 2:00 p.m. Sunday, April 17. o Systems Affected: TeleResults Cerner (HIE) Health Information Exchange Data Migration In response to increased utilization and the convenience of having historical Allscripts information readily available, the HIE Community View tab was made available to Acute ED Providers and a select group of Pharmacy associates on February 10. The overall use of this tab has increased with usage numbers exceeding 2000 for the month of February. As a reminder, the HIE Community View mpage consists of patient data from the historic ambulatory information stored in the UT Medical Group (UTMG) Allscripts system prior to the Cerner Ambulatory electronic health record implementation and provides historical patient data for problems, allergies, medications, immunizations, vital signs, lab, and documents. Direct Communication of the Summary of Care documents to follow up providers and facilities is performed using Direct Secure by Health Information Management and providers in the ambulatory setting. The direct messages are sent using Cerner s Message Center to other Direct boxes. Several follow up providers have now signed up for Direct including Physicians with West Clinic and Primary Care Groups. Physician practices and post-acute care facilities interested in establishing a Direct Connection with MLH should contact us via our Help Desk at or MLHDirect@mlh.org Achieving Meaningful Use Stage 2 requires successful communication via direct for 10% of discharged patients receiving follow up care. MHMH continues to have challenges with successful completion of this measure due to the documentation of problems as free text versus coded nomenclature (see Direct graphs in Appendix 2). Problem List Update To support the coordination of care all patient records must contain coded chronic problems or indicate no chronic problems to qualify for Meaningful Use Stage 2. Problems need to be confirmed and managed by the physician. The Stage 1 goal

3 PAGE 3 requires at least one coded entry on 80% of all Inpatient and Observations patient records. We have successfully met this metric. Stage 2 remains a challenge since all entries must be coded with SNOMED-CT for 50% of our discharged Inpatients and Observation patients. Facility Total Met Snomed Met Total Not Met Snomed Not Met University 51.4% 52.2% 48.6% 47.8% South 33.8% 35.3% 70.0% 64.7% North 30.1% 30.8% 69.9% 69.2% Germantown 41.7% 43.0% 58.3% 57.0% Le Bonheur 43.3% 46.6% 56.7% 53.4% Olive Branch 44.7% 45.4% 55.3% 54.5% Morrisey Case Management Phase 2 of the Morrisey Case Management (MCCM) system will begin March 12. This phase will include the coordination of post-acute placements such as nursing homes and long term care facilities. Methodist will utilize the new functionality to communicate the need for beds, types of care and information related to patients. The anticipated go live for this phase is early June. During this phase, the Milliman Care Guidelines will be integrated with the MCCM system to facilitate documentation and communication of care. Physicians will still be able to access Milliman as they do now to review pathways. HealtheLife (Patient Portal) New functionality: PowerChart banner bar enhancements for HealtheLife that providers know if a patient has activated their Healthe account. When patients are sending messages through HealtheLife, they can now select the physician by name. Previously, only a list of the physician practices Work in Progress: The naming of physician practices has been revised to make it easier for patients to select when sending messages through HealtheLife. Training associates in the Cerner Ambulatory physician practices on HealtheLife and encouraging their personal use of HealtheLife. Enhanced associate understanding and use of HealtheLife will result in improved support for patients in the physician practices.

4 PAGE 4 PACS Radiology PACS McKesson Radiology PACS software successfully upgraded to the latest software version on February 7 with improved functionality. Radiologists workstation replacements are in progress with positive feedback on performance improvement and access to 3rd party applications. Radiation dose tracking project is underway with anticipated completion by April 30, Cardiology PACS Next steps McKesson Cardiology PACS software was successfully upgraded to the latest version on February 28. Upgrade improved web functionality and feedback from physicians has been positive. Upgrade provided some improvement in remote access and slowness in loading studies from archives. Evaluation of the improvements is ongoing. Software update to storage and retrieval system for both Radiology and Cardiology PACS. McKesson Cardiology resources on site to investigate remote access issues and slowness in loading studies from archives. Projects to Begin in Q Anesthesia Documentation Surgical and Endoscopic Imaging Storage and Retrieval in onechart EMR PowerChart Gastroenterology Documentation Telehealth Advisory Committee MLH has chartered a Telehealth Advisory Committee whose purpose is to pursue and advance innovations that improve access to care and drive health as well as recommend the MLH-wide telehealth roadmap and monitor implementation and results. Physician participants include Drs. Jay Pershad and Catherine Womack.

5 PAGE 5 Appendix 1 Orders Update for February 2015 PowerPlans and Order Sets New Plan, LEB NICU Whole Body Cooling & Re-warming is available for use in NICU at Le Bonheur only. The order formula per home routine will be removed from ALL LEB PowerPlans. The provider must order the specific formula diet order. Multiple modifications were made to the LEB NICU General Admit Plan. The following comment will be added to the Vital Signs with Neuro Checks order in applicable CareSets and PowerPlans: Utilize the National Institutes of Health Stroke Scale (NIHSS). The CareSets and PowerPlans are: Alteplase (TPA) IV Ischemic Acute Stroke Care Track Plan, Neuro SAH Post Op Plan, Acute Stroke ICU Orders, Acute Stroke (Non-ICU) Plan, Acute Stroke ICU Plan, Acute Stroke (Non-ICU) Orders, ED Initial Stroke Symptoms Active or Resolved, and the Neuro Intracerebral Hemorrhage Plan. Over the next few weeks, the Admission Status Orders will be updated based on regulatory standards for all Order Sets and PowerPlans. New PowerPlans will be available at Germantown and University for Plastics- Breast Flap, Free Flap and Mastectomy Reconstruction. Antibiotics on the OBGYN Gynecology Surgery PreOp Plan and the OBGYN Gynecology Surgery PostOp Plan have been modified to reflect weight based dosing. Order Alerts When the Discharge Conversation is completed on Inpatient and Observation patient encounters, an alert displays if the patient does not have a Discharge order in the onechart system as required. When a Provider enters an order to Consult Social Worker for NH Placement and the patient is in an Observation Status and has Medicare as their primary insurance, a new rule will display. The Rule informs the Provider of the above described information and provides the option to change the patient s status to Inpatient. Order Updates The order for Pharmacy Consult for PCA will no longer be available at University and MECH. Ondansetron tablets will be replaced with Ondansetron orally disintegrating tablets.

6 PAGE 6 Appendix 2 Meaningful Use Problem List and Summary of Care Complete patient summary details as shown in Measure 1 indicate an upward trend. Sending the summary out electronically to meet Measure 2 is dependent on having a complete summary. We are continuing to add more outside facilities to be able to accept our transmissions. If all of the records we attempted to send out had been complete we would be at 19% for electronic submission. The low compliance with Problem List continues to be the contributing factor. The facility CMOs are working on new processes to improve this required documentation. MLH Meaningful Use Stage 2 Measure 1 - Complete Summary (Problems, Med List, Allergies) 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% Germantown Le Bonheur North South University Olive Branch 0.00% % 10.00% 8.00% 6.00% 4.00% 2.00% 0.00% MLH Meaningful Use Stage 2 Measure 2 - Electronic Transmission of Summary at Transition of Care Germantown Le Bonheur North South University Olive Branch

7 PAGE 7 Appendix 3 Physician Advisory Group (PAG) Key Decisions reviewed by PAG on 02/19/15 Decision - Standardize the Menu sort order for providers so Diagnosis/Problems is easier to find to promote use Recommendation: Recommend moving the position of Diagnosis/Problem selection on menu near the top to improve physician workflow and adoption. Consensus = Approved Recommendation Decision - Do physicians want the Problem List component to the Admission H &P PowerNote in the Impression and Plan section? Recommendation: Add Problem List component to the Admission H&P PowerNote in the Impression and Plan section. Consensus = Not approved, recommend to visit at a later date. Decision - Do physicians want to add pressure ulcer documentation to their QuickView? Recommendation: Create Pressure Ulcer Documentation viewing in QuickView for ease in reviewing. Consensus = Not Approved, Could clutter Quickview Decision - Health Maintenance - Remove all diagnosis codes from Health Maintenance rules. Currently, both Diagnosis codes and SNOMED Problem codes are utilized in qualifying patient for health maintenance. Need to remove diagnosis codes from all Health Maintenance rules so that patients only qualify on active chronic problems. Recommendation: Remove all diagnosis codes from Health Maintenance rules. Consensus = Approved Decision - Health Maintenance - Pap smear guidelines need to be updated in Health Maintenance. Pap smears are no longer recommended every year. Recommendation: Change the Satisfied Duration for most of the Cervical Cancer Screening satisfiers from 365 days to 1095 days (3 years) in Health Maintenance tool, based on the documentation provided by Internal Medicine providers. Consensus = Not Approved. PAG will need to review Governance for Health Maintenance Guidelines

8 PAGE 8 Appendix 4 PowerChart Maternity Germantown Physician Workshops Schedule All session will be in the Physician Lounge. March 9, Monday: March 10, Tuesday: March 11, Wed: March 12, Thursday: March 13, Friday: March 16, Monday: March 17, Tuesday: March 18, Wed: March 19, Thursday: March 20, Friday: 7:00 a.m. - 10:00 a.m. 7:00 a.m. - 10:00 a.m. 6:00 a.m. - 10:00 a.m. 6:00 a.m. - 10:00 a.m. 7:00 a.m. - 10:00 a.m. 7:00 a.m. - 10:00 a.m. 6:00 a.m. - 10:00 a.m. 6:00 a.m. - 10:00 a.m.

9 PAGE 9 Appendix 5 HIE/Community View Counts