Understanding and Utilizing Healthcare Informatics. in Athletic Training

Transcription

1 George G. Couch, DrHA, MBA, FACHE 2017 PATS Annual Meeting & Clinical Symposium Understanding and Utilizing Healthcare Informatics in Athletic Training

2 No Conflict The views expressed in these slides and today s discussion are mine I am not employed by, nor am I a representative of any electronic records vendor My views may not be the same as the views of my institution or my colleagues Use discretion when using the provided information when making decision in your own professional practice

3 Healthcare Informatics and Presentation Overview Athletic Training Healthcare Information Technology (HIT) and Healthcare Informatics Initiatives How HIT can be utilized to enhance patient care and communications The Role of HIT in facilitating evidence-based, patient-centered care, and quality improvement Data-to-wisdom continuum framework application to patient care and quality improvement Legal (privacy and billing) and professional considerations in HIT use for patient care

4 Triple Aim of Health Care Goal 1 Improve patient experience of care Goal 2 Goal 3 Improve population health Reduce per capita cost Clinical information systems and health information technology are central to this pursuit Institute for Health Care Improvement Triple Aim Initiative 7

5 BOC Professional Standards I. Practice Standards (selected) Preamble Standard 2: Prevention The Athletic Trainer implements measures to prevent and/or mitigate injury, illness and long term disability. Standard 4: Examination, Assessment and Diagnosis The Athletic Trainer utilizes patient history and appropriate physical examination procedures to determine the patient s impairments, diagnosis, level of function and disposition. Standard 5: Therapeutic Intervention The Athletic Trainer determines appropriate treatment, rehabilitation and/or reconditioning strategies. Intervention program objectives include long and short-term goals and an appraisal of those which the patient can realistically be expected to achieve from the program. Appropriate patient-centered outcomes assessments are utilized to document efficacy of interventions. Standard 6: Program Discontinuation The Athletic Trainer may recommend discontinuation of the intervention program at such time the patient has received optimal benefit of the program. A final assessment of the patients status is included in the discharge note. Standard 7: Organization and Administration The Athletic Trainer documents all procedures and services in accordance with local, state and federal laws, rules and guidelines. Standards of Professional Practice 2016

6 NATA Requirements Use of Healthcare Informatics Clinicians must increasingly use information technology to manage clinical data and access the most recent evidence pertaining to optimum patient care. Competency in the use of healthcare informatics relates to the athletic trainer s ability to: 1) Search, retrieve, and utilize information derived from online databases and/or internal databases for clinical decision support, 2) Properly protect the security of personal health information in a manner that is consistent with legal and ethical considerations for use of such data, including control of data access, utilization of patient identity coding, deidentification of aggregated data, and encryption of electronically transmitted data, 3) Guide patients to online sources of reliable health-related information, 4) Utilize word processing, presentation, and data analysis software, and 5) Communicate through , text messaging, listservs, and emerging modes of interactive electronic information transfer.

7 Athletic Trainer Expectations for EHR Utilization Three primary components: Use of a certified EHR in a meaningful manner Use of certified EHR technology for electronic interchange of health information Use of certified EHR technology for submission of quality/outcome measures CMS Standards issued in 3 stages between 2011 and 2015

8 Health Information Technology for Economic and Clinical Health (HITECH Act of 2009) A component of the American Recovery and Investment Act (ARRA) of 2009 Designed to encourage healthcare organizations to adopt and implement EHR technology to improve care and efficiency Created incentive programs through CMS via Meaningful Use attestation with certified EHR technology Patient Protection and Affordable Care Act of 2010

9 Growing Demand for digitalization and automation in healthcare A major driver in growth of the EHR market

10 Growing Demand for digitalization and automation in healthcare A major driver in growth of the EHR market

11 Key Definitions EMR Electronic Medical Records - limited in use to ONE healthcare organization EHR Electronic Health Record certified for interoperability standards for information exchange ACROSS healthcare organizations PHR Personal Health Record certified for interoperability standards for HIE, can draw information from multiple sources, consumer controlled

12 Key Definitions Portals HIE CDS Patient Portals Means for allowing secure patient access to his/her health information electronically Health Information Exchange Movement of patient data across organizations or the center that facilitates the process (verb & noun) Clinical Decision Support Provides staff with knowledge and patient-specific information at appropriate times to enhance healthcare delivery

13 Moving Data to Wisdom in health care DATA INFORMATION KNOWLEDGE WISDOM = DECISIONS & ACTIONS Integrated knowledge that creates the capacity to decide, act or project for similar circumstances

14 Interoperability The Key to True HIE Ability to transmit health information electronically in a secure fashion across certified EHR s Unlocks greater data analytics Improved quality Improved outcomes Efficiency Moves users from data toward knowledge/wisdom Central to true HIE

15 Supports Care Related Activities Immediate access to the patients medical record and history Evidencebased Decision Support Quality Management

16 Novel Technologies evolving Mobility Analytics Cater to changing needs of patients Builds a better connection between patients and clinicians

17 Patient-Related Outcome Measures 1. Ease of implementation with certified EHR technology at the point-of-care (available for immediate data analysis) 2. Secure messaging for patient follow-up and reminders 3. Provider evaluation via satisfaction surveys 4. Automated and selected evaluation of outcomes 5. Exchange of de-identified data sets

18 Informatics Study Examples

19 Informatics Study Examples

20 Informatics Study Examples

21 Informatics Study Examples

22 Data Sources for Clinical Research Primary Data Source Secondary Data Sources HCUP (Healthcare Cost and Utilization Project) Largest collection of inpatient, pediatric, discharge, ambulatory surgery and emergency department data NHANES (National Health & Nutrition Examination Study) Population-based survey design to collect information on U.S. health and nutrition NAMCS (National Ambulatory Medical Care Survey) Objective, reliable, ambulatory medical care survey (office based physicians) Other Secondary Data Sources Websites

23 Privacy and Legal Issues for use of patient data Privacy Issues Text messaging Social Media Second-hand conversations Legal Considerations Network Security Protection of Minors Interpretation of and following Physician Orders Billing and Documentation Fraud

24 Road Map to Success Collaborate with HIM professionals and organizations Align with certified EHR providers and provide input on needs Implement and utilize EHR s in your professional practice to the fullest extent possible Embed training of EHR utilization and decision making in AT education

25 Failure is NOT an Option Without effective use of EHR s.. AT patient care will exist outside of the health care information network Evaluation, care and treatment will be uncoordinated Research will be confined to lab settings AT s will be unrecognizable and fail to be integrated with other providers Will be locked out of third-party reimbursement Incomplete data to demonstrate value

26 Peer Innovations What is your organization, or you individually, doing that is innovative in the area of informatics and utilization of electronic medical records in your practice?

27 Informatics Value to Athletic Trainers Patient Safety Patient Satisfaction = Value to AT s HIE exchange with Providers and HCO s Clinical Decision Support

28 Presentation References Conn, J. (2016, August 11). Rio Olympics Sees First Total Interoperable EHR Implementation. Modern Health Care, pp Healthy Roster. (2016, June 4). QCA Invests in Healthy Roster to Advance Mobile Sports=specific Electronic Health Record. Retrieved from PR Web News Center: Hussain, I. (2015, November 3). This Is the First App that Integrates All Wearables into a Hospital's Electronic Health Record. Retrieved from IMedicalApps.com: Intel Corporation. (2017, May). The Power of Predictive Analytics. Chicago: Beckers Hospital Review. Lam, K. C., Snyder Valier, A. R., Anderson, B. E., & Valovich McLeod, T. C. (2016). Athletic Training Service During Daily Patient Encounter: A Report from the Athletic Practice-Based Research Network. Journal of Athletic Training, McKinney, M. (2010, July 6). Web's Sports Health Information Can Be Way Off Base. Modern Healthcare, p. 8. Monegain, B. (2017, April 24). Cerner Adds Concussion Care Platform to Athlete Management System. Retrieved from Health Care IT News: New, J. (2017, January 18). Time Demands, Concussion Policies to be Focus of NCAA Meeting this Week. Retrieved from Starman, J. S., Griffin, J. W., Kandill, A., Ma, R., Hogan, M. V., & Miller, M. D. (2014). What's New in Sports Medicine. Neeham, MA: The Journal of Bone and Joint Surgery, Inc. Sykora, M., Chung, P. W., Folland, J. P., Halkon, B. J., & Edirisinghe, E. (2015). Advances in Sports Informatics Research. Loughborough, UK: Longborough University. Valovich McLeod, T. C., Lam, K. C., Bay, R. C., Sauers, E. L., & Valier, A. R. (2012). Practice-Based Research Networks, Part II: A Descriptive Analysis of the Athletic Training Practice-Based Research Network in the Secondary School Setting. Journal of Athletic Training,

29 Questions? Comments? Dr. George G. Couch, DrHA, MBA, FACHE GANNON UNIVERSITY Dahlkemper School of Business 109 University Square Erie, PA Office: (814)