clinical health informatics practicum Cliff Kaufman

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June Brianne Moody
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1 clinical health informatics practicum Cliff Kaufman Using two case studies, this practicum explored and quantified differing uses, sources, and customer values of health information data.

2 TITLE SPONSOR DATA SOURCE CLIENTS KEY FOCUS Beyond Meaningful Use Data to Improve Patient Care NC Area Health Education Center EHR Data + Queries Small Physician Practices Practice Improvement Improve Patient Care case 1: beyond meaningful use overview

3 supplement meaningful use reporting by facilitating practice collection of specific data and metrics on specific chronic conditions and subsequently improving the quality of patient care establish a sustainable QI prototype process to collect the appropriate data and generate relevant reports and metrics to enable a practice to monitor its progress with treating chronic illnesses case 1: beyond meaningful use practicum scope

Catawba Valley Internal Medicine eclinicalworks (closed db; canned reports) Improve care with a commitment to longitudinally monitor: Diabetics with Hemoglobin A1c > 9 Diabetics with Hemoglobin A1c <

4 Catawba Valley Internal Medicine eclinicalworks (closed db; canned reports) Improve care with a commitment to longitudinally monitor: Diabetics with Hemoglobin A1c > 9 Diabetics with Hemoglobin A1c < 8 Diabetics with LDL Cholesterol < 100 Diabetics with BP < 140/90 Diabetics receiving an eye exam Diabetics receiving a foot exam Diabetics receiving a urine screen case 1: beyond meaningful use practice

5 Run standard Registry Reports Manually enter data into Excel Use Excel to chart data over time 100% Diabetics with Urine Screen documented 95% 90% 85% 80% 75% Practice Total Doc1 Doc2 Doc3 Doc4 70% 4/1/2012 5/1/2012 6/1/2012 7/1/2012 8/1/2012 case 1: beyond meaningful use solution (?)

6 Demonstrated feasibility - cumbersome CVIM and ecw are not uncommon EHR products rushed to market Physicians focused on reimbursement & billing Lack of technical expertise Lack of understanding of future data needs Practices unprepared for changes in business processes/workflows/training Inability to leverage technology (costs) leads to a loss of competitiveness case 1: beyond meaningful use conclusions

TITLE SPONSOR DATA SOURCE CLIENTS KEY FOCUS Bio-surveillance Data to Improve Preparedness National Collaborative for Bio-Preparedness EMS Data + Business Financial Info Government

7 TITLE SPONSOR DATA SOURCE CLIENTS KEY FOCUS Bio-surveillance Data to Improve Preparedness National Collaborative for Bio-Preparedness EMS Data + Business Financial Info Government Agencies Commercial Entities (Brands) Increase Situational Awareness Minimize Illness/Death due to Outbreaks Minimize Risk Exposure Minimize Loss of Brand Equity case 2: bio-surveillance overview

8 determine the feasibility of developing data client relationships for the project (pre- and postanalytics) develop a survey of state EMS Directors to assess technologies in-place and to gauge interest in data sharing for bio-surveillance develop a business plan (based on participation in Launch the Venture) for a commercial (non- Federal) venture. case 2: bio-surveillance practicum scope

9 use of NEMSIS standard software utilized to collect data (state) specific data elements willingness to share by purpose/values data contact preliminary 9/53 case 2: bio-surveillance survey

10 established food industry as beachhead focus on food processors and food retailers value proposition early detection/warning of foodborne illnesses = actionable data > mitigate risk exposure, loss of sales, brand hit market opportunity, resources, timing, milestones case 2: bio-surveillance business plan

11 To supply a credible bio-threat early warning system to DHS (and to food companies), NCB-P will need to roll up data (EMS, 911, Poison Center, etc.) EMS Data is the most disparate (and protected) Develop a process to attain state EMS data Use food industry inputs to define product specifications case 2: bio-surveillance conclusions

12 NC AHEC Laura Brown, Manager Performance Improvement Tammy Yount, Practice Improvement Coordinator Stephen Peterson, HER Specialist Rex McWilliams, Technical Assistance Consultant CVIM NCB-P Dave Potenziani, Executive Director Percina Curtis-Diggs, Project Manager EMS Performance Improvement Center Tony Fernandez, Assistant Professor Paul Cooper, Interim Director UNC School of Medicine Chuck Cairns, PI & Chair of Emergency Medicine cases: practicum acknowledgements

Re: Trust for America s Health Comments on Biennial Implementation Plan for the National Health Security Strategy

Dr. Nicole Lurie, MD, MSPH Assistant Secretary for Preparedness & Response Department of Health and Human Services Washington, DC 20201 Re: Trust for America s Health Comments on Biennial Implementation