Health Information Technology for Post Acute Care (HITPAC): Minnesota Project Overview

Candy HansonProgram Manager

Julie JacobsHIT Consultant

June 13, 2013

Objectives• Understand the purpose of the HITPAC project

• Identify benefits of the HITPAC project to Minnesota health care communities and its patient populations

• Learn about Minnesota’s adoption and use of electronic health records and health information exchange in its skilled nursing facilities

Stratis Health• Independent, nonprofit, Minnesota-based

organization founded in 1971– Mission: Lead collaboration and innovation in

health care quality and safety, and serve as a trusted expert in facilitating improvement for people and communities

• Working at the intersection of research, policy, and practice

The Six Goals of the CMS Quality Strategy

1

2

3

4

5

6

Our Key Collaborators…

8

Minnesota HITPAC is:

5

Minnesota HITPAC Communities

5

TWO MAIN FOCUS AREAS:

6

Minnesota Environmental Scan• Provides a broad brush stroke of the state of

Minnesota skilled nursing facilities adoption and use of EHRs

• Describes EHR Functionality• Informs about Health Information Exchange (HIE)

possibilities• Recommendations for moving forwardLink to Minnesota Environmental Scan:

http://intranet/c1/10sow/siphitpac/es/MN%20Environmental%20Scan%20for%20HIT%20PAC%20%20-%20Final%2001_08_13%20(2).pdf

Minnesota EHR Adoption & Use• 69% Minnesota nursing homes report

adopting/using EHR• 99% report using EHR to document activities

such as MDS assessment• 98% report using EHR to document resident

demographics• 96% report using EHR to document diagnosis

or condition listRef 2011 MDH Nursing home Survey Data

Minnesota Nursing Homes with EHRsMedication Management Activities

• 14% used EHRs for medication reconciliation

• 62% used alerts for medications

• 36% used an electronic medication activity record (e-Mar)

• 3% used e-Prescribing

Ref: 2011 MDH Nursing Home Survey Data

Care Coordination Toolkit http://www.stratishealth.org/expertise/healthit/caretransitions

Readiness Assessment Interviews

Education and Technical Assistance

Current and Future State Process Mapping•

Findings: – Limited Long Term Post Acute Care (LTPAC)

EHR functionality• Interoperability• CCD• Medication Reconciliation and e-Prescribing• Laws and rules that pre-date EHR use contribute

to problematic work flows• Hybrid health records (paper/electronic mix)

Findings: – LTPAC and Acute Care Facilities:

• Understanding the needs of each• Inconsistent expectations of EHR users• Potential points for improving medication

administration in current medication reconciliation workflows

• Privacy and security practices in an electronic health record environment will continue to need attention

• View-only access to hospitals’ EHR does not solve interoperability issues

Next Steps:• Early Recommendations

– All EHR Vendors should design software that can both generate and consume a Continuity of Care Document (CCD)

• 225 Data points• MDS, OASIS, Interact, other proprietary formats

– Configuration and training related to Clinical Decision Support and e-Prescribing tools

• Medication Libraries • Predictive text• Electronically generated reports• Work flow re-designs to advocate for Computer Physician Order

Entry (CPOE)– Best practice around Medication Reconciliation

• Pharmacy consults• EHR CDS

Next Steps (continued):• Early recommendations -LTPAC facilities consider investing in a “super-user”

environment -Financial assistance to help non-EHR LTPAC settings prepare

for EHR adoption and use -Financial assistance made available to help LTPAC settings

who have EHR in place assess adoption and use and workflow issues

Questions?

For more information contact:Candy HansonProgram ManagerHealth Information Technology for Post

Acute Care (HITPAC)Stratis Healthchanson@stratishealth.org