Tuesday, November 6, 2012
Meaningful Use Stage 2 Simplified for Us Pharmacy Folk: Part 5
Monday, October 29, 2012
Meaningful Use Stage 2 Simplified for Us Pharmacy Folk: Part 4
Tuesday, September 18, 2012
Meaningful Use Stage 2 Simplified for Us Pharmacy Folk: Part 3
- Imaging results: more than 20 % are accessible using certified EHR technology
- Family histories are recorded in more than 20 % of patients
- Advanced directives are recorded for more than 50 % of patients 65 years or older
- Lab results are provided to providers for more than 20 % of patients
Thursday, September 13, 2012
ONC Dashboard on Health IT Adoption
- Provider adoption is anywhere from 12 to 40 %. Rural providers have adopted quicker than small practices in general.
- Hospital adoption of Basic EHR (I will explain this in a future post) went from around 20% in 2010 to 35% in 2011.
- About 93% of community pharmacies are in the Surescripts network for ePrescribing.
Monday, September 10, 2012
Meaningful Use Stage 2 Simplified for Us Pharmacy Folk: Part 2
- Demographics: Record for more than 80 % of patients
- Vitals: Record for more than 80 % of patients
- Smoking Status: Record for more than 80 % of patients
- Labs: Incorporate lab results for more than 55 %
- Patient List: generate patient list by specific conditions
- Patient Access: Provide online access to health information for more than 50% with more than 5 % actually accessing. (if broadband available in community)
- Education Resources: Use EHR to identify and provide education resources more than 10 %
- RX Reconciliation: Medication Reconciliation at more than 50 % of transitions of care
- Summary of Care: Provide summary of care document for more than 50 % of transitions of care and referrals with 10 % sent electronically and at least 1 sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR
- Labs: successful ongoing transmission of reportable laboratory data
- Syndromic Surveillance: Successful ongoing transmission of electronic syndromic surveillance data
- Security Analysis: Conduct or review security analysis and incorporate in risk management process
Friday, August 31, 2012
Meaningful Use Stage 2 Simplified for Us Pharmacy Folk: Part 1
- Patient Engagement (interaction between patient and caregivers)
- Advancement of Stage 1 Thresholds
- Interoperability
- Providers and Hospitals MUST implement certified EHR technology that meets ONC standards
- Streamlined reporting through alignment of measures and methods (think ONC and MU synergy)
- No Eligibility changes (these were set in the HITECH Act)
- New clinical quality measures and more flexibility
- Stage 2 starts in 2014 (as previously announced)
- Because upgrading sucks, you only have to report 3 of 12 months data to be eligible in 2014
- Everyone must upgrade to 2014 technology and criteria by 2014
Saturday, August 4, 2012
Meaningful Use Stage 3 Full Steam Ahead @Meaningful Use
Monday, July 30, 2012
EHR use in Pediatric Populations by Anne Bobb et al
Another fantastic contribution to the informatics community on behalf of NIST and the always professional Anne Bobb. Anne has been a long time colleague and one of the very best at quality measures in the field.
To put it in perspective, the word "medication" is used 82 times in the article. Anne is the only Pharmacist on the team of 30. Although I did not have time to read the entire 44 page article before writing this post, my comfort level with the outcomes and discussion are very positive.
My overall summary:
1. EHR Adoption by pediatric providers has lagged behind their general adult counterparts.
2. Overall usability is a seldom addressed but critical piece to successful implementation in high risk populations such as pediatrics. Current EHRs have a long way to go.
3. Time pressure shouldered by healthcare providers makes usability all the more important in pediatric populations.
4. Pediatric patients are unique, and small delays in care due to usability issues can have extreme consequences on patient care.
Thanks to Anne and the NIST team for putting together a wonderful and informative article on the impact of EHRs to pediatric medical practice.
Sunday, April 22, 2012
The quest for an organized peripheral brain
John's wonderful post on the Peripheral Brain sent on a quest to find tools to organize my life. I spent a few hours this weekend looking over Springpad, and decided it is not ideal for those that manage documents. At least for me, I am still getting the majority of my information in a document format. Springpad is fantastic if you spend lots of time on the Internet, and if most of your cataloging comes from web pages. In the Informatics world many of our articles and references are not mainstream (or behind a password protected site) so this makes it hard to conveniently add all articles in Springpad. This coupled with the inability to add multiple documents to one "Spring", and one can see where it quickly falls behind.
It seems as though Springpad might be good for someone that works in a smaller more amoebic type office, or one that deals with mostly internet based business relationships.
After this revelation, I was obviously disappointed! My attempt to make some sense of the email monstrosity, tweets, blog posts, RSS feeds, publications, and articles remained a mystery. At this point I turned my attention back to Evernote. It allows easy cataloging and even easier searches to find those old, obscure articles from years past. Before Evernote I organized items into folders. Before Spotlight on OS X, it was really difficult. Folders had to provide all organization, so I ended up with hundreds of them. Needless to say it was still difficult to find anything. John and I have both been long time users of Evernote, using it on a daily basis. I have a few thousand notes, and I am sure he has many more. Evernote is fantastic for its simplicity. Evernote has no substitute for document cataloging, and it is comparable to other products for all other forms of digital media.
You may be wondering why I was looking for an alternative if Evernote is so fantastic at managing my digital media. Well, my focus this weekend was organizing my tasks and projects. There are many methodologies available to the novice consumer such as myself. One might fall upon GTD or Personal Kanban. However, my goal was to find one product that could do both. To accomplish this in Evernote, we typically rely on tags and notebooks. My research brought me to an interesting system called The Secret Weapon. This methodology uses tags to organize email based on who, what, where and when it needs to get done. For instance, my “what” might be Projects, Informatics Consulting, and Expert Witness. My “where” might be Home, Office, and Town. My “when” could be represented by Now, Next, Later, Someday, and Waiting. To organize the messages you tag each with as many of these categories as you can. So an email about an expert witness report I need to finish might be tagged with Chad, Now, Office. Then next time I am in my Office, I would look through Evernote and find tasks with these tags to work on. This can also be used for home life, say remodeling a room. You could use tags to set the who, what, where, when and organize them into a meaningful, prioritized plan.
So my appetite for organization is sated right? Not so fast. The Secret Weapon is fantastic for organizing emails if you are using Outlook. Where this fails is with simple tasks or lists for small things. No one wants to create a new note in Evernote to say “get laundry”. It just takes too much time. Springpad was great at this type of simple easy to review list management, but weak on document cataloging. Maybe I have yet to stumble upon a simple elusive feature in Evernote to accomplish this. I ran across Nozbe, a GTD application that has promise. It interfaces with the Evernote API and shows notes with related tags right in a task. Nozbe has great reviews on the Apple App Store, as well as the web. They offer versions for iOS products, OS X, as well as a very well designed web application. However, all of this functionality does not come without a price. Each version is a separate purchase, and there is a monthly subscription. However, if Nozbe is the destination on my journey for GTD awesomeness, it is well worth the cost. I am going to give it a try for a few weeks to see if it meets my needs. I will report back on my quest for the best solution!
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