Meeting Meaningful Use Standards

Meaningful use standards. Our two FQHC partners implemented their EMRs, OCHIN-EPIC, with "go live" dates of March 1, 2013 and July 16, 2013, respectively. The Practice Teams are aware of the need to achieve meaningful use and a timeline is in place that should support the achievement of MU by December 2013.

The first FQHC is at the second year of Meaningful Use. This means that its providers use electronic prescribing for more than 40% of prescriptions, assess smoking status in more than 50% of patients, generate a visit summary for patients greater than 50% of the time and generate reminders for visits greater than 20% of the time.

The second FQHC reports that it is currently at Level 2 of the NCQA Primary Care Medical Home (PCMH) and has built into the EMR planning, the attainment of Levels 3 and 4 of PCMH, once staff are fully trained and system is fully implemented. CHC is already using e-prescribing (and does so for more than 40% of prescriptions), tobacco use is assessed for all patients over the age of 12 (and tobacco cessation counseling is available internally), visit summaries are generated in our current paper records (more than 50%), and reminders go out via phone for more than 70% of our patients. The FQHC purchased OCHIN/EPIC. EPIC is the product and OCHIN is the third party seller of the product. Staffs are currently being trained on the use of the product. Discussions are ongoing with CHD Health & Wellness regarding the interface between our EHR and their behavioral health electronic records.

CHD Health & Wellness had already planned to transition to a new electronic medical record (EMR) system called Profiler in advance of award of this grant. As such, other than staff meetings between IT staffs of CHD and the health centers, no additional costs for integration of the systems have been incurred as of yet.

Barriers to Accomplishments. Given constraints of the participating site’s EMRs, there are challenges to integrating the systems which require staff time to facilitate workarounds.

Actions to Overcome Difficulties. In an attempt to reduce as many workarounds as possible, considerable time and effort has been given to mapping out the workflows for staff so that administrative efficiencies may be realized. The original workflows continue to be updated by staff as the project unfolds. Recently, CHD Health & Wellness project manager, Dr. Higgins, began using the workflows as the basis for quality improvement meetings with care managers. During these meetings, staffs continue to identify ways in which to make data entry and EMR use more efficient. Dr. Higgins is also using PDSA analysis to improve efficiency and hopes to supply project funder with her findings at a later time.

CHD Health & Wellness's external evaluation team has developed a dashboard to support the regularly scheduled extraction of data from multiple systems. In July, 2013, the evaluator implemented the first quality assurance process to analyze and improve data extraction processes.