APTA CSM 2012 Presentation. Portion by Daniel Vreeman.

1. CSM 2012 – HPA Tech SIG Feature Presentation
Electronic Health Records
healthcare system chicken soup or rotten egg?
Daniel J. Vreeman, PT, DPT, MSc
Assistant Research Professor, Indiana University School of Medicine
Research Scientist, Regenstrief Institute, Inc
Matt Elrod, PT, DPT, MEd, NCS
Associate Director, APTA Practice Department
Robert “Bob” Latz, PT, DPT, GCFP
Corporate Director of Technology Integration, Select Rehabilitation
Steven G. Wilkinson, PT, PhD
Manager, St Luke's-Elks Rehab - Meridian
02.11.2012
© 2012

2. Overview
1. Why EHRs matter
2. Selecting an EHR
3. Mobile devices and other hardware
4. Case study
5. Implementation considerations
6. Open discussion
photo via Vernio77

3. We are not
alone
Why are we here?

4. The Future
Great Scott!

5. Complete,
longitudinal
information that
follows the consumer

6. Care that is
value-based and
coordinated
across settings
photos via meddygarnet and brykmantra

7. Health decisions made
with information tools that
assist and guide
Have you
considered…

8. Results
Fewer errors, waste, variations
Consumer-centered care
Lower spending

9. Meanwhile, back
on planet Earth…

11. Patients move
faster and further
than their health
information

12. Growing Recognition
1960’s
1991
2003
• 1st studies of • IOM says • HHS promotes
computers in EHR’s are widespread
healthcare
essential
use of HIT

13. Resolved, at the American Physical
erapy Association supports the use of
electronic health record systems (EHRs)
and promotes the widespread adoption
of interoperable EHRs in all physical
therapy practice settings.

15. “ e rst priority in realizing
the bene ts of health IT is to
achieve nationwide adoption
of EHRs and widespread
information exchange.

16. CMS EHR Incentive
Program
a.k.a. “Meaningful Use”

17. EHR “Meaningful Use”
Reimbursement incentives for
eligible providers who
become “meaningful users” of
certified EHR technology

18. EHR “Meaningful Use”
PTs, OTs, SLPs are
NOT eligible providers

19. “Meaningful Use”
drug-drug checks
structured lab results in your EHR
clinical decision support
exchange key clinical info
report on quality measures

20. Do PTs today
really use EHRs?
good question…

21. APTA 2010 Member Survey
Got EMR?
1%
Yes, all
28%
electronic
38%
Yes, part paper,
part electronic
No
33%
Don't know

22. APTA 2010 Member Survey
EMR Use
Fully implemented
Implementation in progress
Aquired, but not implemented
Plan to aquire within 1yr
Plan to acquire but > 1yr
No plans to acquire
0
10
20
30
40

23. Most common
complaint?
anecdotal

24. Where’s the
Rehab stuff???

25. 3 Ways EHRs can Help
Accelerate that Vision
Data reuse
Decision support
Canopy computing

26. Collect once. Use many.
practice management, quality reporting,
accreditation, public health, research…

27. EHR Decision Support me
A computer-generated
suggestion about care for
an individual patient

28. The secret sauce of the
HIT chicken soup
photo via liber

29. e rain forest canopy is a
seamless web through which
arboreal creatures efficiently
move to reach the edible
fruits without any attention
to the individual trees.
McDonald et al. Canopy Computing: using the Web in Clinical Practice. JAMA. 1998;280(15):1325-1329.
photo via nosha

30. Only way to corral the
infinite indiosyncracies
is with standards.
photo via pfarrell95

31. Data standards are like
telephones.
They require a critical mass of
users before they become useful.
- Clem McDonald, MD 1998
photo via iboy_daniel

32. Indiana Network For Patient Care
A Unified Patient Record

33. An EHR is a suite of
applications.
WAY more than just
electronic
documentation

34. 8 Core EHR Functions
Population Results
Orders
Health
Administrative
Decision
Support
Patient support
Communication

35. Where’s the evidence?
photo via paskukaru76

36. Evidence for Health IT
92%
of 154 studies

37. 1968!

38. “ is review suggests that EHRs have
potential bene ts for physical therapists.

39. Benefits of EHRs
12
10
8
6
4
2
0
Improved Improved Improved Improved
Reporting
Operational Communication
Data Accuracy
Efficiency

40. Barriers to Implementing EHRs
6
5
4
3
2
1
0
Behavior or Software or Staff Training
Workflow Hardware Inadequacy
Modification

41. Success Factors in Implementing EHRs
9
8
7
6
5
4
3
2
1
0
End-user Data Adequate Staff Incorporating
Participation in Standardization
Training
Workflow
Development
Analysis

42. Key Lesson
of Today
photo via IMLS DCC

43. or
photo via Robert Couse-Baker and Nina Matthews Photography

44. Computer
+ Human
Human