Cuyahoga County Board of Health CCBH and Regional

Cuyahoga County Board of Health (CCBH) and Regional Extension Center (REC) James W Coates, MS, RS Researcher, Epidemiology, Surveillance and Informatics

Cuyahoga County Board of Health • Serves ~845, 000 residents in Cuyahoga County, Ohio excluding the City of Cleveland Shaker Heights.

Why EHR at LHD? • Participate in the Health Information Exchange • Provide Patient Data • Get Population Data • • Increase Revenue Improve Productivity and Efficiency Improve Customer Service and Quality of Care Improve Regulatory Compliance

Keys to Success • Senior-level Management Support • Funding, priority setting, and executive attention • Physician and Nurse/Staff buy-in • Identify Champions • Abandon inefficient processes • Leave the “we’ve always done it that way” behind • Maintain Constant Communication • Understand Technology alone will not transform nursing practice Liang, L. Connected for Health Using Electronic Health Records to Transform Care Delivery. 2010. Jossey-Bass A Wiley Imprint.

Goal To record all patient interactions, migrate historical data from current practice management (PM) system, track and generate claims, achieve stage 1 meaningful use, participate in the State health information exchange, and comply with HIPAA 5010 and ICD-10 requirements.

CMS Incentive Flow Chart Centers for Medicare & Medicaid Services. ICN# 905343 (September 2010) https: //www. cms. gov/MLNProducts/Downloads/Eligibility_Flow_Chart-ICN 905343. pdf

History of Events • October 2010 • REC Kick-off Meeting • Not Eligible for REC Services • November 2010 • Title X Letter • December 2010 • Signed REC Agreements

Golden Ticket *Additionally CCBH contracts with Certified Nurse Midwife with prescriptive authority and a M. D.

REC Experiences • Case Western Reserve University (CWRU) • Assigned Consultant • Welch Allyn • • Preparation Questions Personnel Budget Work flows

Welch Allyn • Preparation Questions • Personnel • Budget • Work flows

CCBH Direct Services • Immunizations • Child • Adult • Travel • Title X Family Planning • School Based Dental Sealant

Work Flows • • Documents sequence of events between actor and the system. Excellent learning experience for all Communicates needs to developers Essential for developers

Example Work Flow Orlova, A. , Johns Hopkins University, Health Information Technology Standards and Systems Interoperability Course, Spring 2011. http: //ocw. jhsph. edu/courses/infstandards/PDF/inf. Standards_lec 5 c_orlova. pdf

Fork in the Road • System Type • Integrated • Include Case Management • Interfaced • Could Include Case Management

Case Management • Things to consider • Include in build out of EHR • Comprehensive System • Reporting • Maintenance • Cost

Next Steps • • Case Management? Develop RFP Evaluate Vendors Vendor Selection

Timeline Welch Allyn Process {Deliverable: Requirement Analysis Document} |--------------| Send out RFP {Deliverable: Receive at least 3 proposals} |-----| Vendor Selection {Deliverable: Choose 1 certified vendor} |-----| Sys. Development {Deliverable 1: Sys. Development Specifications} |--------------| {Deliverable 2: Working prototype / pilot} Pilot testing & retesting {D: Pilot Testing Protocol/Report} |---| |-----| Modification |------| |---| Implementation {D: Sys. Documentation} |-------------| Evaluation & Operation {D: Ops. Manual} |----------------> ________________________________________ Jun-11 Aug-11 Apr-12 May-12 Jul-12 Sept-12 Nov-12

Contact Information James Coates, MS, RS Researcher Epidemiology, Surveillance and Informatics Cuyahoga County Board Of Health 5550 Venture Drive Parma, OH 44130 Phone: 216 -201 -2001 ext: 1617 Email: [email protected] net