10 - Fundamentals of Health Workflow Process Analysis and Redesign - Unit 6 - Process Redesign - Lecture E

Fundamentals of Health Workflow
Process Analysis and Redesign

Process Redesign
Lecture e
This material Comp10_Unit6e was developed by Duke University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.
Process Redesign
Learning Objectives
1. Identify the factors that optimize workflow processes in health care
settings (Lecture a)
2. Describe how information technology can be used to increase the
efficiency of workflow in health care settings (Lectures a, b)
3. Identify aspects of clinical workflow that are improved by EHR
(Lecture b)
4. Propose ways in which the workflow processes in health care
settings can be re-designed to ensure patient safety and increase
efficiency in such settings (Lecture c)
5. Use knowledge of common software functionality and meaningful
use objectives to inform a process redesign for a given clinic
scenario (Lectures c, d, e)

2
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Fundamentals of Health Workflow Process Analysis & Redesign
Process Redesign
Lecture e
Process Redesign
Topics Lecture e
Eligible Provider and Hospital/Critical
access Hospital objectives
Using the Table of Contents and
specification sheets for objectives
Understand Meaningful Use CPOE 10-15
Process redesign for Meaningful Use

3
Process Redesign
Lecture e
Meaningful Use
The Medicare and Medicaid EHR Incentive
Programs provide a financial incentive for the
"meaningful use" of certified EHR technology to
achieve health and efficiency goals. By putting into
action and meaningfully using an EHR system,
providers will reap benefits beyond financial
incentivessuch as reduction in errors, availability
of records and data, reminders and alerts, clinical
decision support, and e-prescribing/refill
automation. (CMS EHR Meaningful Use Overview, n.d., para. 1)

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Process Redesign
Lecture e
Meaningful Use Stages
5
Process Redesign
Lecture e
Stage 1 2011
Stage 2 2013
Stage 3 2015
Handouts for this unit
The Stage 1 EHR Meaningful Use
Table of Contents and Specification
Sheets for the following are required
for this unit.
Eligible Professionals and for
Hospitals/Critical Access Hospitals (CAH)
These are the criteria for a facility to
make a Meaningful Use claim.
They are available at the following link:

https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use
.asp#BOOKMARK4

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Process Redesign
Lecture e

Eligible Professional
Meaningful Use Table of Contents
Core and Menu Set Objectives

Eligible Professional Core Objectives
(1) Use CPOE for medication orders directly entered by any licensed healthcare professional
who can enter orders into the medical record per state, local and professional guidelines.
AVAILABLE
(2) Implement drug-drug and drug-allergy interaction checks. AVAILABLE
(3) Maintain an up-to-date problem list of current and active diagnoses. AVAILABLE
(4) Generate and transmit permissible prescriptions electronically (eRx). AVAILABLE
(5) Maintain active medication list. AVAILABLE
(6) Maintain active medication allergy list. AVAILABLE
(7) Record all of the following demographics:
(A) Preferred language.
(B) Gender.
(C) Race.
(D) Ethnicity.
(E) Date of birth.
AVAILABLE
(8) Record and chart changes in the following vital signs:
(A) Height.
(B) Weight.
(C) Blood pressure.
(D) Calculate and display body mass index (BMI).
(E) Plot and display growth charts for children 220 years, including BMI.
AVAILABLE
(9) Record smoking status for patients 13 years old or older.
AVAILABLE
(10) Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the
States.
AVAILABLE
(11) Implement one clinical decision support rule relevant to specialty or high clinical priority
along with the ability to track compliance with that rule.
AVAILABLE
(12) Provide patients with an electronic copy of their health information (including
diagnostics test results, problem list, medication lists, medication allergies) upon request.
AVAILABLE
(13) Provide clinical summaries for patients for each office visit.
AVAILABLE

Links Provide More Information
The links on the
Meaningful Use
Table of Contents
Core and Menu
Objectives allow
you to view the
detailed specification
sheet for each
objective.

http://www.cms.gov/EHRIncentivePrograms/Downloads/1_CPOE_for_Medication_Orders.pdf

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Process Redesign
Lecture e
Stage 1 Meaningful Use Objectives
Two sets of objectives, a set for
Eligible Professionals (15 core and 10 menu),
and a set for
Hospitals/Critical Access Hospitals (CAH) (14 core
and 10 menu)

The criteria impact workflow!
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Process Redesign
Lecture e
EP CO 10
Clinical quality measures

Report ambulatory clinical quality measures
to CMS or, in the case of Medicaid EPs, the
States.

Workflow Impact:
Changes to an existing administrative task

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Process Redesign
Lecture e
Requirements and electronic specifications for ambulatory clinical quality measures can be found at:
http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp#TopOfPage

EP CO 11
Clinical decision support

Implement one clinical decision support rule
relevant to specialty or high clinical priority along
with the ability to track compliance with that rule.

Workflow Impact:
Possible new task
Changes to an existing leadership and technical
task

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Process Redesign
Lecture e
EP CO 12
Providing patients an electronic copy of their health
information

Provide patients with an electronic copy of their
health information (including diagnostics test results,
problem list, medication lists, medication allergies)
upon request.

Workflow Impact:
Changes to an existing administrative task

11
Process Redesign
Lecture e
EP CO 13
Clinical summaries

Provide clinical summaries for patients for each
office visit.

Workflow Impact:
Probable new task

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Process Redesign
Lecture e
EP CO 14
Exchange key clinical information

Capability to exchange key clinical information (for
example, problem list, medication list, allergies, and
diagnostic test results), among providers of care
and patient authorized entities electronically.

Workflow Impact:
Probable new task

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Process Redesign
Lecture e
EP CO 15
Protect electronic health information

Protect electronic health information created or
maintained by the certified EHR technology through
the implementation of appropriate technical
capabilities.

Workflow Impact:
Probable new tasks, and
New workflow for existing tasks

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Process Redesign
Lecture e
Process Redesign
Summary Lecture e
Eligible Provider and Hospital/Critical
access Hospital objectives
Using the Table of Contents and
specification sheets for objectives
Understand Meaningful Use EP CO 10 -
15
15
Process Redesign
Lecture e
Process Redesign
Summary
1. Identify the factors that optimize workflow processes in health care
settings
2. Describe how information technology can be used to increase the
efficiency of workflow in health care settings
3. Identify aspects of clinical workflow that are improved by EHR
4. Propose ways in which the workflow processes in health care
settings can be re-designed to ensure patient safety and increase
efficiency in such settings
5. Use knowledge of common software functionality and meaningful
use objectives to inform a process redesign for a given clinic
scenario
16
Process Redesign
Lecture e
Process Redesign
References Lecture e
References
CMS EHR Meaningful Use Overview. (n.d.). Retrieved February 29, 2012, from Centers for Medicare & Medicaid
Services website: https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp
Electronic Specifications, Eligible Professionals (EPs). (n.d.). Retrieved February 29, 2012, from Centers for
Medicare & Medicaid Services website: https://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp
Eligible Professional Meaningful Use Core Measures Measure 10 of 15, Clinical Quality Measures (CQMs). (2010,
November 7). Retrieved from Centers for Medicare & Medicaid Services website:
http://www.cms.gov/EHRIncentivePrograms/Downloads/10_Clinical_Quality_Measures.pdf
Eligible Professional Meaningful Use Core Measures Measure 11 of 15, Clinical Decision Support Rule. (2010,
http://www.cms.gov/EHRIncentivePrograms/Downloads/11_Clinical_Decision_Support_Rule.pdf
Eligible Professional Meaningful Use Core Measures Measure 12 of 15, Electronic Copy of Health Information.
(2010, November 7). Retrieved from Centers for Medicare & Medicaid Services website:
http://www.cms.gov/EHRIncentivePrograms/Downloads/12_Electronic_Copy_of_Health_Information.pdf
Eligible Professional Meaningful Use Core Measures Measure 13 of 15, Clinical Summaries. (2011, April 18).
Retrieved from Centers for Medicare & Medicaid Services website:
http://www.cms.gov/EHRIncentivePrograms/Downloads/13_Clinical_Summaries.pdf

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Process Redesign
Lecture e
Process Redesign
References Lecture e
References
Eligible Professional Meaningful Use Core Measures Measure 14 of 15, Electronic Exchange of Clinical Information.
(2010, November 7). Retrieved from Centers for Medicare & Medicaid Services website:
http://www.cms.gov/EHRIncentivePrograms/Downloads/14_Electronic_Exchange_of_Clinical_Information.pdf
Eligible Professional Meaningful Use Core Measures Measure 15 of 15, Protect Electronic Health Information. (2010,
http://www.cms.gov/EHRIncentivePrograms/Downloads/15_Core_ProtectElectronicHealthInformation.pdf
What are the requirements for Stage 1 of Meaningful Use (2011 and 2012)? CMS EHR Meaningful Use Overview.
(n.d.a). Retrieved February 29, 2012, from Centers for Medicare & Medicaid Services website:
https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK4

Images
Slide 5: Meaningful Use Stages. Available at http://www.cms.gov/ehrincentiveprograms/
Slide 6: What are the requirements for Stage 1 of Meaningful Use (2011 and 2012)? CMS EHR Meaningful Use
Overview. (n.d.). Retrieved February 29, 2012, from Centers for Medicare & Medicaid Services website:
https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#BOOKMARK4
Slide 7: Image adapted from Centers for Medicare & Medicaid Services (2010). Medicare & Medicaid EHR Incentive
Program Meaningful Use Stage 1 Requirements Overview [PowerPoint slides] Retrieved from
https://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf

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Process Redesign
Lecture e

10 - Fundamentals of Health Workflow Process Analysis and Redesign - Unit 6 - Process Redesign - Lecture E

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Process Analysis and Redesign

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