Clinical (EHR) Reminders – More Than Just A Memory Jogger

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RPMS-EHRElectronic Health RecordOriginally developed by :Susan Pierce-Richards, MSN, ARNP, FNP-BC, ANP-BCCDR, US Public Health ServiceOIT National Programs – EHR TestingFederal Lead – EHR, Clinical (EHR) Reminders

Session ObjectivesAt the end of this session, participants should be able to: Understand the basic end user functionality of ClinicalRemindersPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC2

What are Clinical (EHR)Reminders? “The Clinical Reminders system allows caregivers to track andimprove preventive healthcare and disease treatment forpatients and to ensure that timely clinical interventions areinitiated.” (VA Vista Website) Interactive decision support tools that can provide patientspecific screening or treatment recommendations on the basisof the most recent available data within the RPMS (InformationTechnology as a Tool to Improve the Quality of AmericanIndian Health Care. Thomas D. Sequist, MD MPH, TheresaCullen, MD, MS and John Z. Ayanian, MD, MPP).Simple terms:Clinical Reminders chart reviews for you and tells you what thepatient needsPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC3

Where are Clinical (EHR)Reminders? They are visible from 4 places in HER:1- “Alarm clock” icon on the toolbarPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC4

Where are Clinical (EHR)Reminders?2- Reminders list on the Cover Sheet display DUEremindersPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC5

Where are Clinical (EHR)Reminders?3-“Reminders drawer” on the Notes tabPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC6

Where are Clinical (EHR) Reminders?Reports tab (requires configuration):Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC7

Where are Clinical (EHR) Reminders?able by right-clicking on a reminderDetails are avaiPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC8

What are Clinical ReminderDialogs? Clinical Reminder Dialogs facilitate documentation- Looks like a Template- Resolves the reminder (enters info into EHR/PCC)- Creates the note all at the same time!!! Generates order- Meds- Labs- Consults Supports treatment algorithmsPresented by Emmanuel Y. Yennyemb, MBA, CSAP,CAC9

Hands-onThe following reminders are due forthis patientPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC10

Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC11

Why do we need remindersystems? Improve preventive health care tracking Improve disease treatment monitoring Assist in clinical guideline implementation Improve patient safety Improve capture of GPRA and other reporting measuredata (MU/IPC/)Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC12

Why can’t we just use the HealthSummary reminder system with EHR? The Health Summary reminder system is not highlyvisible in EHR The Health Summary reminder system does not have adocumentation tool for EHR No longer using PCC Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC13

Do we need Clinical (EHR)Reminders?YES Clinical (EHR) Reminders restores: A visible reminder system A streamlined documentation toolClinical (EHR) Reminders additionallydelivers:- Locally configurable tools to solve local problems- Reports tool to extract real time data on specific reminderPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC14

Types of Clinical (EHR)Reminders National Reminders Delivered to all sites Based on same logic as Health Maintenance reminders Many have associated ‘dialogs’ for data entry/note generation Local Reminders Written at a local site to solve a particular clinical problem Can be shared between sites Dialogs can also be shared Reminder Reports Can quickly extract data by provider Very helpful for local reminders in identifying and tracking sitespecific issuesPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC15

A little “Reminders” lingo Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC16

Finding A FINDING is a piece of information that the remindersearches for in the computer FINDINGS are used to determine: Who needs an intervention (cohort) What resolves the reminderFindings include individual or groups of Labs, Pt EdTopics, Taxonomies of codes (ICD9, ICD0, CPT), Exam,Measurements, Health Factors, Medications Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC17

Applicable The Cohort is the “who needs the intervention” A reminder is APPLICABLE to a patient if they are in thecohortCohort IdentifiedAge 50Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CACNO h/oColon ca18

Resolution What will turn this reminder OFF?DM HgbA1C Lab test DM ACE/ARB Current & filled rx for ACEI or ARB A reminder is considered RESOLVED if the intervention(finding) defined by the reminder has been met/foundPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC19

Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC20

Due A reminder is DUE for patient if they are in the cohort(applicable) and have not yet had the intervention(finding) that the reminder is seeking.Presented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC21

Basic Reminder LogicNoDoes Patient meet cohort criteria?Reminder not applicable(white clock)Any Exclusions?Reminder not applicable(white clock)Reminder ResolvedApplicable (blue clock)CACFulfills resolution criteria?Reminder DueDue (red clock)22

National Reminder – Dialogtools Screening bundle Alcohol Screening and Brief Intervention (ASBI) Tobacco counseling and interventionPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC23

The future Reminders can be locally created and used for bothproblem identification and interventions Dialogs can be used to resolve reminder Dialogs can stand along and be used as documentationtools like PCC Reminders and Dialogs can be SHARED between sitesPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC24

CAC Resources FTP HR%20Reminders/ Sharepoint site for those with D1 default.aspx Recorded webex trainings Reminders start to finish (several done by Mary Hager) Getting started series (several done by Susan Richards) Road map to deployment Reminders – copy and customize Dialogs – customize Importing/Exporting remindersPresented by Emmanuel Y. Yennyemb, MBA, CSAP, CAC25

Clinical (EHR) Reminders – More than just a memory jogger Author: Emmanuel Yennyemb Subject: Clinical (EHR) Reminders More than just a memory jogger Keywords: Clinical (EHR) Reminders – More than just a memory jogger

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