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Harnessing the Potential of EHR’s Clinical Decision Support and Portals to
Improve the Quality of Care
Virna Little, PsyD, LCSW-r, SAP
What is a Clinical Decision Support “Simply” Stated
• Individual patient prompt • Meet a quality measure • Real time prompt at point of care • Reminder for evidence based
practices/guidelines
Why Decision Supports ?
• Improve quality of care • Improve outcomes • Track compliance to quality guidelines • Identify providers who need support • Compliance
Tremendous Opportunities
• Comprehensive Management • Making decisions from real data • Population Management • Quality Care/ Outcomes • Patient Experiences
10
EMRs in the therapy session can be used to engage patients and review
decision supports together !
The New Manager…….
• How can we use the system to solve this problem ?
• What data do we need to help solve this problem ?
• Where in the system will we want this information ?
• What do you do differently ?
A Real Life Example..
• Addressing issue of suicide risk across system • Thinking of a “spectrum “and using the system
across the “spectrum” to address a problem
• Used consistently throughout health centers • Speak the same language • Attention to question 9
PHQ9 Tool
• Reminder to providers
• Allows quick access to needed tools or resources
• Can be “hard stop”
• Ability to report on providers who “ ignore” decision supports
Decision Support
• “Blows” into all encounters
• Readily seen by providers of all disciplines
• Able to be reported on ( number of patients)
Suicide on the Problem List
• My Safety Plan document – Allows safety plan information to be available to all
providers during all visits for review and/or modification – Patients can access the document via patient portal for
reference – Community providers can see patients at risk through
physician portals – Provided in print to patients as part of after visit
summary – Signed by patient and provider
Safety Planning- An interdisciplinary collaborative effort using the electronic
record
A patient portal is a healthcare related online application that allows patients to interact with their healthcare providers.
What is a Patient Portal?
31
My Goals and Plans You have a diagnosis of DEPRESSION Here are your personal treatment goals: Call you friend Ana on Tuesday at 7pm
• Physician portal as link to community • Almost 100 organizations and specialty providers on
“Institute Link” • Foster care, mental health residences, DD programs • Pharmacy providers • Seamless care system • By-pass admissions • Expedited services • Decreased admissions
It takes a Family……..
• Review of all patients completed and attempts –analysis
• Hard stop decision supports for patients who are considered high risk
• Reports of patients who did not have safety plans reviewed
What Does The Future Hold ?
Compliance
• Use EMR for Compliance Program • Documentation Completion Decision Supports • Billing and Coding Reports • Treatment Plans -60, 85 and 91 days
A Schedule Is Not Just a Schedule Anymore
• Clinical and Administrative Decision Supports • Patient Status • Incentives like “my chart” or other enrollment • Open Encounters • Hospital Discharges • Shadow Templates • “Hotspotting” • Open Slot Reports
On The Back End……
• Billing • Collections • Authorizations • Credentialing • Denials Decision Supports to Remind Providers to do OTR ….
Patient Care Oversight..
• Concurrent Documentation • Time Spent • Review Notes from “Afar” • Open Encounters
Clinical Decision Supports
• A tough balancing act • Support fatigue • Rotating Supports • Coordinating with current initiatives