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Guide to the Future Version 2.0 GUIDE TO THE FUTURE: A Strategic Roadmap to Achieving Meaningful Use Objectives and Selecting an Integrated Electronic Dental Record (EDR)/Electronic Health Record (EHR) System to Improve Oral Health Access and Outcomes TABLE OF CONTENTS INTRODUCTION Introduction ......................................................................................................................................... 1 Meaningful Use for Oral Health .............................................................................................................. 2 The future of health care can be found in combining skillful providers with the technological tools that allow Current Meaningful Use Objectives and Exclusions for Consideration ......................................................... 6 them to provide the best possible care for their patients. At the forefront of this combination is the concept Core Set Objectives .............................................................................................................................. 7 of Meaningful Use: terminology used by the Centers for Medicare and Medicaid Services (CMS) that means providers must show they are using certified Electronic Health Record (EHR) technologies in ways that can be Menu Set Objectives ............................................................................................................................. 8 measured. The National Network for Oral Health Access (NNOHA) developed this white paper to present a Current Clinical Quality Measures for Oral Health ................................................................................... 10 strategic roadmap for achieving Meaningful Use for oral health and to provide critical steps that need to be taken Clinical Quality Measures for Oral Health .............................................................................................. 12 to implement an EHR system that fully integrates Electronic Dental Records (EDR). This white paper will help EHR Selection ................................................................................................................................... 17 oral health providers, staff, and patients understand the benefits of Meaningful Use incentives and serve as a EDR/EHR Selection Tool ..................................................................................................................... 18 guide to selecting an Electronic Dental and Health Record system. Step 1: Eligible Professional Assessment ....................................................................................... 19 Step 2: Vendor Background Information – Request for Information (RFI) ........................................... 20 Step 3: Review of Meaningful Use Core & Menu Set Objectives ........................................................ 21 NNOHA’s Health Information Technology (HIT) Workgroup (formerly HIT Committee) was established to Step 4: Review of Meaningful Use Clinical Quality Measures (CQMs) ................................................ 21 help guide safety-net oral health programs through HIT decisions and challenges as they emerge. EDR issues have remained a priority for the Workgroup, which is continuing to assess the EHR needs of Health Center oral Step 5: Vendor Response to Meaningful Use Certification and Reporting Measures............................. 22 health programs and make recommendations to guide Health Centers in selecting technology solutions that are Step 6: Vendor Response to NNOHA’s Proposed CQMs for Oral Health .............................................. 22 compatible with the systems used by both medical and dental staff. Through a Health Resources and Services Step 7: Vendor Response to EDR/EHR Practice-Specific Requirements ............................................. 23 Administration (HRSA) Cooperative Agreement, NNOHA strives to provide technical assistance to Health Step 8: Vendor Response to Qualitative Requirements..................................................................... 25 Centers seeking to provide, expand, or improve oral health services. Step 9: Vendor Response to Vendor Solution Cost. .......................................................................... 26 Step 10: Vendor Selection Criteria and Summary Ratings ................................................................ 26 Discussion on Use of EDR/EHR Selection Tool, Vendor’s Self Scoring and General Disclaimer .................... 28 NNOHA’s HIT Workgroup goals are to: Challenges Selecting and Implementing an EDR/EHR Solution ................................................................ 29 ■ Provide key stakeholders, Dental Directors, Executive Directors, and Information Technology (IT) EDR/EHR Implementation Strategies .................................................................................................... 30 decision makers with objective comparisons among the current leading EDR/EHR products. Conclusion: A Strategic Pathway to the Future ....................................................................................... 33 ■ Provide input to dental software developers on areas for improvement within existing applications to Appendix A1: Meaningful Use Vendor Survey Responses ........................................................................ 36 better meet the challenges of Meaningful Use compliance, Health Center patient care, and practice Appendix A2: Rating Chart: Vendor Response to EDR/EHR Practice-Specific Requirements........................ 38 management of oral health programs. Appendix A3: Rating Chart: Vendor Response to Qualitative Requirements ............................................... 52 ■ Advocate for integration of a dental module within Electronic Health Records as a vital part of the Appendix A4: Rating Chart: Vendor Response to Vendor Solution Cost ..................................................... 53 product functionality offered to Health Centers. Appendix A5: Rating Chart: Vendor Selection Criteria and Summary Ratings............................................. 55 ■ Identify potential Meaningful Use measures for oral health. Appendix A6: Vendor Background Information and Evaluations ............................................................... 55 ■ Provide Dental Directors and Health Center oral health programs with practical resources for selecting, Product Name: QSI Dental – Electronic Dental Record (EDR) ........................................................... 57 implementing, and optimizing HIT. Product Name: Dentrix Enterprise/Sage Intergy .............................................................................. 62 Product Name: Mediadent ............................................................................................................ 72 When a Health Center finds a system that best meets the needs of their organization, as well as Meaningful Use Product Name: Open Dental and eClinicalWorks ............................................................................. 80 criteria, it allows for maximized resources, increased reimbursements, and improved patient care. This paper can Appendix B: Sources of Information/Additional Resources ...................................................................... 87 serve as a guide in the process, and facilitate the Health Centers’ decision making process toward improved use Appendix C: Glossary .......................................................................................................................... 88 of HIT. Appendix D: References ...................................................................................................................... 89 Appendix E: Credits ............................................................................................................................ 91 Terminology 1 “Health Center” is the term commonly used to refer to Community Health Centers, migrant health centers, health centers that treat the homeless, and centers that © National Network for Oral Health Access, August 2012 treat residents of public housing. 2 “Federally Qualified Health Center” or FQHC is a Medicare/Medicaid/CHIP term related to reimbursement, which includes Section 330 of the Public Health Service The information in this document was accurate at the time of this printing. As regulations and information regarding Health Centers Act funded centers, sub-recipients (e.g. sub-grantees) and look-alikes. are not static, NNOHA recommends readers verify any critical information with different state regulations and changes that may have 3 Authorizing Section 330 legislation has officially changed the term “Community Health Center” to the accepted term “Health Center” and that is the term used occurred since printing. throughout this paper to refer to the above listed types of grant-supported entities. This publication was supported by Grant/Cooperative Agreement #U30CS09745 from the Health Resources and Services Administration (HRSA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA. 1 Guide to the Future MEANINGFUL USE FOR ORAL HEALTH Background One only has to listen to the news or pick up a journal to know that the United States health care delivery system is highly fragmented. Dentists, physicians, and other health care specialists utilize separate records with patient’s health information residing in a broad mix of paper charts, ancient legacy systems, new web-based tools, and everything in between. This variation
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