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March 22, 2017

Health Maintenance with Epic Healthy Planet

If our organization implements registries/Epic Healthy Planet, can we abandon Health Maintenance? Please??

This is a question (a plea?) that I’ve heard more than once, and it is an understandable one. But the answer is, “no.” In Epic, the Health Maintenance build is one of the backbones of the Healthy Planet functionality. And – just like PCP attribution workflows – a Healthy Planet go-live or refresh presents an excellent opportunity to identify and fix gaps in Health Maintenance build, giving providers another tool to improve patient care and outcomes.

When reviewing Health Maintenance build, I will typically encounter some combination of the following three issues:

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  1. Key information is not being documented discretely. Are Diabetic Eye Exams documented only in progress notes? Is the LVEF being documented anywhere for patients with Coronary Artery Disease? Are key pieces of information documented in the same place in the same way? If the answer is, “no,” you’re not alone. Healthy Planet build, however, helps to identify these gaps so that solutions, whether EMR build or workflow updates, can be implemented.
  2. There are gaps in Health Maintenance build. Do all completing procedures appropriately satisfy Health Maintenance? Is there a way to account for the various frequencies for cervical or colorectal cancer screening? Are the correct patients on the correct plans? Do your end users have frequent complaints about the veracity of Health Maintenance? Updated build will address many of these issues, and allow you to accurately track and report on key clinical metrics.
  3. There are usability problems with Health Maintenance workflows. If it takes five extra clicks to discretely document a declined influenza vaccine, it won’t be documented. Well-integrated decision support tools, such as BestPractice Advisories, can actually save work for users while improving documentation. If users are presented with notifications that are accurate (this patient really is due for Health Maintenance), appropriate (I’m seeing this at the ideal time during my workflow), and actionable (there’s are buttons I can click to place orders or take appropriate action), buy-in is almost immediate.

Updated Health Maintenance sounds like a great tool for our users! Should that be a priority over Healthy Planet?

Unless your organization has no resource limitations (in which case: call me!), the follow-up question is always how to appropriately prioritize build items. The best strategy can vary significantly, depending on your organization’s circumstances. One recommendation: don’t let perfect be the enemy of the good. It’s easy to get bogged down in details; often the best strategy for Health Maintenance is one of transparent communication coupled with continuous improvement.

Implementing good Health Maintenance build, with useful decision support tools, can seem like a daunting task, but well-implemented tools can pay significant dividends for tracking key metrics and improving patient care. Optimum would love to help you reach your goals – if you have any questions don’t hesitate to contact us.

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