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Q&A with a CMIO: Ebola response, Meaningful Use

North Shore – Long Island Jewish (NSLIJ) is one of the largest integrated health systems in the United States. Our team recently interviewed NSLIJ Chief Medical Information Officer Mitchell A. Adler, MD.

We asked him about two significant NSLIJ accomplishments in 2014: a rapid response to Ebola and attesting to Meaningful Use. Here are highlights from that interview:

Q. How did NSLIJ respond to Ebola?

A. NSLIJ is one of only 35 centers in the U.S. approved to treat Ebola, which is a tremendous accomplishment. Like most health systems, we also needed to quickly develop an Ebola screening workflow to identify patients at risk for the disease.

Using evidence-based guidance from the Center for Disease Control and New York Department of Health, we presented all patients with two screening questions, one about recent travel to affected areas and the other about the presence of symptoms.

We screen ambulatory patients on the phone when they make appointments, before they physically enter any of our facilities and potentially expose our patients or employees. We also screen patients when they arrive at our facilities, as early in the encounter as possible, in case that information has changed.

Q. What were the key pieces to developing the NSLIJ Ebola screening workflow?

A. We needed our workflow to enable us to do three things: 1) Enter the responses to the two screening questions as discrete data, 2) Display the responses in a flowsheet, and 3) See the responses in our Allscripts TouchWorks® EHR, even though all responses from scheduling or arrival are recorded in another vendor’s system.

We got the help we needed from Allscripts to get this project completed within a matter of days. It was a very gratifying experience.

Q. What was the result of implementing the new Ebola screening workflow?

A. The results have been better than I expected. We have a reporting mechanism that pulls information from our separate scheduling, registration, and EMR* systems and shows the effectiveness of this new workflow. It gave us some insights about how we introduce new workflows, educate staff, receive feedback and continuously improve our processes.

If we have to institute another workflow to address a different illness, we can. It’s not technically difficult, it’s more of an administrative effort to efficiently roll it out to the 400 or so ambulatory practices we have in our system.

Q. Describe your experience with Meaningful Use in 2014.

A. 2014 was a very stressful and demanding year for every health system – and EMR vendor – across the country because of Meaningful Use requirements. They were challenging for both Stages 1 and 2 throughout the year. It didn’t matter which EMR they had, healthcare organizations faced difficulty ensuring proper workflow and reporting to obtain incentives and avoid penalties.

NSLIJ successfully attested to Stage 1 in 2014, for many of our first-time attesters. I’m very proud of this accomplishment. We received a lot of support from Allscripts along the way. I’m confident that most of our remaining first-time attesters will successfully complete this process during the Q4 2014 reporting period. We’re also well positioned to achieve Stage 2 attestation in 2015.

Q. What advice do you have for other organizations attesting for Meaningful Use?

A. I think that many of the Meaningful Use criteria are actually meaningful. We should focus on using the EMR in meaningful ways. More importantly, the EMR technical people should remember how important their work is to benefit patients.


You can learn more about NSLIJ’s response to Ebola in a free new eBook, Fighting infectious disease: A look at Ebola.

Editor’s Note: Electronic Medical Record (EMR) is another term for Electronic Health Record (EHR) or Electronic Patient Record (EPR).

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