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  • Thank you for joining us for this

  • webinar titled "Using Electronic Health

  • Records to Support Diabetes Management

  • and Type 2 Diabetes Prevention" Our

  • presenter is Stephanie Rutledge who is a

  • Health Scientist with the Centers for

  • Disease Control and Prevention. I am

  • Michelle Knight with ICF next and I will

  • be your moderator today. The recording

  • and transcript as well as the PowerPoint

  • slide deck will be available on the CDC

  • website later this year. For the next 60

  • minutes we will share information that

  • will help you understand the importance

  • of EHRs in supporting type 2 diabetes

  • prevention and diabetes management. We

  • will also discuss how state and local

  • health departments can talk with

  • healthcare providers about the benefits

  • of using EHRs while being able to

  • acknowledge the limitations of EHR.

  • Then we will provide examples from the field

  • to aid in learning and understanding.

  • Finally we will wrap up by sharing

  • additional resources. The companion guide

  • for this webinar is titled

  • "Using Electronic Health Records to

  • Support Diabetes Management and Type 2

  • Diabetes Prevention" and will be

  • available on the CDC website later this

  • year. I will now turn the webinar over to

  • Stephanie, Stephanie. Thank you Michelle.

  • An EHR is a digital version of a

  • patient's medical chart. A typical

  • individual EHR may include a patient's

  • medical history, diagnosis, treatment

  • plans, pharmacy records, and laboratory

  • and/or test results. EHRs are real-time

  • records that make information available

  • securely to authorized users ideally

  • including users from multiple

  • organizations.

  • Electronic health record systems are in

  • common use in both hospital systems and

  • community-based health care provider

  • offices. EHRs can help streamline

  • communication among providers including

  • community-based providers. EHRs automate

  • and streamline provider workflows and

  • allow providers access to evidence-based

  • tools to help them make patient care

  • decisions. Because of the cost of

  • diabetes care improving the quality of

  • diabetes management and type 2 diabetes

  • prevention is an important priority. EHRs

  • are one promising tool in these efforts

  • and EHRs can help support efforts to

  • increase awareness, referral, enrollment

  • and retention in the National Diabetes

  • Prevention Program also called the National

  • DPP lifestyle change programs, LCPs,

  • and in diabetes self-management

  • education and support or DSMES

  • programs for type 2 diabetes prevention

  • and diabetes management. EHRs can help

  • support the patient journey

  • which we will further define later in

  • the webinar.

  • For example, EHRs can assist health care

  • providers to educate patients about

  • prediabetes and type 2 diabetes,

  • screen or test for prediabetes and type

  • 2 diabetes and refer patients to type 2

  • diabetes prevention or diabetes

  • management programs. EHRs can also be

  • used to send health care providers

  • information about patient participation

  • and progress in National DPP lifestyle

  • change programs and diabetes

  • self-management education and support

  • programs.

  • Health care providers are the primary

  • users and owners of EHRs. Providers

  • include large health systems and

  • hospitals office based practices and

  • pharmacies although almost all hospitals

  • use EHRs not all providers use EHRs.

  • These differences in EHR use can lead to

  • challenges in interoperability or the

  • secure exchange of information between

  • authorized EHR users which can limit the

  • flow of information between providers

  • and other users. We will discuss

  • interoperability in more detail later in

  • the webinar. Individual patients are

  • secondary users of EHRs. Patient

  • access their health records that are

  • stored in an EHR through a secure web

  • site usually called a patient portal.

  • Community or clinically based

  • organizations may also be secondary

  • users of EHRs. Use by these

  • organizations can happen when they

  • receive referrals to their type 2

  • diabetes prevention and diabetes

  • management programs through an EHR in

  • limited cases. Such organizations may

  • also use EHRs to provide feedback on

  • patient progress to the provider making

  • referrals. Most EHRs are created by

  • independent companies or EHR vendors. EHR

  • vendors create a variety of EHR products

  • and platforms with varying features and

  • cost. On this slide are just a few of the

  • common vendors used by hospitals and

  • individual healthcare professionals.

  • Health care providers have many options

  • when choosing EHR vendors and products.

  • The American Medical Association

  • provides a detailed guide to selecting

  • and purchasing EHRs. There are complete

  • and modulate EHRs. One major distinction

  • is a complete EHR is a complete package

  • that has been certified as meeting all

  • of the Federal government criteria for

  • promoting interoperability or PI

  • programs. A practice with a complete

  • EHR has one

  • vendor and one system to work with, which

  • can make it easier to get support. A

  • modular EHR combines multiple EHR

  • modules that are individually certified

  • for PI programs. A modular approach

  • allows providers to use preferred

  • applications, and it can be less

  • expensive than buying a complete EHR.

  • When complete EHRs or combinations of

  • EHR modules meet federal government

  • criteria for PI programs they are

  • referred to as certified EHR technology.

  • HIPAA privacy and security rules protect

  • individually identifiable health

  • information, sometimes referred to as

  • protected health information or PHI.

  • EHRs must comply with HIPAA regulations

  • since they are electronic repositories

  • of PHI. EHRs must be HIPAA compliant

  • and providers are responsible for taking

  • the steps needed to protect

  • confidentiality, integrity, and

  • the availability of electronic PHI. You can

  • learn more in "The Guide to Privacy and

  • Security of Health Information". The 2009

  • American Reinvestment Recovery Act

  • included the HITECH Act that supported

  • Electronic Health Records Meaningful Use,

  • an effort led by CMS and the Office of

  • the National Coordinator for Health IT

  • ONC-HIT. Providers had to show

  • meaningful use, in other words that their

  • EHR was being used in a meaningful way

  • specifically to improve quality, safety,

  • efficiency, and reduce health disparities,

  • engage patients and families in their

  • health, improve care coordination,

  • improved population and public health

  • and, ensure adequate privacy and security

  • protection for PHI. In 2018, CMS

  • announced a new phase of the electronic

  • health record incentive program with an

  • increased focus on interoperability,

  • including the exchange of data between

  • health care providers and patient access

  • to health data. CMS renamed the EHR

  • Incentive program as

  • the Promoting Interoperability PI 177

  • programs. In 2019, CMS introduced the

  • Interoperability and Patient Access

  • Proposed Rule to expand access to health

  • information and improve the exchange of

  • healthcare data. Starting in 2019, CMS and