EHR Usage and Functionality

1. Identify the EHR functionalities that will be required to successfully provide care and distribute the reimbursement for a one year course of treatment for Stage III Colorectal Cancer under a bundled payments system. What are the sources of information that you require, e.g. administrative, clinical, claims, other? Who should have access to what data?

Note: Focus on:

1. the requirements of treating Colorectal Cancer,
2. what are the unique challenges in diagnosis, treatment, and payment/reimbursement associated with this disease, and
3. How does the EHR enable information integration for multiple providers and stakeholders to treat patients in a seamless manner? What specific functionalities of the EHR facilitate a smooth integration?

Hint: Think about how healthcare organizations must use the "bundled payments" system to ensure proper care coordination among multiple stakeholders involved in patient care. In other words, what types of EHR functionality must be available to provide the necessary information to ensure that "bundled payments" can be successfully implemented? Also refer to the lecture slides on bundled payments. Note that, this question is NOT about you getting into details of colorectal cancer treatment! Therefore a background on cancer treatment is not necessary (although you may do some search on it and get familiar).

2. Please search online for Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and Merit Based Incentive Payments and answer the following:
   1. What is the MACRA legislation about (in your own words)?
   2. What is MIPS? Briefly describe each of the performance category under MIPS quality payment program.
   3. Pick 3 quality measures from the quality payment program as part of MIPS (from your answer to part 2), login to Practice fusion. Does Practice Fusion support the collection of related measure/measures? What are the workflow requirements that would a participating organization need to implement?
   4. Are there any potential challenges in implementing the workflow requirements?

Hint:In understanding workflow requirements, you may consult to your lecture decks on Meaningful Use.

There is no more information I am given. please solve according to your best knowledge.

Activity Counseling on need for colonoscopy Colonoscopy Biopsy Visit to review biopsy Appointment regarding surgery Resection Hospital stay and surgery (3-5 days) Review data for stage III disease Visit social worker Visit chemo nurse for teaching Decide on drug therapy Lab for pre-chemo CBC, CMP, liver, CEA Meet with clinical trial staff regarding protocol Chemotherapy and follow-up visit every two weeks (24 visits) Evaluate and treat potential problems: nausea, diarrhea, fever, etc. One month post therapy, review drug therapy and survivorship likelihood Follow-up visit every 3 months Ongoing disease and case management Person Primary care provider Gastroenterologist Pathologist Gastroenterologist Surgeon Pathologist Hospital, Surgeon and hospital staff Medical oncologist Social worker Chemotherapy nurse Medical oncologist Lab Trial staff Medical oncologist, chemo nurse Medical oncologist, nurse Medical oncologist Medical oncologist Medical oncologist and/or PCP Activity Counseling on need for colonoscopy Colonoscopy Biopsy Visit to review biopsy Appointment regarding surgery Resection Hospital stay and surgery (3-5 days) Review data for stage III disease Visit social worker Visit chemo nurse for teaching Decide on drug therapy Lab for pre-chemo CBC, CMP, liver, CEA Meet with clinical trial staff regarding protocol Chemotherapy and follow-up visit every two weeks (24 visits) Evaluate and treat potential problems: nausea, diarrhea, fever, etc. One month post therapy, review drug therapy and survivorship likelihood Follow-up visit every 3 months Ongoing disease and case management Person Primary care provider Gastroenterologist Pathologist Gastroenterologist Surgeon Pathologist Hospital, Surgeon and hospital staff Medical oncologist Social worker Chemotherapy nurse Medical oncologist Lab Trial staff Medical oncologist, chemo nurse Medical oncologist, nurse Medical oncologist Medical oncologist Medical oncologist and/or PCP