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Strategic Planning for ElectronicMedical Records in Long Term CareSeptember 22, 2010Stephen PaciccoKevin A. StaggJennifer Vitrano D’AngeloChief Executive OfficerExecutive VP & CFODirectorSoftware ImplementationSigmaCareChristian Health Care CenterChristian Health Care CenterCONFIDENTIALThis document contains proprietary ideas, concepts, and other information which belong exclusively to eHealth Solutions. Information disclosed herein should be consideredproprietary and confidential. This document is the property of eHealth Solutions and may not be disclosed, distributed, or reproduced without the express written consent ofeHealth Solutions. 2010 eHealth Solutions, Inc. All rights reserved. SigmaCare and SigmaCare logo are registered trademarks of eHealth Solutions, Inc. 1
Agenda Introductions Current LTC Environment and Upcoming Changes How EMR’s Address the Challenges and Opportunities What’s in an EMR Strategic Planning for Implementation of an EMR Christian Health Care EMR Process & Results Conclusions & Questions 2 2
The Current LTC EnvironmentThe Long Term Care industry is changing: MDS 3.0 changes reimbursement Operational efficiency will be critical Collaboration among all providers of care will berequired - includes LTC facilities, pharmacyconsultants, therapy, labs, radiology, etc. Increased quality expectations, reporting andmonitoring will be needed Health care reform puts more emphasis ontechnologyElectronic Medical Records (EMR’s) are needed toturn these changes into opportunities 3 3
Why Implement An EMREMR’s facilitate immediate compliance and long term gains EMR’s help capitalize on LTC market changes– Increase reimbursement due to accurate ADL and rehab minute documentationand the ability to electronically capture all care given (needed for MDS 3.0) EMR’s promote effective and efficient facility management– Eliminate paper inefficiencies, i.e. faxing orders, re-documentation– Document and monitor facility workflow on a real-time basis– Decrease in nursing paperwork hours allowing more time for quality care EMR’s facilitate risk mitigation– Track the average number of meds ordered and tasks documented per day– Provide allergy alerts and formulary checks– Prepare facilities for seamless and successful surveys 4 4
What’s In A Long Term Care EMRComputerized Physician Order Entry (CPOE)Electronic Medication/Treatment Administration Record (eMAR/eTAR)Online Lab Results and Lab Monitoring PoliciesProgress Notes, 24-Hour Reporting, A&I TrackingClinical AssessmentsAutomated MDS Workflow & Care PlanningCNA Assignments & Nursing InstructionsRehabilitation Charting & Charge CaptureDocument Management & Paperless Charts 5 5
How Long Term Care EMR’s InterfaceEMR’s engage with Pharmacies, Labs and Financialsystems to facilitate electronic data transmissionleading to a paperless, more efficient workflowFacility 6 EMR 6
How to Prepare for EMR Implementation Set clinical, financial and organizationalgoals for your facility Establish firm project governance team tohelp strategically plan for implementation– Set a facility vision– Educate staff from the ground up– Identify champions for each department Facilitate change management to addressgaps in transition process– Adequate staffing and support during process– Require 100% attendance for job-based,hands-on training– Entrench the facility in the implementationprocess – everyone must be onboard! 7 7
Implementation Process & TimingPre-Implementation & Project Oversight(3 .5 months – entire implementation ss & Configuration(3 months)ITInfrastructure(1 Month)WorkflowAnalysis(1 week)OutcomesDataCollectionChangeManagementSystem SetupandConfiguration(3 Months)Go-Live Activities(2 iveSupport(On-Going) 8 8
EMR Process & ResultsChristian Health Care Center:Heritage Manor, Southgate, Ramapo Ridge & LongviewLocation: Wyckoff, NJBeds: 445 totalServices: Skilled nursing, special care inpatient nursing, behavioralmanagement treatment, psychiatric and assisted livingEMR Implementation Timeline (Heritage Manor)CPOE/eMAR/MDS/Care PlanningOnsite Training:Go-live Activities:Live All Units: 9 7/16–7/22/087/23–8/3/088/03/08CNA AssignmentsOnsite Training:Go-live Activities:Live All Units:8/06–8/12/088/13–8/24/088/24/08 9
Our Approach: 100% Involvement Get everyone excited for the paper toelectronic transition– Everyone from Physicians to CNA’s are onboard with the process Treat your relationship with your EMRprovider as a partner not a “vendor”– Work together to drive facility goals andoutcomes Use your EMR to the fullest– Take advantage of facility managementand reporting features 10 10
Our Results: High Adoption Rates at HeritageCNA Documentation – 99.2% On TimeeMAR Documentation - 99.5% On 0%94.00%93.00%Formulary – 99.7% Compliant 11 %99.40%99.20%99.00%98.80%98.60%98.40%98.20% 11
Our Results: High Adoption Rates at SouthgateeMAR Documentation – 99.7% On TimeCNA Documentation – 99.8% On 0%84.00%Formulary – 98.8% Compliant 12 6.00%95.00%94.00%93.00%92.00%91.00%90.00% 12
13 93.00%92.00%91.00%90.00%1/2/2009eMAR Documentation – 98.2% On 912/13/200811/13/200810/13/2008Our Results: High Adoption Rates at RamapoFormulary – 99.2% 0%86.00%84.00%82.00%80.00% 13
Our Results: Increased Reimbursement Medicare Part A rateincreased by 11% resultingin increased reimbursement– Pre EMR implementation,the Medicare Part A ratewas 523– Post EMR implementation,the Medicare Part A ratewas 582 14 14
Our Results: Operational Cost Savings Staffing hours decreased by 2% due to declinein additional paper work needed from prior paperprocess– Pre EMR implementation, total staffing hourswas 87,800– Post EMR implementation, total staffing hourswas 86,900** Includes elimination for EOM recaps 80 hours overtimeper pay period ( 35,000 savings per year FTE) 15 15
Our Results: Additional Benefits Optimal survey results - year 2009recorded best survey results in 10 years Decline in shift to shift paperwork andreporting Increase in direct resident care Increase in Physician and Nurse workplace satisfaction Increased documentation efficiency dueto streamlined reporting and remote andreal-time access 16 16
Questions & Answers 17 17
How to Prepare for EMR Implementation Set clinical, financial and organizational goals for your facility Establish firm project governance team to help strategically plan for implementation –Set a facility vision –Educate staff from the ground up –Identify champions for each department Facilitate change management to address
