Transcription
Integrating Technology to Enhance Patient and Practice ManagementThe Connected Physician Electronic Medical RecordAcquisition Strategies
Mark Anderson, FHIMSS, CPHIMSSHealthcare IT Futurist33 Years In Healthcare ITCIO Position at Three Multi Facility Regional IDN’s– Executive Team Member at 5 Different IDN’s– Worked In 158 Hospitals and 21 Payer OrganizationsAssisting Physician Practices– Advisor to DOQ-IT and State QIOs– Advisor to many Medical Societies– Advisor to National IPA Association– Managed 50 Physician Practices in the Late 1980’s– CIO of a 2,300 physician (500 Practices) IPA
DisclosureSpeaking at numerous professional associationsand at vendor meetings (over 100/Year)White Papers on the use of technologyServe on numerous conference boardsEHR Search and Selections ( 100 Practices)DOQ-IT and CMS EHR Selection ToolNO Revenue from any vendor based on anySales or increase in Revenues
Vision“Technology is simply a catalyst that willempower providers to drive meaningfulchanges in care.”“ People love progress but hatechange”
The Thing About the Future
You Hate Getting It Wrong!
And Big Surprises Aren’t Much Better!
With Only the Past for a Compass Who will guide you?
Patterns Must Lead to ActionSuccess Teamwork
Breznikar's Law ofComputer Technology“Applying computer technology issimply the act of finding the rightwrench to pound in the correctscrew.”
Transitioning from Paper to DigitalElectronic Medical RecordsPAPER 2003 Cisco Systems, Inc. All rights reserved.DIGITAL
Information Overload
Six Levels ofTechnology forPhysician OfficesLevel 6Clinical TrialsLevel 5Practice based EMR w/CDS and KBSWhat will ittake togainadoption?KBS Knowledge Based SystemsCDS Clinical Decision SupportLevel 4Mobile and Real Time AdjudicationLevel 3Document ManagementLevel 2Secured Internet ConnectivityLevel 1Practice Management
Physician Adoption Rates% of Practices 0
What are Practices 00%30.00%20.00%10.00%0.00%1995PMS Only20002002EMR Only2004Interfaced20062008IntegatedSource: AC Group 2005 annual survey of buying patterns
DIGITAL MEDICALOFFICE ptionPaper DocE-PrescribeE & M CodingStandards/CCRNational AlertsChief ComplaintHealth HRXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Installation, Training, and ConfigurationHrs/Phy806040200EMR LiteChartingEMREHR
Ready to look for an EMR/EHRWhere do you start?
Questions:¾ How do you determine if you are ready to “leap” into theEMR?¾ Can you always believe what the vendor tells you?¾ Where does a group go to find third-party independentevaluations of vendor’s functionality, financial viability,customer support, and overall best price?¾ How can you determine if there is a quantified return oninvestment (ROI)?¾ How can you leverage the use of an EMR to improvereimbursement, improve quantified clinical quality, andreduce malpractice costs?¾ Who can you turn to for third-party independent advice?
CCHIT StandardsRecognition of recent governmentalleadership in this area—particularly at thefederal level and encouragement ofexpanded leadership at the state levelRole of standard-setting in assuring baseline quality in products (measure ofprotection to nervous HIT buyers)
Selecting An EHRCreate a Comprehensive CommitteeEstablish a Realistic Requirements ListVerify the EHR Strategy of PMSConduct DemonstrationsCheck References and Visit SitesEvaluate EHR Candidates
Selecting An EHRCreate a Realistic Budget– Project Management– Non-Vendor Assistance– Data Conversion– Adequate Hardware– Training and Support
Contracting1st – What do you want to contract for?2nd – Get a quote3rd – Review the quote and the Contract4th – Negotiate5th – Get everything in writing6th – Get HELP!!!!7th – Sign the Contract8th – Now is where the real work starts !!
EMR/EHR Selection ToolAC Group conducted extensiveevaluation of the EHRmarketplace– 8th report– Completed in May 2006– Included over 3,000 functionalquestions– 38 categories of functionality– 26 subcategories of chartingfunctionality114 Vendors have participated
EMR/EHR Selection ToolCharting VendorsEMR Light VendorsEMR VendorsEHR VendorsCHR VendorsCombined PMS/EHRFQHCMental Health
Top EMR/EHR Vendor ApplicationsPractices with 100 0%Cerner70%60%GE Healthcare50%InteGreat(*) indicates that the product has not been tested yetBased on 2,750 Functional Questions Divided Between 38 Categories
Top EMR/EHR Vendor ApplicationsPractices with 20 to 99 PhysiciansNextGeneCwPMSIRating100%Allscripts95%* OmniMD90%MisysGE85%MedCom Soft80%* Dr. I-NetiMedica75%* PULSE70%InteGreat(*) indicates that the product has not been tested yetBased on 2,750 Functional Questions Divided Between 38 Categories
Top EMR/EHR Vendor ApplicationsPractices with 6 to 19 90%PMSI85%Allscripts80%* OmniMDMisys75%70%MedCom SoftEMR Rating(*) indicates that the product has not been tested yetBased on 2,750 Functional Questions Divided Between 38 CategoriesAcerMed
Top EMR/EHR Vendor ApplicationsPractices with 1 to 9 Misys85%A480%GESynaMed75%70%MedCom SoftEMR Rating(*) indicates that the product has not been tested yetBased on 2,750 Functional Questions Divided Between 38 CategoriesAcerMed
AC Group Product EvaluationsEHR Functionality OnlyPMS – EHR Functionality OnlyTotal Company Rating– Company StabilityCompany RevenuesEHR RevenuesTotal Ambulatory RevenuesClient BaseTechnology– End-UserSatisfactionKLASAAFPAC Group
Potential Return onInvestment
Benefits to the Physician¾ Clinical Integration¾ Reduce operating cost 8%¾ Improve Revenue Capture 3%¾ Lower costs 40%reduction¾ Monthly fixed costs withlocal support¾ Contract terms andconditions¾ The power “of the many”¾ Pay-for-performance - 5K-10K¾ Interfaces to all sources¾ Data exchange betweenPrimary Care, Specialists,and Hospitals¾ Grants to the IPA offsetcosts¾ Local clinical support viaIPA¾ More service more value
Why systems FAIL!
RESULTS 74% of discarded EHRs were because the software did not meet the actual needs of thephysicians.Spending too much for the software.80% of the vendors implementing the software donot help the practice determine “how” to use theproduct to improve operations.The wrong EHR decision could cost the averagephysician more than 50,000 per year.
Role of the EHR VendorThe vendor sells you a car and teaches you howto turn it on.– The vendor does not teach you to drive.– The vendor does not show you how to getwhere you want to go.You could end up wasting your time andmoney
Bottom LineTechnology can improve your operationsTechnology can help improve reimbursementTechnology can help reduce costsHoweverTechnology alone does nothingIt’s the staff that makes it all workComputers are dumb – they only do what you tell them to do– but they are thousands of times faster than we areDon’t leap into EMR until you are readyTake an incremental approach toward automation
For More InformationMark R. Anderson, FHIMSS, CPHIMSCEO and Healthcare FuturistAC Group, Inc.118 Lyndsey DriveMontgomery, TX 77316(281) 413-5572eMail: mark.anderson @ acgroup.orgwww.acgroup.org
Questions
DIGITAL MEDICAL OFFICE FUNCTIONALITY PHR X Health Maint. X Chief Complaint X X National Alerts X X Standards/CCR X X E & M Coding X X X E-Prescribe X X X X Paper Doc X X X X X Transcription X X X X X X Labs X X X X X X Scheduling X X X X X X X Billing X EMR EMR EHR Lite Secured DIM Charting Message FunctionFunction PMS
