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Doctors Go DigitalPresentation to the Clinic Board

Dec 3rd 2009 Group 4 – Lynne Carveth, Barbara Kapelman M.D., Lisa Heavilon, Chad Hodge, Jeremy

Music

Current State - Chad

Large Multi-specialty Freestanding Outpatient Clinic

• 150 MDs• 150 MAs• 50 RNs/LPNs• 200 secretary and clinical support staff• 120 administrative staff • 10 On-site dedicated IT staff• All clinics housed within 6 floors• Clinic is a member of local RHIO• Lab, Radiology and Pharmacy on-site

Strategic Plan - Barb

Phased approach over 4 years to bring clinic up to date on technology based on needs assessment

• Phase 1: 1 year – Implement EMR

• Phase 2: 1 year – integration with Lab, Radiology and Pharmacy, including ePrescribing

• Phase 3: 2 years – RHIO

ROI – Qualitative - Barb

An Electronic Medical Record will:

• Improve patient care• Improve patient safety• Improve efficiency• Improve patient satisfaction• Improve staff satisfaction• Improve public perception of our clinic as a first-

rate, state-of-the-art facility

ROI – Quantitative - Barb

The Clinic will experience:

• Reduction in chart-pulls (reduction in medical records staff)• Reduction in transcription costs• Savings in rent for storage space• Malpractice premium discount (5%)• Increased revenue:

– Improved charge capture and billing efficiency– Higher coding levels– More efficient documentation

cleaner charge submissions faster paymentfewer claims denied

• Decrease in Accounts Receivable

• Estimated break-even at 5 years

EMR Selection Process – 1 BARB

Establish a selection committee of:

• Physicians

• Nurses

• Revenue cycle specialist

• Medical records specialist

• Pharmacist

• IT experts

Vendor Selection Process - Lisa

Selection Method• High Level screening• Send RFP• Establish in-depth evaluation criteria

– Vendor background– Functional Requirements– Technical Requirements– Interoperability Requirements– Performance Requirements– Usability– Privacy and Security Requirements

• Evaluation– RFP– Demos– Site Visits– Use Case scenarios– Costs

RFP - Lisa

Top Vendors provided details on:• Functionality:

– Customizable electronic chart– E-prescribing– Interoperability

• Labs• Radiology• RHIO

– Patient portal– Clinical Decision Support

• Cost (including one-time and annual)

Top Vendors Selected - Lisa

Top 5 Vendors Evaluated (in no particular order )

• Allscripts (Healthmatics/Touchworks )

• CliniComp Intl. (Essentris)

• Eclipsys (Sunrise Clinical Manager)

• IDX (Groupcast)

• Next Gen (Next Gen)

Project Budget - Jeremy

Phase 1 – EMR - Jeremy

EMR – Implementation• Startup and planning• Hardware and software• Staff preparation and training• Workflow re-engineering• Custom clinical content and set-up• Pre-loading of information• Go-live• Continuous improvement

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Phase 2 – Integration - Jeremy

Integration – Phase 2

• Lab– Technology – HL7– Lab/Micro

• ePrescribing

• Radiology (PACS)– Technology - DICOM

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Phase 3 – RHIO -Chad

• Our facility has signed up to join the local RHIO, which encompasses 5 metropolitan hospitals in our state, and 2 in a neighboring state, as well as a dozen free clinics, and over 50 local physician offices.

• RHIO’s allow participants to query medical records of a patient across multiple facilities, to get a more complete picture of the patients medical history.

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Phase 3 - RHIO Implementation -Chad

• Insurance companies offer incentives to use the RHIO, by paying higher prices for certain services, or by paying for each search result that is used.

• We are participating in the RHIO not as a competitive advantage, but as a way to keep up with the other local facilities, and to not miss out on the incentives from the use of patient search.

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Communication Plan - Lynn

PHASE I (6 months prior to training)

Posters – Contact PR Medical Staff Office – Contact regarding plan Newsletters – Contact PR Department Heads – Contact regarding plan Hospital Website – Contact designer

PHASE II (4 months prior to training)

Posters – Display 30 Medical Staff Offices – Schedule physicians Newsletters – For staff and physicians Department Heads – Schedule staff Hospital Website – Links for staff and physicians

PHASE III (2 months prior to training)

Posters – Remain unchanged Medical Staff Offices – Remain unchanged Newsletters – For patients Department Heads – Remain unchanged Meet and Greet – Table for questions

Training/Education - Lynn

Training PlanPHYSICIANS (3 HOURS)-Scheduled through Medical Staff Office-Occurs over a 3 week period after clinic hours until 10 pm

CLINICAL STAFF / CLINIC SUPPORT STAFF (2 HOURS)-Scheduled through Department Heads-Occurs over a 4 week period during clinic hours with staff coverage provided

LAB / RADIOLOGY / PHARMACY (2 HOURS)-Scheduled through Department Heads-Occurs over a 2 week period during clinic hours with staff coverage provided

ADMINISTRATION (2 HOURS)-Scheduled through Department Heads-Occurs over a 3 week period after clinic hours until 10 pm

Training/Education - Lynn

EMR Functionality Training• Log into and out of patient system

• Open chart and locate encounter

• Locate table of contents

• View complete chart

• Locate problem list, medication list, flow sheets, doctor’s orders, lab and radiology results

• Communicate with lab, pharmacy, and radiology staff

• Locate progress notes

• Utilize charting tools including smart list, smart text and smart phrases

• View clinic schedules

• Review templates (department specific)

• Review roles and responsibilities (department specific)

• Practice scenarios

Recommendation _ Lisa

We’ve presented • Needs Assessment• Long-term Strategy • Financial Impact • Training and On-going Education

Our recommendation is:

Recommendation - Lisa

Eclipsys (Sunrise Clinical Manager)

• Based on overall weighted evaluation criteria – Interoperability– Ease of Use– On-going technical and customer support

• Consider applying for stimulus funds at a later date when ‘Meaningful Use’ has been better defined

Are there any questions?