doq-it: ehr roadmap to success - provider's edge€¦ · doq-it: ehr roadmap to success tepr...

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DOQ-IT:EHR Roadmap to

Success

TEPR 2006

DOQ-IT DelmarvaDelmarva Foundation

May 21, 2006

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DOQ-IT Delmarva TeamMichael C. Tooke, MD, FACP Chief Medical OfficerBeth B. Franklin, RN, MS, CPEHR/CPHIT EHR Implementation AdvisorDonette Emory Branch, CPEHR/CPHIT Quality Improvement ConsultantTobi PrattEHR Implementation Advisor

Meskerem Abebe, RN, MSClinical Informatics Advisor

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Delmarva Foundation• National, not-for-profit organization• Mission: Improve Health• 30+ year history, 250 employees (associates), $30+ Million Revenue• Associates: Physicians, Nurses, Scientists, Analysts, Reviewers, Improvers• Quality Improvement Organization (QIO) for Maryland and DC• Customers: Centers for Medicare & Medicaid Services (CMS), State Medicaid Departments, Agency for Healthcare Research and Quality(AHRQ), Private Foundations, Private Firms• We Provide:

• Resources• Education• Training• Data Analysis

• Clinical Review• Best Practice Sharing• Collaborative Improvement• Leadership

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DF Team National ExperienceMedicaid External Quality ReviewMedicaid Quality AssuranceMedicare Quality Improvement OrganizationMaryland Patient Safety Center

Medicare Quality Improvement OrganizationMedicaid External Quality Review (Washington, DC)

Developmentally Disabled Statewide Quality Assurance Program

Medicaid External Quality Review

Program Safeguard ContractWestern Integrity States

Medicare+Choice Quality Assurance/Performance Improvement Project

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Delmarva FoundationMaryland PerformanceExcellence Award

Winner of the 2005 U.S. Senate Productivity Awardfor Maryland

Eligible for Baldrige Award pilot for non-profit organizations

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Quality Improvement Organizations (QIOs)National network of organizations in each U.S. state and territory under the direction of CMS.Enacted by federal statute “to improve the efficiency, effectiveness, economy, and quality of services delivered to Medicare beneficiaries.”Work with consumers, physicians, hospitals, and other caregivers to refine care delivery systemsEnsure patients get the right care at the right timeShare information about best practices with providers, to identify opportunities and provide assistance for improvement.

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CMS Quality Improvement Organizations

Non-governmentalAll 50 states & territoriesExisting commitment to work with

PhysiciansHospitalsLong term care facilitiesHome health agencies

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National Local Level

“The government’s 10-year strategy to have most Americans using electronic health records will fail unless small physician offices adopt technology…

…I can’t get to that goal without getting to the small physician practices.”

Dr. David Brailer, former National Coordinator, ONCHIT

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“DOQ-IT”

Doctor’s Office Quality-Information Technology:

A three-year project to accelerate the adoption of health information technology, in adult primary care physician offices.

A program of free technical assistance from Delmarva for adult primary care physicians committed to harnessing the power of electronic clinical information to improve patient care.

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Target physician groups

Adult primary care practicesFamily PracticeGeneral PracticeInternal MedicineIM/CardiologyIM/Endocrinology

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At Any Stage of HIT Adoption!

Without existing HITWith some modality

e-prescribinge-laboratoryMedical Registry

EMR in place, but would like assistanceTried, failed, would like to try again…

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Agenda for Workshop

3:15 pm – 3:25 pm Introduction3:25 pm - 5:00 pm EHR Roadmap Part I

* Adoption* Implementation

5:00 pm – 5:15 pm Break 5:15 pm – 6:00 pm EHR Roadmap Part II

* Implementation (continued)* Care Management

6:00 pm – 6:15 pm Questions

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PHR (Personal Health Record) - “contains medical information and it is owned by the patient.”1

EMR (Electronic Medical Record) - the electronic version of the health information about the patient owned by the healthcare organization. 2

EHR (Electronic Health Record) – ”is a longitudinal electronic record of patient health information produced by encounters in one or more care settings.”2

1 Hartley, CP, Jones III, ED EHR Implementation American Medical Association Press 20052 http://www.himss.org/ASP/topics_ehr.asp

EMR vs. EHR

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EHR Implementation Roadmap1. Assessment Practice readiness:

Physician(s), staff & office2. Planning Develop goals & barriers

Identify opportunitiesWorkflow redesign

3. Selection Understand and review available HIT/EHR options

4. Implementation Prepare staff and office for EHR. Go Live!

5. Evaluation Production of ECIImplement workflows

6. Improvements Practice evidence-based medicine. Patient safety.

CAREMANAGEMENT

IMPLEMENTATION

ADOPTION

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Assessment

What you want, what you need, what you can afford…

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EHR Implementation Roadmap

Adoption

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EHR Implementation Roadmap1. Assessment

ADOPTION

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When you think about implementing an EHR, what does “assessment”mean to you?

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Assessment

Assess the practice to:Identify opportunities to design and improve processes for patient careImprove workforce moraleIntegrate Health Information Technology (HIT)

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“Start where you areUse what you have

Do what you can…”

Arthur Ashe, Tennis Player, Wimbledon Winner

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Identify and Analyze Practice Needs

Know the practiceUnderstand the processesUnderstand the workflowIdentify the “pain points”Prioritize and focusPlan for changeManage change

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ASSESSING YOUR PRACTICE“The Green Book”

www.clinicalmicrosystem.org

http://www.clinicalmicrosystem.org/

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What is “The Green Book”?

A diagnostic tool that provides guided discovery of your patients, people, processes, and patterns. It helps you to start thinking about improvement…from the “inside-out.”

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Plan for

CHANGE!

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AssessmentIdentify a Physician ChampionDevelop an EHR Implementation Team to identify practice issues, (the team should be selected from key staff in each area of the practice.)How often does everyone get together?

HuddlesStaff meetings

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Assessment

Workflow assessment“Walk through”Identify pain points and bottlenecks

Begin mapping: Current processesIdealistic processesWhere do the two intersect

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Assessment

Assign an individual or team leader to lead practice changes (this may be the physician)For a successful implementation:

Plan regular communication with staff Staff must be committed to adoption of EHRChoose workflow changes to maximize results

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Physician(s), staff & officeADOPTION

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PlanningFailing to plan is planning to fail!

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Physician(s), staff & office2. PlanningADOPTION

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How does a practice plan for an

EHR implementation?

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Planning

Identify goals, priorities and barriers Identify high priority needs, features and functions of EHR from staff perspectiveDefine a project scopeCommunicate to staff the anticipated change

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Planning

Identify project goalsWhat are you doingWhen do you want to do itWhat is your budget

Long term objectives of the practiceWhat do you need nowWhat do you need in 5 years based on your projected growth

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Identify Project Scope

Putting a fence around what you want to accomplish

Identify goals and objectivesProduct functionalityResources availableTime defined

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Establishing ScopeWithin the scope:

Identify and prioritize components that are critical to project success

• Budget• Physical environment• Hardware requirements• Software requirements• Human resources• Budget

Set realistic timeline for attaining goals

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Establishing ScopeInvolve practice leader(s) with:

Requirements identification Project scope managementFeature functionality

Involvement ensures:QualityTimelinessSuccess

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Planning

Understand the implications of different rollout approaches:

Big BangIncremental

Do I need an “RFP” (Request for Proposal)?

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Planning

Scanning Patient ChartsProcess of making an electronic image of a documentScanned documents may or may not be searchableIs scanning the right option for your practice?

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Planning

To scan or not to scan?What scanning capabilities do vendors provide?Identify key information and documents that will need to be in the systemHow much of the chart do you want to scan?

The whole chart?The last three visits?Only pertinent data?

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PlanningDiscuss a plan for entering existing chart documents into the system

When will data be entered How will existing documents be enteredHow will new information be entered

How much will you scan going forward?ReportsOther documents

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Planning

Other planning needs:Change management with staffNotifying patients and other parties about your move to EHR

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Financial Planning

Do I need to complete:A cost/benefit analysis

Return on Investment (ROI) for an EHR system

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Classifying the Benefits“Hard” benefits

Predictable, reliable decrease in costs or increase in revenue

“Stretch” benefitsFinancial in character, but variable in quantityVaries based on effectiveness in using IT tools

“Soft” benefitsNon-financial

• Improved quality of care• Patient safety• Higher staff satisfaction

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Hard Dollar BenefitsCapture lost charges IF charges are now

being lost1% - 5% revenue gain

Reduce ‘defensive downcoding’

IF downcoding is prevalent

5% - 11% revenue gain

Reduce claims denials & delays

IF denials or delays are common

15 – 30 day A/R speedup

Increase preventive and management

services

IF new services are profitable AND capacity

exists

5% revenue gain

Reduce transcription IF dictating AND willing to change

$5K - $15K/yr costs cut

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Stretch BenefitsIncrease physician

productivityIF physicians have extra capacity AND get ‘faster’

with EMR

0% - 15% revenue gain

Staff efficiency IF overtime being paid, or IF staff ratio can be

reduced

0% - 15% cost reduction

Reduced chart pulls IF practice charged for pulls

$5/pull or $6K/yr/MD

Reduce cost of paper chart materials

IF office goes “paperless”

$1-5/patient or$1k/yr/MD

Reduce costs of chart storage and archiving

IF office goes paperless and chart room

eliminated

$1k/yr per physician

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Approximate costs per physician in a 2 physician family practice office

Assumes preexisting PMIS, but no preexisting computers at point-of-care

Year 1:<$20k> cash deficit

Cumulative ROI <$20k>

Relative CashFlows

Project Mgmt $5k

Training $5k

Software $7.5k

Hardware $7.5k

Revenue gain fromright coding $5k (50% of expected)

H/W, S/W Support$3k

Revenue gain from right coding $10k

Year 2:$12k cash benefit

Cumulative ROI <$8k>

H/W, S/W Support$3k

Revenue gain from right coding $10k

Year 3:$17k cash benefit

Cumulative ROI $6k

Cost saving from transcription reduction $10kCost saving from transcription

reduction $5k (50% of expected)

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ADOPTION

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Selecting an EHR

Wading through the possibilities…

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IMPLEMENTATION

ADOPTION

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3. SelectionIMPLEMENTATION

ADOPTION

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How do you know if an EHR system is right for you?

How do you go about selecting a new car?

Research, Evaluate, Test Drive!

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Requirements

Do you need a new billing system (PMS)?Does your PMS support an interface to an EHR?Do you want a single vendor solution or an interface?Do you want a server on site or a vendor to host it remotely?

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Integrated Solution - ‘Best of Fit’

Single databaseInformation real-timeSimilar “look and feel’Reports less complicated to writeSingle support sourceNo “finger-pointing”

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Interfaced Solution - ‘Best of Breed’

Multiple databasesAdditional hardware and softwareInformation delivery delayAdditional maintenanceGreater complexity and costsComplicated support structure

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EHR Hosting ModelsApplication Service Provider (ASP)

Data & servers located off-site by third-partyCommunication across InternetSystem administration and maintenance managed remotelyLower initial costsOwnership and maintenance is spread over timeWho controls data?

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EHR Hosting Models

Locally Hosted ApplicationData and servers located in practiceCommunication across local networkSystem administration & maintenance managed locallyHigher initial cost of ownershipControl of data

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EHR Hosting Models

Web-basedUtilizes web browser to access patient dataNo installation of software on PC requiredNo ongoing management of PC requiredSystem updates easy to manageWho controls data?

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EHR Hosting Models

Client-ServerUtilizes specific softwareRequires installation/configuration of software on PCRequires ongoing management of PCSystem updates difficult to manage Potential conflict with existing software

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InteroperabilityWhat do you want to connect to?

LaboratoriesLocal hospitalPhysician Offices/ClinicsPharmaciesMedical devices

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Documentation Options

Understand the implications of your options:TemplatesFree TextVoice RecognitionDictation

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What will provide value?

Value does not necessarily equal ROIFocus on things physicians do 95% of timeWhat are staff needs?

EmailInstant messagingPatient education toolsForms

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Don’t Forget About…

HIPAAAuthentication & authorizationRole-based securityAudit trailsElectronic signature

Documented policies and procedures

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Full Featured vs Good Enough SystemsFull Featured

More customizable and flexibleMore moving partsBetter modeling of practice’s workflowsImplementation more complex and longerMore training required

Good Enough Less ability to accommodate workflowsImplementation less complex and shorterEasier to get going and maintain

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End User HardwarePhysician work habits

How and when do physicians do their work?Patient-physician interactionMobility needs (home, house calls, etc)Comfort level with technology

Practice infrastructureDesktop space in exam roomsSpace in staff workstationsNeed to re-wire practice

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End User Hardware OptionsDesktop PCs

Powerful & inexpensiveFull use of EHR

LaptopsPowerful & relative inexpensiveFull use of EHRFairly mobile, but short battery lifeErgonomics of physician-patient interaction

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End User Hardware OptionsTablet PC

Slate vs. convertibleLarge screen displayRequires different work styleExpensiveExtremely mobile but short battery life

PDAsExtremely mobile but short battery lifeLimited screen = limited use

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End User Hardware Options

Document ScannersHigh vs. low throughput (PPM)ResolutionType depends upon needs• What are you scanning• Who is scanning

‘Paperless’ vs. ‘chartless’

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Database Server

Buy Best Server You Can AffordExpandability – 5 year plan• Processor• Memory• Disk space

Back-up – what can go wrong• Redundancy• Failover server• Routine system back-up

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EHR Selection ToolsWeb-based Tools

EMR Update – www.emrupdate.com (free)EMR Institute – www.emrinstitute.com (free)HIMSS Ambulatory EMR Selector –www.ehrselector.com ($49/$149)EMR Consultant – www.emrconsultant.com (free)ELMR.com – www.elmr-electroninc-medical-records-emr.com (free)

http://www.emrupdate.com/

http://www.emrinstitute.com/

http://www.ehrselector.com/

http://www.emrconsultant.com/

http://www.elmr-electroninc-medical-records-emr.com/



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EMR Selector (EMR Consultant)

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EMR Selector (EMR Consultant)

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EHR Vendor Reports

AC Group Annual Reportwww.acgroup.org

KLAS Reportwww.healthcomputing.com

Family Practice Management Vendor Surveywww.aafp.org/fpm/20010100/45elec.html

http://www.acgroup.org/

http://www.healthcomputing.com/

http://www.aafp.org/fpm/20010100/45elec.html

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Other Sources of InformationDiscussion Forums

EMR Update, AAFP

Vendor Fairs and ExhibitsTEPR EMR Road ShowAAFP Intelligent Medical PracticeDOQ-IT Vendor Fairs

ReportsAC Group, KLAS

Peers

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Request for Proposal (RFP)General Format

Proposed solutions to problemsImplementation processTrainingSupportCosts

• Hardware and software• Implementation and training• Interfaces• Support

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Request for Proposal

RecommendationsFocus on practice’s needs and requirements Ask vendor to tell “HOW” system will address practice’s problems, not “IF”Ask specific, focused questions – not broad, open-ended questions

• Vendors will usually say they can do it – you need to probe and see it for yourself.

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Remember yourDUE DILIGENCE

of the vendor you select

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Evaluating EHR System OptionsProduct Demonstrations

Use patient visit-based scenarios the practice defines

• Multiple chronic conditions• Different diagnostic/treatment needs• Utilize actual patient cases

Develop work flow scenarios based on your practice• Referrals• Prescription refills

Ask data questions• Patients taking certain meds• Diabetic population• Elderly population

Make it your demo not the vendors demo!

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Options for Evaluating EHR System

Product DemonstrationsEvaluate functionality vs. ease of useDrive product – don’t be drivenMake vendor show youValidate vendor’s RFP responseInvolve practice staff

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Vendor Evaluation Matrix

Functionality/Usability Priority Vendor A Vendor B

Charting

Can the system accommodate (and potentially improve) my workflow?

Can I easily build and/or customize “off-the-shelf” templates?

Does the system offer a variety of data entry options, e.g., dictation, voice recognition, structured notes, etc.?

Can I make subsequent edits and addendums to clinical documentation?

Does the system alert me about unfinished portions of the clinical documentation and can I bypass it if necessary?

Can I access other such clinical information as previous labs, progress notes, etc. from a patient’s “electronic chart” while charting?

Does the system allow me to multi-task, e.g., create task, order lab, etc. while charting?

Does the system allow me to forward patient information to staff, other physicians, etc. via e-mail, electronic faxing, messaging, etc.?

Does the system ensure that only authorized clinicians can sign clinical documentation?

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Evaluating EHR System OptionsSite Visits

Vendor recommends site Visit practice with similar profile

• Size and specialty• Problems and goals• Geographic area

Conduct structured visit• Overall goals• Questions to ask• Things to observe

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Evaluating EHR System Options

Site VisitsInvolve practice staffSpend as much time as possible watching system in use Understand references’ incentives

• Discounts• Freebies

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Contract Considerations

What If:Need to get out of contract

• Bi-lateral termination clauseVendor goes out of business

• Data ownership• Source code escrow

Vendor merges or is acquired

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Contract Considerations

What If:Things don’t work …

• Performance warrantiesThings go wrong

• Resolution process• Breach of contract• Exit points and strategies

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Contract ConsiderationsScope of License

Total vs. concurrent usersTerm vs. perpetualTransfer of licensesAdditional licenses

Bold-typed ClausesWarrantyDisclaimerIndemnificationLimitation of liability

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What to Include in the Contract

Milestone-based Payment ScheduleIncentive for successful completionLeverage for practice

Example15% - Signing of contract10% - Installation of software and hardware20% - Completion of training25% - Completion of system testing30%- Final system acceptance

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Key Points to EnsurePreliminary Project Plan

Timing and scopeResource allocation

Acceptance TestingUnit (individual modules)Integration (inter-functionality of modules)Interface (functionality between systems)Stress testingLiveFinal (30 – 60 days post go-live)

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Key Points to EnsureCompliance with HIPAA

Transaction standardsSecurityConfidentiality (Business Assoc. Agreement)

Compliance with CHI StandardsOwnership of Data

Non-proprietary, readable format, e.g., XMLData can be converted to another system

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Key Points to UnderstandMinimum Hardware Specs

Practice’s Responsibilities

Ways vendor can terminate agreement and make contingency plans

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What’s included in your contract?Implementation & Training

What are costs?What resources are provided?How many hours included?What else is included?

• Project plan• Training and user documentation• Implementation guides

Who covers expenses, e.g., travel?What if more assistance is needed?Cost for customizations?

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What’s included in your contract?Interfaces

What interfaces will be provided?What are costs for each?What is included, e.g., specifications, development hours, etc.?What if additional hours needed?Who pays for modifications?Who will troubleshoot when it goes down or there are errors?Who is responsible for upgrades?

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What’s included in your contract?Support Agreement

Level of support provided• Normal hours• Response time• Services includedCost for additional or increased support• After hours, weekends, and holidays• Increased response time• Local or onsite assistanceWho is responsible for upgrades, patches, etc.?

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What’s included your contract?

Third Party Software/ContentAdditional costsAdditional licenses requiredResponsibilities for support and upgradesRestrictions on use

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http://ehr.medigent.com/assets/collaborate/2005/11/04/EHI-EHR-Master-Quote-Guide.doc

http://ehr.medigent.com/assets/collaborate/

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Final thoughts on contracts

Does what you are purchasing meet your requirements?Have you done your due diligence on the vendor?Have your contract reviewed by your legal council

If they are not familiar with EHR vendor contracts find someone who is

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3. Selection Understand and review available HIT/EHR optionsIMPLEMENTATION

ADOPTION

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Questions?

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Break time…back in 10 minutes!

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ImplementationYou have signed a contract, now

what do you do?

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Physician(s), staff & office

2. Planning Develop goals & barriers Identify opportunitiesWorkflow redesign


4. Implementation

IMPLEMENTATION

ADOPTION

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What needs to be done to get the system up and running…

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Incremental ApproachReduces “shock” to staff and physiciansSpreads out costs of software and implementation over longer periodProject less likely to ‘blow up’Total training, implementation costs may be higherROI is not achieved as quicklyMore of a risk getting ‘stuck’ at midpoint

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“Big Bang” ApproachShortens painful “parallel paper/EMR” operation periodAchieves ROI more quicklyLess likely to get “stuck” part way to the goalHigher risk of ‘blow up’Significant productivity hit at go-live and some time afterwardStaff or physicians unable to cope with change may rebel

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Critical Success FactorsExecutive Support/SponsorshipPhysician and End-user InvolvementProject Scope and Project PlanCommunicationStaff TrainingTesting

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Implementation

PreparationWorkflow changesPaper to electronicPolicies and proceduresScenario testingDevice testing

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Project Management Components & Tools

Project Scope and PlanRoles and Responsibilities MatrixAction Items and Risk TrackingCommunications ProcessMeasure Satisfaction/Quality

Sign-Off Milestones

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Project Kick-off

CommunicationsTeam BuildingStrategy for successSet expectationsValidate practice readiness

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Fitting the System to the Practice

Workflow reviewTemplate buildingAlertsInterface specificationsReportsChange management

Current vs. new workflow transition

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Fitting the System to the PracticeHardware InstallationSystem Configuration• Data Dictionaries• Templates• Workflow• Reports

Interfaces Developed

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Fitting the System to the PracticePolicies and Procedures

Backup and DowntimeSupport and MaintenanceSecurity

Test Infrastructure ConnectivityNetworkDatabase

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Fitting the System to the PracticeTest Interface(s)

PMSResultsOrderse-Prescribe

Test Workflow Changes

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Training the Practice on the SystemMake Training Mandatory for all Staff Members

Administrative UsersPhysician End UsersSystem Support Users

Devote sufficient time to trainingDevelop super-users Do not overload staff during training

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Training the Practice on the System

Training Agenda ItemsDay-to-Day Workflow ChangesAdministration and Clinical SetupGo Live Planning

Create training documentation

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Go-LiveRollout the system to site(s)Shadow staff operationsDebrief, trouble-shoot, and fine tuneMaintain an ongoing issues list

System/software issuesInternal issuesWorkflow issuesGo-live and Post go-live

Celebrate success and make it fun!Have snacks to celebrate the go-live

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Post Go-Live Transition to support Implementation evaluation

Lessons learnedAdd new features/functions

If incremental approach taken

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IMPLEMENTATION

ADOPTION

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EvaluationOr, now that you are live…

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CARE MANAGEMENT

IMPLEMENTATION

ADOPTION

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5. EvaluationCare Management

IMPLEMENTATION

ADOPTION

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Now that the EHR is live:Is it meeting the goals you set

during your assessment and planning phases?

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Evaluation

Conduct post-live review of:Practice goals being metTraining needsWorkflowData captureReports

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Evaluation

An ongoing process Conduct post-live evaluation at determined intervals

DailyWeeklyMonthlyQuarterly

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EvaluationDid the practice meet their goals with installing EHR?

Not all goals will be met at liveWho needs additional training?

Assess staff daily/weekly during initial live period to determine need for additional trainingAre providers charting correctly?

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Evaluation

Are your new processes working?TweakTrashTry again!

Is you staff adopting to the changes?

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EvaluationHow do you notify the staff that the patient is ready to be seen? Are the ALERTS appropriate?What about:

Referrals?Prescriptions?Reports from outside sources

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Are you collecting the data you want?Does the system allow you to capture and report on the clinical data you want?

Assessment data• Vital signs• Tests performed• Pertinent history

Preventive data• Immunizations• Mammograms

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Workflow ChangesAre your charges being captured correctly?

Daily review of charges to ensure they are being captured for 30-60 days post live

Are the reports telling you what you need to know?Now what happens to the paper chart?

How long do you keep it before sending to storage? What do I do with all the paper reports that come in to the office?

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Scanning Patient Charts

Did what you scanned meet your needs:The whole chart?The last three visits?Only pertinent data?

How much will you scan going forward? ReportsOther documents

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5. Evaluation Production of ECIImplement workflowsCare Management

IMPLEMENTATION

ADOPTION

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IMPROVEMENT

The use of electronic clinical information…

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6. Improvement

Care Management

IMPLEMENTATION

ADOPTION

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Now that you are live…what to do with the data?

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Video

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Care ManagementA process which:

AssessesPlansImplementsCoordinatesMonitors, and Evaluates the options and services to meet

the health needs of an individual or a population of patients.

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Your Practice can now…

Track patient follow-up activities, patient compliance and patient progressTrack patient health maintenanceSupport patient self managementIncrease patient education with online disease management toolImprove continuity of care and timeliness of diagnoses and treatment

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Using Electronic Clinical Information (ECI)

A successful DOQ-IT practice must be able to do all of the following:

Generate medication listsGenerate problem listsEnter laboratory tests and retrieve resultsSelect medications, print them out or transmit them to a pharmacy, and conduct safety checks

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Using Electronic Clinical Information (ECI)A successful DOQ-IT practice must be able to do

all of the following:Identify specific patients by disease Produce reminders or promptsDevelop patient-specific care plans

In at least two of the following clinical areas:DiabetesHypertensionCoronary Artery DiseaseCongestive Heart FailurePreventive Services

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Individual Patient Care Management

Improve the availability, timeliness, and accuracy of communication among health care providers Point-of-care decision support Rapid and remote access to patient information Easier chronic disease management Integration of evidence-based clinical guidelines

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Population Management

Target specific patients with special care needs (immunization, treatments, tests)Aggregate data on all patients to look of overdue interventionsStratified patients by risk or conditionsObtain population reports and profilesProvide feedback to healthcare providers

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Population ManagementSegment the patient population to administer tailored educational interventionsUse simple statistics to characterize the practice needs and patients demands

(Note: make sure that the EHR system that you are buying has population management functionality. Not all EHR systems have these features)

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6. Improvement Practice evidence-based medicine. Patient safety.

CAREMANAGEMENT

IMPLEMENTATION

ADOPTION

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Acknowledgements

Centers for Medicare and Medicaid ServicesLumetra, QIO for CaliforniaNew Mexico Medical Review AssociationeHealth InitiativeVistA Office

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Suggested Readings/ReferencesHartley Carolyn P., Jones, Edward D.,III EHR Implementation: A Step-by-Step Guide for the Medical Practice. AMA Press, 2005Houck, Suzanne What Works: Effective Tools & Case Studies to Improve Clinical Office Practice. HealthPress Publishing, 2004Kilo, Charles M, MD, MPH, Leavitt, Mark, MD, PhD, FHIMSS Medical Practice Transformation with Information Technology. HIMSS, 2005Wasson, John, MD, Benjamin, Regina, MD, MBA How’s Your Health? FXN Corporation, 2005.

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Questions?

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Contact Information:

[email protected]

Delmarva Foundation

mailto:[email protected]

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