PTSO of Washington

Comprehensive Information Technology Services Helping Community Health Enhance Patient Outcomes

Roy O. La CroixChief Executive Officer

Date

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PTSO Client Overview

• Eight practices in Washington State

• 37 clinics

• 330 providers + 200 case workers and enabling providers

• 200,000 patients

• 550,000 annual encounters

• 1,200 online users (850 concurrent)

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• Application Service Provider (ASP) model

• PTSO hosts and provisions the NextGen (EPM/EHR) and QSI (EDR) applications, numerous interfaces, Patient Portal (2011), and HIE (2012)

• Additionally, PTSO also provides the following: Help desk Meaningful use readiness Integration services Custom template development Data center operations

Reporting services Claims processing Project management office (PMO) EDI services

PTSO Services Overview

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Our Comprehensive Approach

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PracticeManagement

(EPM)

ElectronicHealth Record

(EHR)

EDI & ClaimsData CenterHelp Desk

Application

Operations

Disaster Recovery

PTSO enables its members to focus on their mission, not technologyAll our services are delivered via hosted ASP and distributed support models

Electronic DentalRecord(EDR)

Patient Portal Health InformationExchange ( Q2 2012)

InterfacesLabs, registries, etc.

Integration

Training (Q2 2012)

ProgramManagementOffice (PMO)

Program Management

Other Services

Consulting

PTSO Services

Meaningful Use

PCMH(Q2 2012)

Reporting

Client IT &Infrastructure

Services

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PTSO Board

Enterprise Committee

EPM Committee EHR Committee

EPM CommitteeChair: Member CHC Executive Leader

• Member-led.• Establish EPM priorities.• Coordinate policies and projects.• Share knowledge.• Problem-solving.

EHR CommitteeChair: Member CHC Executive Leader

• Member-led.• Establish EHR / clinical priorities.• Coordinate policies and projects.• Templates / workflow oversight.• Clinical process improvement.

Enterprise CommitteeCharter: Establish PTSO priorities

• Committee is led by members.

• Chair & Vice Chair lead committee.

• Chair & Vice Chair report jointly to Board.

• Each member CHC has equal voice.

Board of DirectorsCharter: Governing authority for PTSO of Washington

• The Board of Directors (BOD) is comprised of the ED / CEO of each Founding Member. The BOD serves as the governing authority for the organization.

• The CEO is accountable to the BOD and has authority for the daily operations of the organization.

Governance: Our Users Drive the Bus

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Practice management (EPM)

• Integration• In-depth services• Connectivity• Time savings• Extensive experience

Electronic health record (EHR)

• Extensive EHR experience• Complete EHR support and services• Fully integrated EHR• Shortened EHR implementation process• Enhanced productivity• Straightforward and predictable EHR

implementation

Electronic dental record (EDR)

• Integrated EDR (QSI – NextGen)

• Customized for CHCs• Full EDR support and services

Application Services

Application Services

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In-depth services

• System migration• 24 x 7 help desk• Full application support• UDS, billing, and claims

expertise• Electronic statements• Create / Add new payers• Sliding fee scale• Managed care contracts

Integration

• Comprehensive integration of EPM, EHR, and EDR

• Charge capture from EHR

Extensive experience

• Staff with over 60 years of EPM implementation and support experience

• PTSO provides established and proven workflows and best practices

Connectivity

• Direct connections with major payers Medicare A/B State Medicaid (dental / medical) Premera CHP QSI (dental)

Clinic time savings

• PTSO executes most updates

Contracts Fee schedule ICD9s CPT ADA codes

Application Services - EPM

Practice Management(EPM)

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Extensive EHR experience

• PTSO staff have over 45 years of EHR implementation and support experience

• PTSO provides established and proven workflows and best practices

Our experience will

• Shorten the EHR implementation process• Limit reduced productivity• Ensure a straightforward and predictable EHR

implementationFully integrated EHR

• Customized for clinic workflow

• Interface development• Standardized

Templates Documents Data elements

• PTSO customizations Lab module Health maintenance Disease management OB

Complete EHR support & services

• 24 x 7 help desk• Template development• Full application support• KBM and application upgrades• Full training environments• In-depth development and test

environments

Application Services - EHR

Electronic Health Record (EHR)

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Integrated EDR: QSI – NextGen

• Interfaced with NextGen for scheduling (demographics), charges, and billing

• Interfaced dental X-ray machines• Integrated UDS reporting

Full EDR support & services

• 24 x 7 help desk• Full application support• Training environments• Development and test

environments

Customized for clients

• Customized palettes• Paperless practices• 14 dental practice locations• 81 operatories• 133 dentists, assistants, and

hygienists

Application Services - EDR

Electronic DentalRecord (EDR)

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Disaster recovery

• Dedicated back-up and disaster recovery site• Off-site disaster recovery location• Complete disaster recovery support and

services• Disaster recovery preparation• Recovery objectives

Help desk

• In-depth support and problem resolution• Available 24 / 7• Electronic data interchange (EDI) and

claims

Data center, systems & network management

• Robust, state-of-the-art data center • Applications and systems hosting• Secure platforms• Active management and monitoring of applications and

systems

Operations & HostingServices

Operations & Hosting Services

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Key benefits

• Fast implementation leveraging CHC’s existing resources

• Expandable system working with virtually any data• Excellent service delivered on SaaS platform • Patient data fully secure behind CHC’s firewall• Improved work efficiencies and increased productivity• Enhanced quality measures and delivery of patient

care• Significant cost reduction• Affordability and fast ROI

Online reporting and dashboarding capabilities

• Intuitive self-service interface for any member of staff• Fast and flexible production of custom reports and

dashboards• Available for most major clinical and quality reports (ER, OR,

ICU, CAD, medical homes, meaningful use, and diabetes)

Report Services

Report Services

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Interface development and support

• Live interfaces for lab, immunization registry, pharmacy, and EDR systems

• Patient portal (2011)• Health information exchange (2012) • New interface development• 24 x 7 help desk• Interface and database experts on staff• Data conversion and integration services

Our experience will

• Shorten the interface implementation process

• Ensure a straightforward and predictable interface implementation

Enterprise-level interface engine• Provides flexible data translation among multiple rigid partner

systems• Saves money and maintenance by consolidating similar interfaces

Integration Services

Integration Services

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PMO guidelines

• Great companies first build a culture of discipline (disciplined people who engage in disciplined thought and take disciplined action – Good to Great by Jim Collins )

• Rigor, discipline, and structure lead to successful project outcomes

A six-phase process

• Planning• Design• Development• Testing /

Acceptance• Deploy• Close / Lessons

PMO goals

• Implement consistent, formalized project management

• Emphasis on consistency and uniformity in projects • Facilitate improved use of resources • Finish projects on time and budget

Program ManagementOffice (PMO)

PMO Services

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EDI Services

EDIServices

Claims submission

• Daily claims processing execution• Set-up, communication, and testing of claims with all trading partners on behalf of

clients• Building, scrubbing, and transmitting of files on behalf of clients• Acknowledgement (997) and Claims Status (277) retrieval and posting

EDI administration• Creation and publishing of weekly and monthly EDI activity reports• Retrieval and posting of files with address changes• Retrieval and return of files with invalid address information to

clients• Negotiation of very low fee with vendors

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Scope

• Client support – GAP assessment and remediation, new hire training, train the trainer, NextGen user competency

• Training effectiveness• Best practice use of NG applications

Training goals

• Optimized use of NextGen • Standardized and consistent approach• Improved use of resources • Enhanced provider and user

satisfaction

Training guidelines

• Great companies first build a culture of discipline (disciplined people who engage in disciplined thought and take disciplined action – Good to Great by Jim Collins )

• Consistent and disciplined training leads to more effective and efficient use of NextGen

Training Services

Training Services

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Off-site disaster recovery location

• Geographically located away from production data center

• Redundant hardware configured and available• Data replicated from production site

Disaster recovery preparation• Regular DR drills to verify

functionality

Complete DR support & services• 24 x 7 help desk• Work with partners to provide staff at time of

disaster

Recovery objectives• 4-hour recovery point objective (RPO)• 24-hour recovery point objective (RTO)• Continually looking for methods to improve all

objectives

Disaster Recovery Services

Disaster Recovery

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Reduce time sponges through technology

• IMO: English Diagnosis• Online eligibility• Integrate EDR with NextGen and dental X-ray• Charge posting• Automate business office processes• Patient Portal• Enterprise reporting (UDS)

Meaningful use (MU) readiness

• Potential $ impact: $44,000 – 64,000• Solutions

Implement MU-compliant NextGen Fall-back solution Workflow modifications

Improved use of NextGen

• Client support – fix high-return, low-cost items• Workflow management and system tricks• Influence NextGen

Optimize Operating Margin

Targeted Areas

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Why Use Change Management?

Current Plan

Performance Matches Plan

PerceptionTrust in PTSO

Customer Satisfaction

Manage Expectations

SuccessLast

ExperienceEqual or Exceed

Expectations

Consistent Plan Performance

Circle of Trust

END (Today – Where we are)

BEGINNING(Future – Where we will be)

Change adoption occurs here.Success is managed here.

Risk is managed here.

Transition

Change Model

What principles guide PTSO change management? • Manage expectations• Be disciplined

Great companies first build a culture of discipline – disciplined people who engage in disciplined thought and take disciplined action (Good to Great, Jim Collins )

Where we apply discipline• Strategy – What (projects) should be done

Annual process, customer-driven Project roadmap• Approach – How (projects) should be done• Execution – Do the work (project roll-out)

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• PTSO employs the Information Technology Infrastructure Library (ITIL) to deliver and manage its services in a predictable and reliable manner.

• ITIL is a comprehensive best-practice documentation for IT service management.

PTSO ITIL Best Practice Services

Making Health IT Predictable

Service Delivery PMO & SDLCService Support

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ITIL-compliant disciplines• Services levels• System availability• Financial rigor• Capacity planning• IT service continuity

Other disciplines• Reporting

UDS Quality measures Enterprise reports

• Training – EPM, EHR, EDR• Conversions & interfaces lab, Rx, medical instruments

ITIL-compliant disciplines• Change management• Incident management• Release management• Configuration management• Problem management

Other disciplines• Capability maturity

management (CMM)

Enterprise disciplines• EPM implementations• EHR implementations• EDR implementations• Project management office

(PMO)• Software development• Project roadmaps• Workflow & process

improvement• Business case analysis

Our Health IT Best Practices

Service Delivery

Service Support

PMO &SDLC

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“By providing us with comprehensive, integrated electronic health and dental

record support, PTSO of Washington has been an essential partner in our success.”

“PTSO gives us access to the IT professionals we need to implement and maintain

integrated technology systems at a fraction of the cost of trying to hire them ourselves.”

“PTSO provides us with complete peace of mind. We know that our electronic medical and dental records are online

and always up to date.”

“PTSO’s reporting solutions have enabled us to achieve meaningful use

status early.”

“By partnering with PTSO, FHC is able to take advantage of group

purchasing discounts that small rural clinics can only dream about.”

“When our Medicaid agency changed from MMIS to Provider One, PTSO transferred all new patient

ID numbers into our practice management system, saving us thousands of dollars.”

“Participating in PTSO’s CHC-controlled network has

maximized our ability to be efficient with technology.”

“Thanks to PTSO, we are much closer to achieving meaningful use core measures than we would had we

been working on our own.”

“PTSO’s technical guidance allows our providers to focus on the quality

outcomes of the process, rather than the process itself.”

What Our Clients Say About Us …

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For additional information, please contact:

Roy La CroixCEO

PTSO of Washingtonrlacroix@ptsowa.org

206.613.8876

Thank You

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