The Best of Times & The Worst of Times

Founder Medical Strategic Planning, Inc

Art Gasch

Some prosper while many suffer – let’s make it successful for all

It’s a law, not a suggestion; but many MDs are crippled by fear and uncertainty

82% of practices and 92% of hospitals lack comprehensive EMR/EHR

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Crucial Decision(s) Physicians Now Face

1. When to sail into action?

2. How to navigate EMR adoption?

3. Continue to wait in port for the reform storm to weaken and pass by?

Once the storm passes, the waters will become more calm & saferOnce the storm passes, the waters will become more calm & safer!!

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Uncertainty & Market Slow Down Impact Smaller EMR Developers

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Those who can’t depend on other revenues are most affected

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It is not clear yet if EMR Failure rate will increase considering all this change.

~60% MDs Dissatisfied With Deployed EMRs – M. Anderson

Successful

20 – 30% of EMRs are actually abandon or decommissioned after deployment *

* a/c AMA News - 2009

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Tasks, checklists & assessments are organized by ‘role’

Some staff may have to 

assume more than one role

What can be done?

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Key Activities May be overlooked or abbreviated in accelerated deployment approaches

Copyright 2009 ‐

All Rights Reserved by MSP

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Typical EMR Planning Timeline (with Sected EMR Milestones)

The EMR or EMR/PMS or EMR/PMS/Portal Planning Process Has MORE steps (takes longer) if an in‐office EMR deployment is the objective!

All Detailed Tasks by Role are NOT shown above

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Areas of Concern What you need to consider

Loss of Internet Connection Can be a power failure, or I-Net provider failure, so your contingency plan must cover all of these.

EMR Responsiveness Internet can be slow, and add 1 (or more) seconds to menu responses.

Non-control of EMR upgrades In the ASP model, every client migrates to new versions at same time at the will of the EMR developer. Can create a training issue.

Workflow Customization Issues ASP apps may not be as user-customizable as in-office EMRs.

PMS Integration Challenges Can be more challenging to integrate Web-EMR with in-office PMS, or even impossible.

Browser IssuesWith 4 major brands, and several versions/brand, and numerous options, and different renderings of sites, browser management is not trivial to get and keep right.

Increased Security RisksEvery ASP user is ‘facing’ the I-net, and any user breach can compromise entire network. ASP EMR are also better targets for hackers than any individual office is.

Lack of Control of Backup Strategy and on-site access to patient files

How long does it take an ASP to restore backup if patient files are lost or breached, or ASP and EMR are two different organizations

Special Licensing considerations to be addressed

Some issues don’t exist with in-office deployments, but require special terms for web-based deployments.

User Interface Constraints Speech recognition is more challenging in I-net based EMRs. Many practices are used to transcription, and like speech recognition EMRs.

Issues With I-Net Based SaaS ASP EMRs

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A One-stop Portal for Diverse EHR Needs

www.ehrselector.comOffering Independent, Impartial:

• Lists of EMR Planning, Deployment & 

Security Consultants, Accountants, 

Lawyers, Chart Conversion/Scanning 

Services 

• EMR Educational Resources 

• Hardware Suppliers 

• Post‐Deployment System Support 

• EMR Product satisfaction scores (KLAS)

• EMR Selection Tracking, Tools & Reports 

for EMR Consultants/RECs

•

Ability to compare 687 features of key 

EMR products to your needs.

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2010 EHR Book Library

Learning Resource Category

Resource Supplier & Website Resource Name/Title Contact or Author &

WebsiteContact Email & Phone

Books

Wiley-Blackwell Customer Care 10475 Crosspoint Blvd Indianapolis, IN 46256

Successfully Choosing the Right EMR – 15 Crucial Decisions Released April 2010ISBN 978-1-4443-3214-8

Arthur Gasch & Betty Gasch, RN, BSN

877-762-2974 Voice 800-605-2665 FaxOr Amazon

Books MGMA Press or Amazon

Electronic Health Records, 2nd Edition, Transforming Your Medical PracticeReleased 2010ISBN 978-1-56829-343-1

Margret Amatayakul2313 W. Weathersfield Schaumburg, IL 60193

877-ASK MGMA

Books

AHIMA 233 N. Michigan Ave., Suite 2150 Chicago, IL 60601

How to Evaluate Electronic Health Record (EHR) Systems ~$129 - Released 2008

Patricia Trites and Dr. Reed Gelzer

312-233-1100 Rita Scichilone

Books Prentice Hall PTR EMR Complete: A Worktext, January, 2010 Daniel Limmer Amazon or Borders

Online

Books Elsevier Health Sciences

The Electronic Health Record for the Physician's OfficeReleased 2010ISBN 978-1-43770-0-282

Any DeVore Amazon or Borders Online

Just released (2010) books provide excellent introduction to EMR issues that transcend MU. They can prepare staff for college courses or may be all that is needed, depending on baseline EMR knowledge in clinical staff. Your Practice Readiness Assessment will show you.

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Medical Strategic Planning I Professional Information Transforming North American Healthcare Markets

Learn the basics – See Chapters 13, 15 and 16Successfully Choosing Your EMR: 15 Crucial Decisions

Fact: Most physicians have little awareness of security issues.

Fact: Many physician feel Internet based EMRs are more secure than in-office deployed systems.

Ch 1 Why Adopt Electronic Medical Records Now?

Ch 2 How EMR Will Enhance Your Practice

Ch 3 How EMR Will Impact Your CPM System

Ch 4 Structured Data and Report Generation

Ch 5 Interacting With Your EMR

Ch 6 Where to Deploy Your EMR

Ch 7 Vocabularies, Standards & Interoperability

Ch 8 Interoperability Beyond EMRs

Ch 9 Workflow Enhancement/EMR Customization

Ch 10 Documenting Your Office Workflow

Ch 11 Essential Medical Record Content

Ch 12 Evaluating Vendor Stability

Ch 13 Lawyer Proofing Your EMR

Ch 14 Configuration & Deployment

Ch 15 Crisis Planning and Mitigation

Ch 16 Protecting Your Patient Data

Ch 17 What You Can Expect to Spend

Ch 18 Negotiating the Agreement

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Medical Strategic Planning, Inc. Arthur Gasch – Founder, Board of Directors 5 Shelbern Dr. - Lincroft, NJ 07738 art.gasch@medsp.com Ph: 732-219-5090 Fax: 732-219-5066 Wm. F. Andrew – VP EHR Business Unit Online: http://www.medsp.com and bill@medsp.com http://www.ehrselector.com

Selected MSP EHR Partners/Associates:Carolyn Samuels, M.D. – Creator of EHR Selector, Managing Member CSMed, LLCRobt. Bruegel, Ph.D. – Associate for Andrew & Associates EHR BenchmarkDavid Ginsberg – Founder, Privaplan, Inc.

Selected EHR Cooperating Organizations:ACC – College of Cardiology AGA – Gastroenterological AssociationAHQA – Health Quality Association HIMSS – Hlth Info Mgmt & Sys. Society

MSP Contact Information