EHR Vendor Adoption and Change: Considerations, Tools & Tips

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1 EHR Vendor Adoption and Change: Considerations, Tools & Tips Tabitha Mercado Client Systems Coordinator NYC REACH NYC Department of Health & Mental Hygiene April

2 PCIP was founded in 2005 as a bureau of DOHMH Mission Improve the quality of care in medically underserved areas through health information technology (HIT) Successes Nearly 16,000 providers joined PCIP and the Regional Extension Center (NYC REACH), including nearly 9,000 primary care providers. Access to data for over 3,000 providers at over 700 practices. 2

3 The Selection Process Define your needs and EHR Criteria Narrow your choices Actively Shop Compare and Evaluate Choose! 3

4 Determine Your Specific Practice Needs Analyze your current work flow Efficiencies/difficulties How can an EHR help you with practice management? Establish your EHR criteria Support from vendor Practice Management options Can they match your templates? Are you comfortable with their existing templates? Is this vendor popular in your specialty? For what reasons? Initial appointment setting Patient check-in at front desk MA/Nurse check-in Physician diagnosis of patient Orders 4

5 Assess Your EHR Needs Assess Your EHR Needs: Identify high-priority needs and EHR features that may meet those needs Identify what EHR features you will need to achieve meaningful use and practice goals Set EHR Goals: Follow the SMART goals process: specific, measurable, attainable, relevant, and time bound Make Key Decisions: List of potential deal-breakers decide whether you want your EHR data to reside in-office, a vendor server, or in web-based storage ( cloud storage ). Research vendor websites and speak to colleagues and/or your local Regional Extension Center.. Narrow the Field using the Certified HIT Product List: 5

6 Considerations for Specialists For specialists shopping for the right vendor, the following are some important factors to explore: Before implementing, make sure that the EHR you are considering has: o Appropriate templates you will need for your specialty o Testing functionalities that accommodate the specific tests you need to run Contact your professional society to locate resources they have for choosing the right vendor to fit your specialty type If you are a specialist and have additional questions, make sure to contact your professional organization or NYC REACH to get the answers you need before moving forward! 6

7 The Selection Process Define your needs and EHR Criteria Narrow your choices Actively Shop Compare and Evaluate Choose! 7

8 Considerations When Switching EHR Vendors Will my patients be migrated into my new EHR System? Do I have a data governance plan? What do I need to know about this new vendor I am considering? Does this new vendor offer data merge? How much and what is the expected timeline for completion? Will there be downtime? Is this new vendor Stage 2 Meaningful Use compliant? Will this EHR system help me with documentation and be able to improve for better care coordination? 8

9 ONC Certified EHR Technology (CEHRT) Office of the National Coordinator (ONC) certifies EHR systems for compliance with the Meaningful Use standards EHR vendors may have multiple products, or multiple versions of a single product When selecting an EHR vendor, providers can select from a wide range of prices, functions, customer support, hosting options, etc. There have now been two rounds of EHR Certifications You must have a 2014 Certified EHR 9

10 Criteria for Meaningful Use Stage 2 All EHR vendors publishing certified electronic health record technology (CEHRT) for Eligible Provider (EP) and Eligible Hospital (EH) use must conform to the 2014 Edition EHR Certification Criteria (45 CFR ) pdf All system versions of CEHRT in compliance with certification criteria is listed in the ONC s CHPL list: 10

11 Cost Considerations When choosing an EHR, it s important to consider the various costs associated with adoption. Be mindful of the costs that come with getting up and running on an EHR and maintaining your system! EHR Fees IT Costs (hourly vs. fixed fee) Other EHR license Data Hosting Implementation Training Maintenance and Support Data Migration Hardware & Office network IT support (Implementation) IT Support (Ongoing) Billing clearinghouse Interfaces (device, lab, imaging, HIE) Lost revenue during implementation/training Patient Portal Custom Reports 11

12 Data Management and Privacy Considerations Benefits: Patient data access & entry Templates Record consolidation Electronic prescriptions Lab interface connectivity Trending/targeting with reporting Patient follow-up & engagement Electronic claims Challenges: Privacy concerns Identity theft Data loss 12

13 Other Considerations Consider asking your vendor about: Disaster Preparedness what can they offer to keep you protected? Billing components are they ready for ICD-10? Interfaces with laboratories and registries? Are is system able to run special reports for ACOs, PQRS, HEDIS/QARR, PCMH, and others? Is the vendor PCMH pre-validated with NCQA? Are they ready for Meaningful Use Stage 2? Contract terminations and considerations: What if the vendor goes bankrupt? Can you get your data back? What if they no longer make updates? What if they ask you to make an upgrade that s too costly? What are the costs associated with data migration if you do decide to switch systems? 13

14 Divorce Clauses What happens if you decide not to upgrade? Will there be an additional cost of support? Are you willing to pay the current support fees? If you decide to part ways is there a cost for data migration? Will the EHR company purge all patient records? What happens if the EHR company goes out of business? Will the EHR you are leaving be willing to assist the new EHR company when switching? Will the EHR vendor transfer all the data? Demographic, clinical & financial data Get all the cost of parting ways in writing. Be firm in your questions! 14

15 The Selection Process Define your needs and EHR Criteria Narrow your choices Actively Shop Compare and Evaluate Choose! 15

16 Choosing the Right EHR System Balance Data Quality Data Access Data Literacy Data Content Analytic Prioritization Master Data Management 16

17 Good Workflow *HIMSS E-Learning Academy: Selecting your Electronic Health Record Module 1: Preparing for Your EHR 17

18 The Selection Process Define your needs and EHR Criteria Narrow your choices Actively Shop Compare and Evaluate Choose! 18

19 Narrowing Your Choices Certifications (ONC) Specialty-based Success with similar practices --- ask your colleagues! Practice size Patient volume Location Language 19

20 Compare and Evaluate Company Integrity Cost & Benefit Look & Feel Features & Functions 20

21 Tools & Resources from NYC REACH: Vendor Comparison Worksheet NYC reach offers a Vendor Comparison Worksheet to assist providers while they compare different vendors. Use the worksheet to keep track of EHR specifications and compare! 21

22 The Selection Process Define your needs and EHR Criteria Narrow your choices Actively Shop Compare and Evaluate Choose! 22

23 You ve Selected an EHR: What next? After you ve become an NYC REACH member and selected the EHR system right for your practice, our staff can work with you to make the necessary next steps: Implementation Support: Sharing best practices in IT infrastructure assessment, project management, workflow analysis, and vendor relations Clinical Quality Consulting: Coaching around EHR-enabled workflow redesign for key disease areas Assistance on clinical and administrative workflow redesign and optimization Meaningful Use Training and Support: In-person and online classes on Meaningful Use, billing best practices, privacy and security and patient engagement. Classes are both in-person and online Online members-only resource library with a variety of self-help tools Stay tuned for more information about additional quality improvement services from NYC REACH! 23

24 NYC REACH Member Resources Member Digests Tips on how to meet the measures Important changes and deadlines Upcoming classes and events Tailored for small and large practices Sent via , available in resource library Please contact us at if you are not receiving your Digest 24

25 Resource Library 25

26 Thank you! Questions? Interested in joining NYC REACH? NYC REACH New York City Department of Health & Mental Hygiene