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1 Intercounty Health Facilities Association Managed Care in a New York Minute November 13, 2014 What s Next with Electronic Medical Records Presented by: Veronica M. Bencivenga, CPA Director HMM Consulting. Office: (631) vbencivenga@horanmm.com Today s Agenda Medicaid Redesign: Managed Care Data flowing out of your SNF RIGHT NOW EMR 1.0 vs. EMR Truths about EMR Managing Expectations 2 HMM Consulting 1
2 Medicaid Redesign: Managed Care 3 Numerous Major Initiatives 4 HMM Consulting 2
3 Healthcare System Changes Alignment Payment Care Delivery Patient Engagement More Integrated Care Value Not Volume More Risk and Responsibility Patient Centered Care Reward Quality Support Collaboration 5 Environment today Medicaid Managed Care MLTC, FIDA, DISCO, HARP DSRIP Quality Pools (NHQI) Recovery Audits (RAC, ZPIC, OMIG) Payment Reform Patient Centered Care Coordination Transitions in Care Continuity of Care Document (CCD) Care Delivery Performance Monitoring Data Analytics (Pepper) Predictive Modeling CDSS Technological Enhancements 6 HMM Consulting 3
4 Coming Soon DSRIP 25% reduction in avoidable hospitalizations INTERACT Project #2.v.bii E-Prescribing Mandatory March 27, 2015 All prescriptions, including controlled substances Interface 7 Health Information Exchange Immunizations Source: 8 HMM Consulting 4
5 Data flowing out of your SNF RIGHT NOW 9 Data Collection Initiatives Claims Clearing House MDS 3.0 CPOE Is this It? Labs emedny Immunizations 10 HMM Consulting 5
6 Data Collection Initiatives A&I Reporting Pepper HIE efinds Immunizations CPOE RHCF MDS 3.0 Meaningful Use Claims Clearing House 5 Star Rating QAPI emar Therapy emedny NHQI CQM 11 EMR 1.0 vs. EMR HMM Consulting 6
7 EMR 1.0 Census, MDS, Careplans, Therapy, Billing Annual Updates Collecting Data Static 13 EMR 2.0 Assessments, Discharge Tracking, CDSS, QI/QA, Tasking/Workflows, Interfaces Quarterly Updates Analyzing Data Dashboards Business Intelligence Dynamic 14 HMM Consulting 7
8 EMR 3.0 Predictive software to identify potential care issues and suggest corrective actions Intuitive 15 Increasing EMR Adoption Make list of things you wish your EMR could do Schedule an optimization or tune-up session with vendor Review updates and release notes for new features/functions and get trained 16 HMM Consulting 8
9 Truth about EMR 8 Truths of EMR Selecting an EMR is HARD-NO PERFECT EMR People make decisions, EMR is just a TOOL that helps EMR WILL NOT fix poor workflow/performers ALL departments need to be included On-going software maintenance and training are CRITICAL to success Workflow MUST be changed Productivity is REDUCED when implementing new features EMR is a series of overlapping investments whose benefit accumulates OVER TIME 17 Key EMR Modules and Functionality Clinical Modules Financial Modules Census/ADT MDS Document Management Business Intelligence, Analytics Care Plans Physician Orders Assessments Progress Notes e-mar/e-tar Weights/Vitals Point of Care Third Party Software: Therapy QI/QA (Interact, COMS) Billing/Claims Management Accounts Receivable Collections Referral Management Patient Trust Accounts Payable General Ledger 18 HMM Consulting 9
10 Key EMR Modules and Functionality Key functionality to look for: Logical and effective workflow built-in Do you want software to drive you through the documentation process or alert you to documentation required (matter of preference) Clinical Decision Support Software (CDSS) and other logic checks Alerts/Warnings/Messaging/Prompts Parameters exceeded (temps outside of normal range) Documentation to be completed for an Event Duplicate orders (Rx, lab or other tests) Past due accounts Claims data missing or inconsistent (onset date, diagnosis code) 19 Key EMR Modules and Functionality Key functionality (continued): Interfaces - Standard and Custom Ability to communicate and transmit orders electronically Pharmacy, Lab, Radiology, Physician referrals, etc. Document Management Ability to incorporate third party documents to ensure chart integrity and completeness Lab, radiology results, Physician consults, etc. Healthcare Proxy, DNR, or other Advanced Directives Benefit Cards (Medicare, Medicaid, Other Insurance) 20 HMM Consulting 10
11 Critical Ingredients For Success Managing EMR Expectations: Timeframe No instant gratification multiple stages over months or years Productivity/Workflow Workflow WILL/MUST change Users will experience inefficiencies at various stages of the project (expect overtime) There will be trial and error Won t fix poor performing employees Resources Clearly identify project lead one person ANNUAL BUDGET for hardware and on-going training to use new features and functions as they become available Compliance Monitor and enforce consistent utilization by all users (QA) Update Policies and Procedures, Staff education, etc. Tie compliance to job performance 21 Thank you.? Questions? 22 HMM Consulting 11
12 HMM Consulting a Division HMM CPA s LLC Veronica M. Bencivenga, CPA Office (631) Cell (631) VBencivenga@horanmm.com 23 HMM Consulting 12
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