Vermont s EHR Pilot. State Alliance Learning Forum September 25-26, 2008

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1 VERMONT INFORMATION TECHNOLOGY LEADERS Vermont s EHR Pilot State Alliance Learning Forum September 25-26, 2008 Paul Forlenza, V.P. Policy and Special Projects x103

2 Agenda Health Care Reform in VT VITL EHR Pilot Select EHR Systems Select Primary Care Practices Select EHR Systems for Practices Lessons Learned 2/11/2009 2

3 Health Care Reform Many attempts at reform last 20 years Current Goals of Governor and Legislature Increase access to affordable coverage Improve quality of care Contain costs Current initiatives Blueprint for Health: chronic disease management Catamount insurance Funding of HIT and HIE 2/11/2009 3

4 VITL Created 2005 as public-private partnership Initial funding: state appropriation, VT Dept. of Health contract and VT. Hospital Association Additional funding: federal grants and new Health IT-Fund Major Projects VT Information Technology Plan: update to focus on standards and privacy/security issues Medication History for emergency rooms Operate exclusive statewide HIE EHR Pilot 2/11/2009 4

5 Legislature/Governor established framework for $1m EHR Pilot Fund voluntary contributions from payers, hospital association, Office of VT Health Access Goals EHR Pilot encourage and facilitate deployment and utilization of EHR-S for independent primary care practices promote sharing of EHRs using statewide HIE Grants of 75% with $ cap per FTE provider 2/11/2009 5

6 Pilot Phases 1. Select EHR-S for Pre-screen list Request for Information 2. Select 5 Primary Care Practices Request for Application / Clinical Assessment 3. Select Specific EHR-S for Practices Request for Proposal 4. Procure & Implement 5. Measure progress: Milestones & Evaluation 2/11/2009 6

7 1. Selecting EHR-S Stakeholder Advisory Committee Required criteria (filters) CCHIT certified systems KLAS or AC Group rating Scored Technology Interoperability IHE profiles Cost Vendor vision Final Measurement: financial viability 2/11/2009 7

8 1. Selecting EHR-S (continued) Initial respond from 27 vendors Reduced to 17 vendors after filters applied Reduced to 11 vendors based on scoring CCHIT 2007 preferred Additional points for CCHIT 2008 roadmap IHE plans and/or implementation Final filter: financial analysis Independent financial analyst Scored into 3 groups: A, B, C Only vendors from group A selected List at end of presentation 2/11/2009 8

9 2. Selecting Provider Practices Select limited number of practices: Primary care practices (18 FTEs) Serve low income population Demonstrate a financial need Participate in chronic disease management and medical home pilots Demonstrate high likelihood of success 2/11/2009 9

10 3. Select EHR-S for Practices RFP: select EHR/PMS systems for 5 primary care practices VITL assisted practices in RFP design & selection Product demonstrations with VITL scripts Cost of interfaces to HIE Total cost of ownership Purchase of hardware, communications, printers 2/11/

11 4. Procure and Implement Procurement Assist with contract negotiation with vendor Payment schedule and cost of HIE interfaces Implementation Clinical Microsystems education Clinical process modifications Realistic schedule Role of Health Care Quality Organizations Vermont Program for Quality in Health Care Health Care Quality Foundation (northern N.E.) 2/11/

12 5. Milestones and Evaluation Grants 75% of total budget with a cap Milestone Payment Schedule Contract signing and hardware purchase: 50% EHR Go-Live (first productive use): 30% Connectivity to HIE: 5% Compliance with acceptance criteria: 15% 2/11/

13 1. Functional Lab orders & results, clinical messaging, e- prescribing, clinical decision support 2. Patient-centeredness 3. Cost Panel management, information therapy Productivity, coding 4. Satisfaction 5. Milestones and Evaluation* Patient and staff satisfaction * For more details see slide at end of presentation 2/11/

14 Status of Pilots EHR systems selected for 4 practices one small practice dropped out of pilot Agreements Business Association Agreements (BAA) signed by VITL and practices procurement contracts signed by vendors and practices Early, mid, late adopters at different stages of implementation one early adopter connected to HIE 2/11/

15 Lessons learned Selection of EHR systems and practices is a lengthy process Selection criteria should be measurable with more weigh on cost of ownership Size of pre-screened list should be manageable Significant involvement of clinicians is critical for success Clinical Microsystems education should be earlier in process 2/11/

16 Contacts and Resources VITL: and Paul Forlenza, V.P. Policy and Special projects: Angela Barnett, Director of Clinical Effectiveness: VT Information Technology Plan Draft of new privacy and security policies Governor s Office: Susan Besio, Director of Health Care Reform Implementation VT Government Health Care Reform website Health Care Reform Commission website 2/11/

17 Pre-screened List of EHR-S Allscripts HealthMatics Allscripts TouchWorks eclinicalworks EMR GE Healthcare Centricity EMR McKesson Practice Partner NextGen EMR 2/11/

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