Networking Your Way to an Interoperable EHR

Transcription

1 Networking Your Way to an Interoperable EHR Minnesota Rural Health Conference June 28, 2010 Anne Schloegel Minnesota Department of Health Office of Rural Health and Primary Care

2 Health Information Exchange and Interoperability Definition of health information exchange: Mobilization of health information electronically across organizations within a region or community according to nationally recognized standards Interoperability is comprised of: technical: transmitting of data accurately and securely from one point to another semantic: sender and receiver understand what the data means process: best practices between the sender and receiver

3 Why Interoperable EHRs? To improve health care quality, increase patient safety, reduce health care costs and improve public health Part of Minnesota s 2015 EHR mandate To be meaningful users must exchange health information

4 Minnesota Model for Adopting Interoperable Electronic Health Records Breaks achieving interoperable EHRs into manageable steps Applies across organizational settings Continuum of EHR Adoption Achievement of 2015 Mandate Adopt Utilize Exchange Assess Plan Select Implement Effective Use Readiness Interoperate 4

5 Meaningful Use Minnesota health care providers and hospitals could access $450-$800 million in incentives if they can successfully demonstrate meaningful use of an EHR system. The three core elements for demonstrating meaningful use are: Use of nationally certified EHR systems Submission of clinical quality measures Electronic exchange of health information 5

6 Health Information Exchange and Meaningful Use Health Information Exchange Transactions Required for Meaningful Use Electronic Prescribing Immunization Information Exchange Laboratory Results Reporting Exchange of Clinical Summaries Public Health Surveillance and Case Reporting

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8 Health Information Technology Resources and Tools Office of Rural Health and Primary Care Webpage for HIT/Telehealth Monthly Update Quarterly

9 Health Information Technology Resources and Tools Minnesota e-health Web Page Minnesota e-health Weekly Update Gov Delivery distribution list Monthly HITECH Update Calls Third Thursday of the month from 4:00-4:45 p.m.

10 Related Sessions at the Conference Session 3B Navigating Medicare and Medicaid HIT Incentives Session 4B Finding EHR/HIT Opportunities and Support Session 5A Health Information Exchange Opportunities

11 On Their Way- Session Speakers Mark Roisen Executive Director, Lac qui Parle Health Network 2007 Planning and 2009 Implementation Grants Jackie Moen Executive Director, Northern Minnesota Network 2008 Implementation Grant

12 Lac qui Parle Health Network Non-Profit tax-exempt hospital services cooperative Appleton Area Health Services Appleton Johnson Memorial Health Services Dawson Madison Lutheran Home Madison Figure 1

13 EHR Due Diligence Governance Structure > AAHS, JMHS, MLH Board of Directors > LqPHN Board of Directors > LqPHN IT Steering Committee - Clinical - Administrative - IT

14 EHR Due Diligence Vision >Affordability: >Compatibility: >Interoperability: >Data stewardship:

15 EHR Due Diligence Strategic Plan Functionality Business Case Other Factors

16 EHR Due Diligence: Functionality End Users 3 dimensional Chess Match EHR Software Existing Software & Systems Third Party Vendors & Payers Communication Infrastructure Production Servers / Backup Systems & Maintenance Plan

17 EHR Due Diligence: Functionality Steering Committee RFP Goal Setting Process Mapping

18 EHR Due Diligence: Business Case >Total Cost of Ownership >Benefits

19 EHR Due Diligence: Business Case 5 year Total Cost of Ownership Vendor A Vendor B (current vendor) $5,259, $4,588,669.00

20 EHR Due Diligence: Business Case Benefits >Improved Patient Outcomes >Cost Savings >Productivity Improvements >Cost Avoidance >Revenue Increases >Contribution to Profit

21 EHR Due Diligence: Other Factors Cost of Conversion from Current Vendor Applications to different vendor 6-12 Month Conversion timeframe during which you need to license both systems. Historically Accounts Receivable go up and cash flow goes down during this transition time frame Staff training increases significantly due to learning new systems

22 EHR Due Diligence: Other Factors Both Vendors are considered Premier Vendors for our Market Both are Hospital based Health Information Systems with modules for clinic and long term care settings Both Vendors are CCHIT Certified Both hospitals have good references Consultants all agree either system will work well, if our staff is willing and capable of making the transition from a paper to electronic environment

23 EHR Due Diligence: System Maintenance LqPHN received 2 grants totaling over $1.6 million specifically for the planning and implementation of EMR software and hardware The LqPHN will be applying for several additional Grants: MDH State E-Health Grant/Loan Program Blandin Broadband Connections HRSA Outreach Grant Microsoft HealthCare Grant Group Purchasing bring down cost of ownership LqPHN User Group meetings will facilitate adoption of best practices in achieving meaningful use

24 Networking Your Way: Interoperable EHR NORTHERN MINNESOTA NETWORK Jackie Moen M.A. Project Director

25 OUTLINE 1. NMN - who we are 2. Our path to health information technology 3. Our HIT system 4. Lessons learned 5. Future plans

26 NMN - Who We are 501(c)3 HCCN organization Health Center Controlled Network Started 2001 incorporated 2004 Mission: provide health information technology systems, resources and support to our Members to assist in delivering quality patient care

27 NMN Our Members Currently three members - FQHCs Sawtooth Mt. Clinic, Scenic Rivers Health Services, Migrant Health Services, Inc. Operate 20 medical and dental sites in Minnesota and eastern North Dakota Patients served: 25,866 Encounters: 104,756

28 NMN Our Collaborators Medical : 17 physicians, 8 mid-levels, 19 others lab, imaging, therapeutic. Oral Health: 4 dentists, 4 hygienists, 8 support Exchange information with Cook Hospital, BigforkValley Hospital, Cook County North Shore Hospital

29 NMN Our HIT Path. 2004: Incorporated, secured funding, selection team and project plans 2005: Due diligence, RFP = eight responses, four demos, two site visits, contract negotiations. GE Healthcare Centricity Practice Solution CySolutions Applications SISU Medical Systems

30 What A Crew! Site Visits

31 NMN Our HIT Path. 2006: Developed infrastructure, phased implementation of Practice Management 2007: EHR Planning - readiness assessments, process mapping, workflows, connectivity issues, interface planning 2007: Converted Practice Management 2004 to Centricity Practice Solution 2006 (only PM)

32 NMN Our HIT Path. 2008: EHR flip the switch! SMC - live in April MHSI - live in June SRHS - live in September 2008: Eleven clinical sites live, three lab interfaces, and many tired, battle-weary folks! 2009: Brought up nine additional sites, one lab interface, and went from this..

33 Relative calm..

34 Eye of the Storm..

35 CURRENT STATUS 2010: Dental health record implementation, imaging, HL7 interface Dentrix to Centricity Additional interfaces Optimize functionality QI Data Reporting Expand infrastructure

36 Our HIT System Electronic Health Record Practice Management System Dental Health Record Voice Recognition E-faxing HIE Bridge Expanded Reporting Applications Interface Applications Meditech, Quest

37 Our HIT System HIE Bridge Query patient demographics between hospitals and health center databases, participating patients Expanded Reporting Applications Crystal Reports CCC (Chronic Disease Management) MQIC MN Community Measures Program

38 Our HIT System Interface Applications Quest Diagnostics Lab OE and results Meditech Hospital Information System Lab results only Documents Management (ITS) - surgical procedures, discharge summaries, rehab, ER, H & P, OT, PT. Transcribed report immediately goes electronically through the interface to patient record

39 LESSONS LEARNED Use a team approach Must have physician champions Dedicated clinical and IT support Plan change management strategies Address negativity right away

40 LESSONS LEARNED Be sensitive to your workplace culture Set a standard people agree to live with Pay attention to observation terms during set up Process maps help avoid paving the cow path Provide LOTS of training, multiple formats

41 LESSONS LEARNED Double estimates for interface development Determine financial impact initial productivity costs and ongoing costs Be flexible this is a LONG process Celebrate the early wins!

42 What Next? Plans for the Network!

43 Projects and Plans Complete major upgrade v8.0 to v9.0 Implement Sure Scripts e-prescribing application Develop additional interface applications Expand data collections reporting applications

44 Projects and Plans Increase NMN membership Implement systems with new members Expand health information exchange applications

45 Northern Minnesota Network Looking for more information? Contact Jackie Moen Project Director