Electronic Health Records (EHR) An Educational Session

Transcription

1 Electronic Health Records (EHR) An Educational Session Prepared For <Client Name> Presented By JP Killeen & Associates, Inc Osage Street, Suite 405 Alexandria, Virginia

2 John P. Killeen Introductions President, JP Killeen & Associates, Inc. <Client> Staff Other Attendees

3 Purpose: Purpose & Objective Assist <Client> in maneuvering the road during their journey to an Electronic Health Record Objective: Share K&A s proven process for a successful EMR implementation

4 What have we done so far? Initial phone conversations Review of basic EHR information and online resources Initial EHR questionnaire

5 EHR Questionnaire What were your responses? (Exhibit A) What do they tell us? What are our observations?

6 EHR Questionnaire 1. Do you have any personal experience with an EHR? 2. Do you have any colleagues who have had experience with an EHR? 3. What in your current practice / workflow causes you the most frustration? 4. What do you think are the top 3 benefits of an EHR? 5. What concerns / fears do you have about implementing an EHR? 6. Do you have any other questions / comments?

7 The K&A Approach The 6 Phases in the Transition Process to EHR

8 The 6 Phases Phase 1: Ask the Hard Questions Phase 2: Vendor / Product Search Phase 3: Training Phase 4: Workflow Phase 5: Data Conversion Phase 6: Go Live

9 Phase 1: Ask the Hard Questions Why do I need an EHR? What do I expect from an EHR? How much will it cost? Are we ready?

10 Phase 1: Ask the Hard Questions Why do I need an EHR? Industry Forces E-Prescribing Incentives (Medicare) Pay for Performance Coding / Documentation Malpractice

11 Phase 1: Ask the Hard Questions Why do I need an EHR? Technical Advantages / Savings Writing Twice (Rx s) Clinical Alerts Recruiting New Doctors Working From Home After Hours Supervision of NP / PA Patient Portal

12 Phase 1: Ask the Hard Questions Why do I need an EHR? My old system needs updating Can t find paper chart Can t find document in the chart Can t read paper chart

13 Phase 1: Ask the Hard Questions What do I expect from an EHR? Better Patient Care Reduced Expenses Improved Time Management Maximize Office Space

14 Phase 1: Ask the Hard Questions How much will it cost? Be aware of various pricing structures Per provider Per user Start up and training costs Hardware and connectivity Maintenance and transaction costs Do a 1, 5, and 10 year cost comparison Be prepared to negotiate

15 Phase 1: Ask the Hard Questions Are we ready? Are the decision makers in agreement? Do we have the management and staff capacity to execute? Do we understand the process?

16 Phase 2: Vendor / Product Search What software features and functionality do we want? Truly Integrated System CCHIT Certified E-prescribing E-lab (Populating the Patient Record) Improved Coding & Documentation Patient Portal Internal Messaging

17 Phase 2: Vendor / Product Search Truly Integrated System (See Exhibit B) Make sure the EHR and the Practice Management System were built as one Avoid the ours works as one Reduces the risk of data loss or data errors Most of the new generation systems are integrated

18 Phase 2: Vendor / Product Search CCHIT Certified (Exhibit C and D) Certification Commission for Healthcare Information Technology Recognized Certification Body (RCB) for EHRs and their networks Independent, Private & Nonprofit Certification is Voluntary

19 Phase 2: Vendor / Product Search A CCHIT Certified 08 Ambulatory EHR ensures: Additional electronic prescribing features: access to the patients medication history, formulary and eligibility Better and safer medication dosing, adjusted for patient weight and other factors Better ability to prevent adverse reactions due to drug interactions or allergies Use of standard formats to exchange basic patient information for continuity of care Enhanced ability to view X-rays and other diagnostic images Better management of patient consents and authorizations Increase use of standard formats when receiving and storing laboratory results

20 Phase 2: Vendor / Product Search E-prescribing (Conference sponsored by CMS)

21 Phase 2: Vendor / Product Search E-lab (Populating the Patient Record) Bi-directional with lab (out and in) Direct flow of results to correct patient record and ordering provider Ability to compare labs over time Track Incomplete Labs

22 E-lab Electronic Results Reporting Lab ordered in EMR (Exhibit E) Order written, printed and given to patient Patient has study done Results prepared and reported Results electronically transmitted and filed in patient chart Results Not Received Provider reviews results and signs off electronically A report can be generated to identify results not received. Saving time for both the practice and the Lab, as well as improving patient care Results communicated to Patient Results Trending Results over a period of time can be reported and graphed for comparison and trend analysis

23 Phase 2: Vendor / Product Search Improved Coding & Documentation Supports Medicare Evaluation and Management Guidelines Template Management Critical documentation elements captured for appropriate E/M code assignment (CPT Code) HPI, ROS, PFSH and medical decision making Capture of diagnosis codes for ICD-9 assignment Legible Documentation

24 Phase 2: Vendor / Product Search Patient Portal Streamline and Improve Communications with Patients How easy is it to use For the Practice? For the Patient? What is the cost?

25 Phase 2: Vendor / Product Search Internal Messaging Ability to record messages electronically and attach to patient record Ability to communicate non patient specific messages to staff Improves clarity and accuracy of written message Reduces noise and physical movement inside office

26 Phase 2: Vendor / Product Search Hardware Server (2 Options) Client Server (Located Onsite) ASP (Located in a Server Farm) Tablets with stylus (dual screens) Scanners Cameras Printers

27 Phase 2: Vendor / Product Search Networking Internet Access For Vendor support For Providers and Staff Lab and Hospital Interfaces Remote Access From Home From Hospital

28 Phase 2: Vendor / Product Search Legacy System Accounts Receivable Migration Requirements Retrieval of Historical Information

29 Phase 2: Vendor / Product Search How do we evaluate the costs and benefits? Return on Investment (ROI) (See Exhibit F) Costs Actual Dollars Extra Time for Planning, Implementation and Training Lower Production (How long / How much?) Find the Benefits

30 Phase 2: Vendor / Product Search What software features and functionality do we want? What vendor and product best matches your needs? Develop a Control Log for comparisons (Exhibit G)

31 Phase 3: Training What type of training do we need? On-Site Offsite (Local Hotel) Online (Web-Based) Training Aids (CD s, Flash Drives) When will we need it? How long will training take? How much will training cost?

32 Phase 4: Workflow EHR will change your current workflow Flowcharting helps clearly document the workflows Map Future State Much easier on paper (See Exhibit G) Can be reused for training new staff Look for roadblocks and opportunities

33 Phase 5: Data Conversion What data do we want to convert To the practice management (PM) system? Billing Information Patient Information Appointments To the EHR? Labs Radiology Problem List Medication List Immunizations Consults

34 Phase 5: Data Conversion How will we convert our data? Usually done in 2 parts PM data first Legacy converted to Excel, then to new PM EHR paper chart / clinical data as you go Scanned and / or data entry Requires detailed plan Do we want to do the conversion in-house? Do we want to use outside (contract) resources?

35 Phase 6: Go Live Have a Rollout Plan Role-play with Staff for Day One Make It Fun! Adjust Provider / Patient Workload Vendor Staff is On-Site Expect the Unexpected

36 Questions or Comments

37 Why K&A? Experienced in successful EHR Implementations (We ve done it!) Practice Advocate, keeping the vendor and project on track Save physicians time and money so they can stay focused on patient care