Jocelyn Piccone, MHA, MA, CMPE

Transcription

1 Jocelyn Piccone, MHA, MA, CMPE DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Has no real or apparent conflicts of interest to report HIMSS

3 Salary: Royalty: Receipt of Intellectual Property Rights/Patent Holder: Consulting Fees (e.g., advisory boards): Fees for Non-CME Services Received Directly from a Commercial Interest or their Agents (e.g., speakers bureau): Contracted Research: Ownership Interest (stocks, stock options or other ownership interest excluding diversified mutual funds): Other: Jocelyn Piccone no longer works for Wright State Physcians 2013 HIMSS

4 Explain why more physicians are choosing cloud-based EHRs Describe the role that cloud-based EHR technology plays in clinical workflow and Meaningful Use attestation Recognize the primary benefits of using an integrated, cloud-based EHR and practice management system List the complexities and challenges associated with a having a non-integrated EHR Identify the importance of aligning a physician practice with a credible cloud EHR vendor

5 23 locations, 5 hospitals 150 academic physicians from Boonshoft School of Medicine Lean management and support staff 9 independent departments with slowly developing corporate/team spirit Family Medicine Internal Medicine Ob/Gyn Dermatology Orthopedic Surgery Trauma/Surgery Surgery Oncology Geriatrics Psychiatry Plastic Surgery Pediatrics

6 o Managing mountains of paper work o Numerous locations with varying IT environments o Server and personnel costs o Time spent educating and training IT personnel o ANSI 5010, Meaningful Use, ICD-10 were all on the horizon o Not taking advantage of P4P $ o Information flow between practices was fragmented at best o Faxes & Phones

7 High Cloud-Based Service (athena, Amazon) Performance & visibility ASP SaaS (SalesForce) Software High Connection to Outcomes

8 Fewer FTEs needed to manage idiosyncrasies of the system

9 Ability to centralize billing, eliminate in-house software, and easily interconnect multiple locations was critical Phased rollout started with Family Medicine, all other departments were added by Q Training residents who will be using EMRs by time complete residency

10 Which providers should pursue Medicare or Medicaid? MU could not slow us down - Not on same EMR - Developed workaround for 1 st and 2 nd year MU As an organization, how are we going to support our staff? What resources do they need? Training clinical staff and physicians Managing naysayers MU $$ distribution - Ensuring each practice is on driving towards the same goals - Keeping eye on deadlines and department progress

11 athena s 5 stage patient workflow allowed for standardization across the organization, but also provided flexibility for different documentation styles Utilized family medicine as pilot department which challenged/encouraged other departments to want to be second, third etc. Compliance Manager and athenahealth Project Coordinator lead team, reported to COO. Each department had lead person to train and organize staff workflows to capture MU data points. athenahealth s QM dashboard allowed us to measure provider performance across the organization

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13 Standardized patient workflow made it easy for MU data capture

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17 COO Compliance Manager Compliance Director EHR vendor project coordinator FM MU point person IM MU point person OB MU point person OR MU point person SU MU point person DE MU point person Front office and clinical staff Front office and clinical staff Front office and clinical staff Front office and clinical staff Front office and clinical staff Front office and clinical staff

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20 1. Implement one clinical decision support tool 2. Report ambulatory clinical quality measures 3. Use CPOE for medication orders 4. Maintain active medication list 5. Maintain active medication allergy list 6. Record vital signs 7. Record demographics 8. Provide clinical summaries 100% 100% 93.0% 88.2% 82.1% 68.2% 28.3% 6.4%

21 Vendor Client Performance: 5/27/2011: 28% 7/11/2011: vendor made Race & Ethnicity a required field 7/24/2011: 61% 8/13/2011: 89% 9/24/2011: 99%

22 1. Implement one clinical decision support tool 2. Report ambulatory clinical quality measures 3. Use CPOE for medication orders 4. Maintain active medication list 93.0% 88.2% 100% 100% 99.6% 99.2% 5. Maintain active medication allergy list 82.1% 98.7% 6. Record vital signs 7. Record demographics 28.3% 8. Provide clinical summaries 6.4% 68.2% 97.7% 99.9% 96.1%

23 Integrated Patient portal assisted with clinical summaries distribution which was most challenging piece High adoption rate for portal

24 athenahealth Client Performance: 5/30/2011: 8% 8/13/2011: 24% 9/10/2011: 77% 10/8/2011: 88% 12/31/2011: 96%

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27 Same process and measures, longer reporting period Directed our focus towards advancing our HIE in anticipation for MU Stage 2. Built more interfaces between our EHR and hospitals EHRs.

28 New challenges await in my new role at Texas Tech University Shifting from a cloud based service to software High Cloud-Based Service Performance & visibility ASP SaaS Software High Connection to Outcomes

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