Evaluate Before You Purchase

Transcription

1 ELECTRONIC HEALTH RECORD Evaluate Before You Purchase Richard A. Wright MD, Mph Executive Director, Denver Community Health Services Principal, Wright Consulting

2 ELECTRONIC HEALTH RECORD Electronic Medical Record Practice Management Software Cost Accounting Software

3 CRITICAL FACT!!! 50% of EHR Implementations Have Failed or Produced Suboptimal Results

4 EHR: Important Success Factors 1. Organizational Readiness 2. Economic Feasibility 3. System Selection 4. Performance-Based Contracting 5. Implementation Plan

5 System Selection Product Evaluation Vendor Evaluation

6 Vendor Evaluation Financial Strengths Experience Technical Support Training Support Customer Satisfaction Research and Development Implementation Plan Democracy reigns supreme in vendor selection

7 EHR Product Evaluation Establish Standards Standards are basic functional requirements for applications Standards must be based on operational and clinical care functions Assess Performance Standards used to assess products

8 EHR Standards Presidential Certification Commission on Information Technology (CCHIT) HRSA/BPHC EMR Standards IOM EMR Standards www. iom.edu/report.asp?id=14391 Maryland Health Care Commission PMS Standards aspx

9 EHR Performance Standards CCHIT Framework Functionality Interoperability Security

10 EHR Evaluation Methodology In Vitro Approach On-line access to application Assessment of functionality in relation to standards In-Vivo Approach On site assessment of application Vendor Self Assessment

11 Standard In Vitro Evaluation Methodology Scoring Standards Exceeds Expectations Meets Expectations Below Expectations Programmed to automatically generate (set up "job stream") End of Day and/or End of Month Reports Application produces UDS report X X Application produces productivity or workload measure reports using unduplicated users, X visits, and RVU by provider and practice Reports can be downloaded to other applications (for example, Excel, Access, or Word) Application produces common financial management reports such as revenues for income statements, gross charges, and net revenues Application reports on appointment system including no shows, cancellations, appointment slot capacity, total appointment slots used, and total appointment time per provider per time period Application supports population-based reporting by interfacing with a patient registry such as PECS X X X X

12 PMS Components Patient Registration Pre-registration Kiosks Document imaging Provider Database NPI Credentialing Result Reporting UDS RVU productivity Profit-loss reports Trending analysis Appointment Scheduling Template design Scheduling Cycle time Referral tracking Accounts Management EOD status reports System Security System access Function access Audit trails HIPPA RBAC standards Billing and Coding Certified Coding Decision support Compliance reviews Fee maintenance Payment Collection Point of service Claims processing Manage care FQHC Interoperability EDI billing HL7 interface General ledger Document merge Fax and

13 Results Reporting Ease of Information Retrieval Reports Relevant to CHC management Ad-Hoc Reporting Available Reports Customizable Data Importing and Exporting Capability

14 E&M Coding Analysis

15 EMR Components Clinical Results Reporting Data warehouse Patient registries Quality and cost analysis Trending analysis Clinical Notes Clinical intake Provider note/procedure Nurse triage Patient education Preventive care Interoperability Health status data Survey data Ancillary systems Wireless transmission Care Management Problem list Reminders and alerts Order entry Prevention prompts Patient tracking Clinical Decision Support Clinical rules and guidelines On-line clinical information Medication Management Medication list Formulary access Allergies Advance data entry Snomed III vocabulary Imaging PDAs and tablets Multimedia Voice recognition Billing and Coding Automatic Coding Decision support System Security HIPPA compliance Bio-sensor access Signature Audit trails Encryptic On-line scheduling

16 EHR EVALUATION: The Ultimate Goal Performance-Based Evaluation Performance-Based Contracts