Electronic Interfaces Overview 101 September 2013 Where is facility on Electronic Continuum Marketplace offers products that range from fax orders and paper medical records, to fully electronic EMRs/EHRs that tightly integrate with Pharmacy Need flexibility to move at a pace and investment level each organization is comfortable with Fax Orders & Paper Records Electronic MAR EMR/EHR Interfaces Pharmacy Services Provider Electronic ordering and records solutions emar (Electronic MAR/TAR) An electronic MAR and TAR system (Medication and Treatment Administration Record) enables facilities to place medication orders, document medication administration and clinical interventions at the point of care in facility. Starts electronic transition with nursing functions and administration records. An electronic health/medical record (EHR) involves a broad collection of health data about individual residents, to share across different healthcare settings. EHRs may include medical history, medication and allergies, immunizations, test results, vital signs, etc. Facilities looking to transition most core facility processes to a computerized system. MARs POSs TARs Assessments MDS ADLs TARs MARs Billing 1
What s the difference between them? emars (Electronic MAR/TAR) An electronic MAR and TAR enables facilities to place medication orders, document administration and clinical interventions at the point of care. Functional Highlights: Computerized Order Entry to document orders, for meds and non-meds Medication and Treatment Administration Records (emar and etar) are kept synchronized in real-time Tracking of med administration, vital signs, weights, personal stats, allergies and ordered labs An electronic health/medical record collects a broad set of health information, to eliminate paper medical records and can be shared across healthcare settings. Functional Highlights: Pharmacy Interface delivers electronic order entry and real-time transfer to pharmacy Electronic Medication and Treatment Administration Records (emar/etar) Billing Information can be imported into their financial software Broad range of data: medical history, medication and allergies, immunization status, labs, radiology images, vital signs and personal stats Which is a good fit for my organization emar (Electronic MAR/TAR) Ideal for independent facilities or small chains just starting the transition from paper to electronic. Facilities who desire to computerize nursing functions and administration records vs. those looking to computerize the financial process, etc. Independent facilities Smaller chains (less than 10 facilities) Facilities that use little technology today, but want to add electronic efficiencies in key areas Full EMR/EHR is better suited for larger facilities or chains currently using some electronic solutions for ordering, census and administration/treatment records. Facilities looking to transition most core facility processes to a computerized system. Large Corporate Groups Large Management Group (10+ facilities) Groups that require Regional/Territorial review High Acuity Facilities Pharmacy support for EMR/EHR systems Interfaces allow facilities to transmit census and order information electronically from facility systems to pharmacies and billing office Enables facilities to maintain documentation in an electronic format, which can reduce and eliminate faxing of orders and maintenance of paper medical records. 2
What pharmacy receives and confirms Send back Dispense Info Pharmacy Support Facility Interface Receive Med Orders and Census data What do pharmacies support with EMRs Medication Ordering Interface: Facility can send medication and treatment orders to our pharmacies in near real-time New Orders, Refill Orders and Discontinued Orders Dispense Information: Can receive dispense information back from Pharmacy for use in documenting medication and treatment passes (MAR/TAR) Census Interface: Transmits Admission, Discharge and Transfer (ADT) information from facility census management system to pharmacy systems Note: Each vendor or pharmacy may not support all order types or updates Common message formats or standards eprescribing is an electronic method of communication between the facility and pharmacy for order requests and resident census Bi-directional messaging between facility systems and pharmacy systems Messages are sent and received real-time, with acknowledgement messages sent back immediately Messaging Standards NCPDP (National Council for Prescription Drug Programs) Developed messaging standard specifically with national e-prescribing initiatives in mind. To act as a standard format for pharmacies, prescribers and payers. HL-7 (Health Level Seven) Another standard messaging format in the healthcare arena. HL-7 is an older format than NCPDP that allows for significant flexibility in integration. With this flexibility comes less standardization across vendor platforms. Both formats can support core messaging needs for new prescriptions, cancellations, refill requests, prescription fill status and census changes 3
Part 1: Build Vendor Integration Work with EHR/EMR vendor to build pharmacy interface Average time to complete integration is 2-4 months Build order/message types to support New orders, re-order and discontinues Admission, discharge, transfers and census updates Test various message types and data elements Incoming messages from EMR system Dispense messages back from Pharmacy Pilot with several facilities before making available to all clients, usually 1-3 month pilot phase Part 2: Facility Implementation Initial vendor integration is already complete Both vendors coordinate date to turn on interface and go live with facility Implementation takes approximately 30-60 days to complete Based on client and vendor schedules Load and synch order and patient information in both systems Key implementation tasks Kick-off call to establish go-live date Interface setup and testing Entry or import of order and patient info Go-Live support from Parallel ordering period to ensure accuracy What to consider for electronic offerings Is your main objective to focus on cost savings or manpower efficiencies to improve care? What components are you looking to move to electronic format? Medication Ordering, MAR/TAR, Medical Records, Billing, etc. What is your timeframe for transition? Where is organization on electronic continuum today? Can system be implemented in stages or components? Does system support pharmacy interface to transmit order and census information in real-time? Type of orders supported: New Orders, Refill Orders and Discontinued Orders Does pharmacy already have interface in place with vendor live at facilities? Average timeline to implement in a facility? What is the cost to implement for facility? 4
Costs to Implement for facility What is the cost to implement core modules for ordering and MAR/TAR Usually based on per bed per month charge (PBPM) Does EMR vendor charge an additional fee to implement/support pharmacy integration May charge for initial setup and/or ongoing fee Does pharmacy provider charge additional fees to implement or support interface PharMerica does not charge any additional fees to implement Questions? 14 Thank you 15 5