Discovering Healthcare Technology Solutions for Ensuring EHR Success Sponsored by
Presented by Jeffery Daigrepont, Senior VP Coker Group 1000 Mansell Exchange West Suite 310 Alpharetta, GA 30022 770-597-0590 jdaigrepont@cokergroup.com Scott Ziemann, COO Viral Mehta, MD Comprehensive Cardiovascular 5945 Truxtun Ave. Bakersfield, CA 93309 661-323-4278 sziemann@ccvmg.com Pat Williams, VP of Business Development Entrada 109 Westpark Drive, Suite 480 Brentwood, TN 37027 615-750-2077 pwilliams@entradahealth.com
Future Trends and Current State of the Market Jeffery Daigrepont, Senior Vice President The Coker Group 1000 Mansell Exchange West, Suite 310 Alpharetta, Georgia 30022 jdaigrepont@cokergroup.com 770-597-0590
Agenda Current State of the Market Happy / Sad - Analysis Future Trends Case Study / Featured Solu;ons
Current State of the Market & Vendors
Current State of the EHR Vendors
EMR Adoption According to a 2008 survey by the Centers for Disease Control and Preven1on, 38.4 percent of doctors reported they were using full or par;al EMR systems, and 20.4 percent said they were using minimally func;onal EMRs, including e- prescribing, the ability to order tests and view lab results, and electronic notes.
The 4% Reality When the CDC asked about EMR systems actually being used at the point of care, with cer;fied interoperability, and erx, only 4% of respondents said they had fully func;onal EMRs at the point of care
U.S. EMR Adoption
US Physician Population* This data was included to reflect the updated number of prac6cing physicians in the US
Market Share Claims (by Vendors)* This data was included to show the differences between vendor claims and market share reali6es reflected in Coker s data
What has Happened
Estimated Rate of Ambulatory EHR Failure According to some researchers there has been a 30-40% failure rate of EHR implementa;ons. These failures are a result of: Lack of implementa;on planning Inadequate research and expecta;ons of technology Incomplete training of staff Mismanagement of workflow and staffing changes Reluctance of providers to take on addi;onal burden
Implementing Technology The Happy / Sad Analysis HAPPY SAD
Putting It into Perspective Software Practice Management Reporting Coding Document Imaging EHR Portals Messaging E-Health Patient Access Interfacing Pharmacy Transcription Hospitals Lab PACS Devices Desktops PDAs Tablet
Standalone Interfacing Development Fragmentation of data challenges Multiple points of entry Unable to share with other providers Version control Multiple vendors Expensive
Fully Integrated
Where are We Going
Life Span
Patient Kiosks
Smart Pens
Dashboard Tools / Analytics
Cloud Computing / SAAS
Portable Devices 83% of physicians carry a smart phone
Scribes
Patient Portals, PHRs, Social Media for Patients 70% of the consumers said they would switch primary care physician if using a pa;ent portal saved them ;me and money. MicrosoY Health Vault Google PHR NoMOREclipBoard.com
The Evolution of EHR Implementation
Population Disease Management Source: SyntraNet
Senior Wellness Solutions 48M Seniors are not entitled to FREE wellness visits Seniors are becoming the largest segment of our population People are living longer
Health Information Exchanges
ACO Enabling Tools Source: ACOManagement
Telehealth Solutions
Voice Recognition
Protecting Your Investments
How to Negotiate an IT Contract Like a Pro
There are 2 Important Factors to Successful Negotiations Make the vendor aware that he has a credible competitor, but not who it is Identify all the costs and deliverables to negotiate
What to Negotiate Over Initial costs Hardware cost Software cost Communication cost Installation cost Ongoing support cost Implementation cost Support cost Technical support cost Integration costs Interface cost Entitlement to new release/ bug fixes The cost of tailoring Future upgrades and releases (This should always be at no additional cost.)
Modifying the Contract Source code Acceptance period (Hardware & Software) Implementation caveats No front loading of support fees No front loading the purchase items Assignment
Modifying Contract (cont.) Future upgrades and new releases Copyright infringements Warranties Termination Future providers and fees (recurring cost)
Final Steps to Negotiation Time is on your side so do not rush. You will have up to 10 years of regret for making a quick decision. FREE Vendor Contract Review jdaigrepont@cokergroup.com Or call: 770-597-0590
One Solution for Every Workflow
Productivity Crunch Physicians are being asked to do more with less. " Rising patient population " Accelerating doctor shortage " Shrinking reimbursements
Physician Challenges I never expected it would be this difficult. I can honestly say my EHR has ruined my life. - Dr. William Edwards The Surgical Clinic, Nashville, TN
Specialty Revenue Per Patient Revenue Reality Cardiology $682 Orthopedics $642 Surgery $722 Urology $572 The #1 cost of an EHR is lost revenue due to declines in physician productivity. Ophthalmology $340 Internal Medicine $345 Average $300 - $800
One Solution for Every Workflow
Productivity " Voice " Mobility " EHR Integration
Backend Workflow Solution Real-Time Speech-to-Text
Dictation Capture (Apple ios, Windows Mobile, PCs) Voice Tagged (HPI, Impression, Plan, etc.)
Dictation Capture (Apple ios, Windows Mobile, PCs) Voice Tagged (HPI, Impression, Plan, etc.)
Cloud-Based Voice Profiles Simple Installation Recovering I well. Advance diet. Continue to monitor labs. Follow-up with Cardiology within three days of discharge for stress testing as an out-patient. Prepare for discharge home tomorrow morning. Better Management Sensation I may be expanded to include dull, sharp, vibration, temperature, and position sense. A mental status exam may be reported at the beginning of the neurologic exam, or under a distinct "Psych" section.
Simplicity Redefined Traditional Voice-Rec " Expensive, up-front licensing " Heavy software footprint, requiring intensive IT resources " Device-based voice profiles " Profile and language models built during physician adoption " Administration requires on-site management at the device Real-Time Speech-to-Text " Flexible, monthly subscriptions " Light software footprint, works well with remote-hosted EHRs " Cloud-based voice profiles " Profile built BEFORE physician ever begins using Entrada " Efficient management tools accessed in a single online portal
Entrada integrates with all major EHRs
We believe Entrada is a game changer in the mobile healthcare industry, providing users a level of flexibility and ease-of-use that has largely been absent in health care IT. - Jonathan Bush, Chairman and CEO of athenahealth
Send a fax within NextGen With ExpressFax, And this mess goes away. " Any generated document with a CC is faxed automatically " Accelerate document delivery while reducing costs and errors " Flexible for even the most complex faxing workflows
Comprehensive Cardiovascular 5 Cardiologists, 1 PA, 1 RN 30 Members on Staff 4 Locations Average 27,000 patient visits per year Specializes in: Heart Disease Vascular Disease Heart Rhythm Disorders
Challenges Before EHR Adoption Physicians would dictate every note, which became very cumbersome Medical Assistants would write on worksheets to check patients in Staff were slowed down looking for charts, slowing down productivity Missing Chart Phenomena
EHR Adoption Goals Improve productivity with patient workflow Let physicians adopt at a streamlined, organized pace Position clinic to meet Meaningful Use goals
Why NextGen? NextGen is a customizable EHR system which factored into the CCVMG workflow Looked for a system to meet growing needs for the demand of their practice Allowed growth for CCVMG Adopted NextGen PM system in July 2007 Adopted NextGen EHR system in January 2008
Implementation Strategy Methodically sought an organized EHR implementation strategy Implemented NextGen EHR system Ran a parallel paper chart system in the beginning EHR was implemented slowly, phasing in physicians one at a time Physicians used EHR system for 3-4 patients each day, to familiarize themselves with the system
EHR Findings Successfully transition from paper to digital records in 18 months Met Meaningful Use Incentives 3 weeks ago Documentation workflow is now organized and seamless Patient charts and information are readily available Revenue per physician remained the same, despite reimbursements
Entrada Adopted Entrada in 2012, using the self-edit platform All physicians at CCVMG dictate using Entrada on their iphones With Entrada, clinical notes are returned 1 week to 10 days sooner Reduced need for 1 full-time transcriptionist Physicians now spend less time documenting, more time with patients
My primary focus is to provide the highest quality of patient care possible. With Entrada, I have found the ease-of-use and mobility I have been looking for when interacting with my EHR. - Viral Mehta, MD Comprehensive Cardiovascular
Conclusion Implementation process for the EHR with Entrada was methodical and streamlined, avoiding many pitfalls some clinics face with adoption CCVMG has seen a lot of growth within the last year, becoming more efficient with the NextGen EHR and documentation process Physicians have been able to see more patients, while spending less time documenting their clinical notes
Thank You! Any Questions? Jeffery Daigrepont, Senior VP Coker Group 1000 Mansell Exchange West Suite 310 Alpharetta, GA 30022 770-597-0590 jdaigrepont@cokergroup.com Scott Ziemann, COO Viral Mehta, MD Comprehensive Cardiovascular 5945 Truxtun Ave. Bakersfield, CA 93309 661-323-4278 sziemann@ccvmg.com Pat Williams, VP of Business Development Entrada 109 Westpark Drive, Suite 480 Brentwood, TN 37027 615-750-2077 pwilliams@entradahealth.com