The%20Future%20of%20Health%20Information%20Technology%20Necessary%20Evil%20or%20Blessing%20in%20Disguise - PowerPoint PPT Presentation

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The%20Future%20of%20Health%20Information%20Technology%20Necessary%20Evil%20or%20Blessing%20in%20Disguise

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Title: The%20Future%20of%20Health%20Information%20Technology%20Necessary%20Evil%20or%20Blessing%20in%20Disguise


1
The Future of Health Information
TechnologyNecessary Evil or Blessing in Disguise
  • Mark R. Anderson, FHIMSS, CPHIMS
  • AC Group, Inc.

2
Mark Anderson, FHIMSS, CPHIMSSHealthcare IT
Futurist
  • 34 Years In Healthcare IT
  • IDN Expertise
  • CIO Position at Three Multi Facility Regional
    IDNs
  • Executive Team Member at 5 Different IDNs
  • Worked In 158 Hospitals and 21 Payer
    Organizations
  • Physician Expertise
  • Managed 50 Physician Practices in the Late 1980s
  • Former CIO of a 2,300 physician (500 Practices)
    IPA
  • Currently Conducting EHR Searches for gt 100
    Practices
  • National Speaker on EHR - gt 380 sessions since
    2001
  • Negotiated more than 100 EHR contracts
  • Installed over 1B in technologies since 1972

3
Disclosure
  • Speaking at numerous professional associations
    and at vendor meetings (over 100/Year)
  • White Papers on the use of technology
  • Serve on numerous conference boards
  • EHR Search and Selections (gt 100 Practices)
  • DOQ-IT and CMS EHR Selection Tool
  • NO Revenue from any vendor based on any Sales or
    increase in Revenues

4
Why is this session important
  • In 2006, the healthcare industry saw an explosion
    in interest in the ambulatory EHR marketplace
  • Partially driven by quality indicators, P4P, and
    a relaxing in the Stark law that prohibited
    hospitals from funding community EHR
    initiatives.   
  • What does this mean for the average Physician
    Practice?

5
Topics
  • How will EHR initiatives are changing the way
    practices look technology decisions?
  • What is the governments involvement in EHRs?
  • How are hospitals leveraging EHR projects to
    increase physician bonding?
  • How with EHR affect your revenue stream?
  • Why do systems fail?
  • How the EHR vendors are rated and why many will
    not survive?

6
Vision
  • Technology is simply a catalyst that will
    empower providers to drive meaningful changes in
    care.
  • People love progress but hate change

7
What issues are physicians interested in?
  • Maintain or improve Quality
  • More timely and accurate payments from carriers.
  • Save time and money.
  • Allow them to see more patients per day.
  • More productive organization's.
  • Provide information about their organization's.

8
The Thing About the Future
9
You Hate Getting It Wrong!
10
And Big Surprises Arent Much Better!
11
With Only the Past for a CompassWho will guide
you?
12
Patterns Must Lead to ActionSuccess Teamwork
13
The Digital Medical Office of the Future
14
  • Update patient demographics
  • Scan Insurance cards/
  • Scan Drivers license
  • Sign consent forms
  • Take patient picture
  • Collect Co-pay
  • Create Encounter
  • Document PFSH
  • Document ROS
  • Take Vitals

Check-in
  • Receive Appointment Request
  • Schedule/Reschedule Appointments
  • Perform eligibility check

Refer in
Pre-exam
Appointment Scheduling
C C D
The EHR Process
Refer out
C C R
Charge Codes
Check-out
Exam
  • Review PFSH/ROS/Vitals/ Diagnostic Reports
  • Perform Physical Exam
  • Document Assessment
  • Order Rx/Diagnostic Procedures/Treatment
    Procedures
  • Provide Patient Education
  • Schedule follow-up appointment
  • Perform referral authorization
  • Obtain Referral appointment
  • Collect payments

Post Exam
  • Perform Treatment Procedures
  • Draw specimen for Diagnostic Procedures
  • Fax/Transmit Rx and Diagnostic Orders

Billing
15
Information Overload
16
who already have implemented EHR Applications
17
What is the governments involvement in EHRs?
  • Free EHR - Vista
  • Congress What till 2009
  • Personal Health Record Initiatives
  • Setting Standards CCHIT
  • CMS and P4P
  • Setting Guidelines - HIE
  • Relaxation in Stark Law

18
Enabling Responsive Local Patient Care
Patient Demographics Patient Insurance Medications
Allergies Health Maint Alerts Lab
Results Dictated Reports Vital Signs DX and CPT
codes
Patients Home
CCD Data
Physician at Home
Wireless Access Point
Wireless Access Point
Wireless Access Point
EMR/PM Application
Wireless Tablet
Wireless Tablet
EMR/PM Application
Wireless Tablet
EMR/PM Application
Practice 1
Practice 2
Practice 3
19
Connecting PhysiciansDelivers the Connected
Community
In-patient Clinical Physician Portal
Physician Office Solutions
Broad CommunityConnectivity
20
It shouldn't take a brain surgeon to design one
patient centric community EHR
21
Offering Physicians Choices A Flexible and
Modular Path to EMR
  • Level 3
  • Practice
  • Support
  • Fully functional EMR
  • CDS
  • KBS
  • Level 2
  • Practice Support
  • EMR Light
  • Charge capture
  • Hlth Maint Plan
  • Referral Management
  • Level 1
  • Practice Support
  • eRX
  • Orders
  • Results
  • Clinical Access
  • Physician Portal
  • Results Viewing
  • Messaging and Alerts
  • 50-70
  • Results
  • Printing
  • Auto-route to the office
  • Auto-print to the office
  • 30-50

EHR/Interoperability
22
Hospital Benefits
  • Physician Bonding
  • ER has access to extensive information about
    patients (prior Meds, allergies, lab results,
    chronic issues, health maintenance alerts)
  • Single source Enterprise Wide documentation
  • Nursing, PT, OT, Dietary, Social Workers
  • Reduce errors by up to 78
  • Nursing has access to prior patient clinical
    information in a summary format and detailed data
    by date
  • 35 of nursing documentation is auto generated
  • Physician Order Entry adoption based on best
    practices
  • No change in registration, scheduling, and
    billing
  • Auto generation of HPI and Discharge Summary
  • 98 reduction in HPI and Discharge Transcription
    Costs

23
Physician Benefits
  • Hospital Sponsorship
  • Help with cost (Relaxation in the Stark Law)
  • One system for all charting
  • One system for orders
  • Reduce charting while in the hospital by 73
  • Auto Charge Capture for physician office visits
  • Hospital Lab results delivered 87 faster
  • Access to hospital data from home (with security)

24
Benefits to the Physician
  • Clinical Integration
  • Reduce operating cost gt 8
  • Improve Revenue Capture gt 3
  • Lower costs 40 reduction
  • Monthly fixed costs with local support
  • Pay-for-performance - 5K-10K
  • Interfaces to all sources
  • Data exchange between Primary Care, Specialists,
    and Hospitals
  • Contract terms and conditions
  • P4P

25
Potential Business Benefits
  • Clinician time savings of between 19 and 26 of
    non direct pt. care time
  • MA/Nurse time savings of between 20 and 28 of
    daily activities
  • Medical Record cost reduction of between 64 to
    74
  • Transportation cost reduction of between 80 and
    92
  • Paper cost reduction of between 61 and 68
  • Transcription costs reduction of between 73 and
    87
  • Billing costs reduction of between 6 and 12

26
Potential Business Benefits
  • Charge capture and coding costs reduction of
    between 84 and 90
  • Reception costs reduction of between 10 and 14
  • Lab handling costs reduction of between 61 and
    70
  • Rx handling costs reduction of between 57 and
    64
  • Scheduling costs reduction of between 6 and 12
  • EOB Posting costs reduction of between 61 and
    68
  • Collection costs reduction of between 4 and 8
  • QA Reporting costs reduction of between 46 and
    60
  • ER costs decrease by 31 since the ED physicians
    has access to prior clinical records and results.

27
Benefit to the patient
  • Answer questions one time
  • Centralized Patient Record
  • Reduced potential errors
  • Improved clinical quality and outcomes
  • Reduced unnecessary tests by 73
  • Reduce costs by reducing waste in the clinical
    process
  • ER has access to data at the point of care

28
  • Why systems FAIL!

29
EHR Failure rate
  • Through 2007, the EHR failure rate continues to
    increase.
  • When asked, 1 year of EHR installation, are you
    seeing 80 of your patients using the EHR for
    charting, ROS, HPI, Evaluation, coding, orders
    and results reporting.
  • 73 of the physicians (3,245) indicated that no,
    they were NOT using the EHR for 80 of their
    patients.
  • 18 replaced or were not using EHR
  • Why, are 73 of the physicians NOT fully
    utilizing the EHR after 1 year?
  • So why are there so many failures?

30
Why do Implementations Fail?
  • Poor planning
  • Unrealistic expectations
  • Lack of physician and provider support
  • Flawed selection process
  • Mismanagement of workflow and staffing changes
  • Poor Contract Terms
  • Workflow redesign - COT

31
Organizational and Clinical Transformation
32
Delivery Model Levels of Value Delivery
Transform Maximum Value Realization
Implement EMR Process Change
Install EMR Usage
33
Roles Responsibilities
EMR Vendor Transformation Practice
Deliver Technology Product Ensure Value Delivery Facilitate Exchange Adopt Perform with New Solution
Provide EMR Best Practices Strategy Goal Alignment Provide Sponsorship
Tech System Assessment Assess Readiness Commit Resources
Build Technology Interface Create Program Structure Make Decisions
Present Standard Templates Program Communications Steering Committee
Train Super Users Program Planning Management Practice Management Liaison
Train Users Process Development Clinical Liaison
Configure Software Benefit Tracking Administrative Workflow Team
Load Software Change Management Activity Clinical Staff Workflow Team
Test Support Vendor Management Provider Workflow Team
Respond to Change Requests Roll Out Management Billing Workflow Team
Integrate Lessons Technical Workflow Team
34
What are Practices Purchasing
Source AC Group annual survey of buying patterns
35
When will Physicians Purchase
Source AC Group annual survey of buying patterns
36
When will Physicians Purchase
Implementation Gap
Source AC Group annual survey of buying patterns
37
Who will be purchasing of sales by Service
AC Group annual survey of buying patterns
38
How the EHR vendors are rated and why many will
not survive?
  • Too many vendors to count
  • Too many vendor promising the world
  • Too many failures
  • How do you tell them apart?
  • What are you looking for?
  • How do you evaluate them?

39
Market Change over time
Over 380 vendors claiming to sell EHRs
Selecting the wrong vendor could cost you over
50K per provider
40
EMR/EHR Selection Tool
  • AC Group conducted extensive evaluation of the
    EHR marketplace
  • 9th report
  • Completed in October 2007
  • Included over 3,000 functional questions
  • 48 categories of functionality
  • 26 subcategories of charting functionality
  • 114 Vendors have participated

41
EMR/EHR Selection Tool
  • Charting Vendors
  • EMR Light Vendors
  • EMR Vendors
  • EHR Vendors
  • CHR Vendors
  • Combined PMS/EHR
  • FQHC
  • Mental Health

42
AC Group Product Evaluations
  • EHR Functionality Only
  • PMS EHR Functionality Only
  • Total Company Rating
  • Company Stability
  • Revenues
  • CCHIT
  • Total Ambulatory Revenues
  • Client Base
  • Technology
  • End-User Satisfaction
  • KLAS
  • AAFP
  • AC Group

43
  • Certification Commission for Healthcare
    Information Technology
  • CCHIT is the recognized certification authority
    for electronic health records and their networks,
    and an independent, voluntary, private-sector
    initiative.
  • The mission is to accelerate the adoption of
    health information technology by creating an
    efficient, credible and sustainable product
    certification program.

44
CCHIT Certified EHR VendorsCertification is good
for 3 years but!!!!!
2006 Certified vendors will need to renew again
in 2007
As of Feb 1, 2008 only 13 vendors have passed the
2007 CCHIT
45
Top EMR/EHR Vendor ApplicationsPractices with gt
100 Physicians
GE does not want their ranking published
Based on 2,750 Functional Questions Divided
Between 46 Categories
46
Top EMR/EHR Vendor ApplicationsPractices with 20
to 99 Physicians
Based on 2,750 Functional Questions Divided
Between 46 Categories
47
Top EMR/EHR Vendor ApplicationsPractices with 6
to 19 Physicians
GE does not want their ranking published
Based on 2,750 Functional Questions Divided
Between 46 Categories
48
Top EMR/EHR Vendor ApplicationsPractices with 1
to 5 Physicians
GE does not want their ranking published
Based on 2,750 Functional Questions Divided
Between 46 Categories
49
Bottom Line
  • What does it take to thrive?

50
BOTTOM LINE
  • Physicians need help when it comes to technology
  • Physicians need local support
  • Physicians need help with contracts and pricing
  • The community needs to share data
  • 80 of the data is in the office
  • Lets empower the physician

51
For More Information
  • Mark R. Anderson, FHIMSS, CPHIMS
  • CEO and Healthcare Futurist
  • AC Group, Inc.
  • 118 Lyndsey Drive
  • Montgomery, TX 77316
  • (281) 413-5572
  • eMail mark.anderson _at_ acgroup.org
  • www.acgroup.org

52
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