Welcome. Project Overview. In this Issue. 1

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1 July 2018 The Advocare Transformation Welcome More than one year ago, Advocare began a process to secure a best in class Electronic Health Record (EHR), Practice Management, Revenue Cycle Management (RCM) and Population Health Platform. Recognizing the limitations with our current platform and the need to continue providing extraordinary care to our patients, we began the process to select our new platform. Throughout the past year we spent more than 10,000 hours working on this project. In order to summarize the project, we have structured this communication as PAST, PRESENT and FUTURE. As the Executive Sponsor for Advocare, I am honored to work with not only national experts from across the country but extraordinary individuals from Advocare who are representing and advocating for our patients, employees, care centers, and our organization. I am proud that we have assembled a world class team. I would like to thank all our participants from the Request for Proposal Committee, EHR Demonstration Labs, Advisory Committee, Innovation and Technology Committee, Executive Council, Board of Managers, Workgroups, Project Management Office, and the Steering Committee. Jon Mackler, MPA Chief Strategy Officer Project Overview We are pleased to announce the ecw implementation project is underway! The initiative has been named Advocare Transformation to symbolize the process currently in place to build tomorrow s Advocare. There are nine dedicated teams comprised of over 100 Advocare employees, hard at work, executing their tasks within a massive Project Plan. Below you will see the project logo and the 9 teams involved with the initiative. Steering Committee Project Management Office Contracting Workstream Communication Workstream IT Infrastructure Workstream Implementation Workstream Practice Optimization Workstream Data Migration Workstream Revenue Cycle Management Workstream The current homework assignment for all employees is simply to stay informed. The Communications Workstream is dedicated to ensuring all employees have access to up-to-date information. More than a year ago Advocare began the process to select a new PAST Electronic Health Record (EHR) Platform. We recognized that our new system will need to expand as we grow, support multiple specialties, adapt as we develop ambulatory care facilities and other corporate endeavors, and assist us when we participate in global or risk contracts. We sent Request for Proposals (RFPs) to four vendors to secure the best Electronic Health Record, Practice Management, Population Health and Revenue Cycle Management solutions. During that period we met with the CEOs of each company to ensure that we were a philosophical and practical fit. An RFP Committee commenced review of the documents (totaling 1,655 pages) received from the vendors, to identify the major differences, highlight key capabilities and assess the financial implications. Three vendors were identified to return for Demo Labs. The Labs provided a structured forum for all personnel to assess the platforms and allow the vendors to: Introduce attendees to the use and capabilities of their system. In this Issue Project Overview 1-2 Project Operating Structure 3 Workstream Overview 4-5 Press Release 6 Demonstrate work flows (new patient, follow-up patient, features, functionality, etc.) and assess the features that are important for day-to-day use. Support hands-on time for users to try their workflows on the system. Demo Labs were held over a three-day period for each EHR System. Advocare s current GE platform was also compared against the three EHRs. During the period of the Labs, reference calls for the three platforms were made. Continued on page

2 Project Overview (cont d) An Advisory Committee was formed with 30 of your PAST colleagues and charged with meeting with the (cont d) vendors to review various patient case studies, demonstrate nearly 100 features and functions, address outstanding questions, assess key capabilities, etc. Some of the meetings extended until midnight! eclinicalworks, the preferred vendor, by the vast majority of users that were involved in the process, was presented to the Executive Council and Board of Managers for approval. Advocare spent thousands of hours performing the aforementioned due diligence (system review, lab demos, reference calls, site visits, data center, central business office, and help desk). The vote was unanimous to support executing a contract with eclinicalworks. In an effort to ensure an efficient PRESENT implementation we have created a best in class implementation model. The Workgroups will each have oversight for a particular aspect of the project. If you are interested in participating with any of the groups please ttpmo@advocaredoctors.com Listed please find an overview of the Workgroups. We can always use more help at any level! Contracting Oversees the contract and its implementation. Communication Develops communication and ensures clear awareness across the organization and adoption of the changes. IT Infrastructure Oversees implementation and coordination of the help desk, data center, security, and care center hardware and network. Implementation Focuses on implementation of ecw software systems including training, interfaces, reporting and any exceptions (i.e. practices on other IT platforms). RCM Determines the best approach of revenue cycle management operations in order to implement best practices for optimal outcomes. Data Migration Focuses on ensuring that there is one comprehensive chart for each patient within the new system. Practice Optimization Determines best practices including data integrity, RCM and population health, as well as staffing and MSO interfaces. We are beginning to plan the training for all FUTURE Advocare users. We are planning on having one or more Super Users per care center. A Super User would provide a first point of contact (go-to-people) within the Care Center to answer questions, provide support to the team, understand the system, and function as an ambassador for the Care Center. We will be hiring EHR Trainers. The EHRTs will design and conduct training programs that will work across multiple departments to get employees up to speed in their specific department as well as meeting the overall training needs of the organization. The EHRTs will be responsible for managing, designing, developing, coordinating and conducting all training programs. Other responsibilities are: Contribute to the configuration and testing of the EHR system along with Subject Matter Experts (SMEs) Conduct organization-wide training needs assessment and identify skills or knowledge-gaps that need to be addressed Conduct seminars, workshops, individual training sessions etc. Acclimate new hires to the organization s workflows and conduct customized training sessions Conduct refresher training courses for existing employees to ensure adherence to best practices and recommended workflows Prepare educational materials such as module summaries, classroom handouts, aids and manuals, videos, quizzes, etc. Maintain attendance and other records FUN FACTS healow Health Dial Patients will be able to view their lab results, medications, vitals, and request appointments all on the go with the healow app, on their iphone or Android phone. 2

3 Project Operating Structure This is the organizational structure that demonstrates the relationship with each Workstream Steering Committee Program champions, strategy alignment, oversight and guidance, budget Ensure resources are in place to meet objectives and success criteria Project Management Office Day-to-day management of the project Manage/monitor and escalate issues Ensure proper resource allocation Workstreams Day-to-day task management within scope of responsibility Manage/monitor and escalate issues Contracting IT Infrastructure Revenue Cycle Management Practice Optimization Oversees the contract organization and its implementation Oversees implementation and coordination of help desk, data center, security, care center hardware and network Determines the best approach of RCM operations in order to implement best practices for optimal outcomes Determines best practices including data integrity, RCM and population health to include staffing and Management Service Organization interface Communication Develops communications and ensures clear awareness across the organization and adoption of the changes Implementation Focuses on implementation of ecw software systems including training, interfaces, reporting and any exceptions (i.e. practices on other IT platforms) Data Migration Focuses on ensuring there is one comprehensive chart for each patient within the new system 3

4 Updates from the Workstreams Revenue Cycle Management Workstream The ecw Transformation Initiative is one of the most anticipated projects for Advocare, to date. The RCM Team, Providers and Care Center Staff will be actively engaged with the support of senior leadership to ensure a successful implementation of the new ecw EMR and operating platform. On a high level, the RCM Workstream is responsible for determining the best approach towards RCM operations in order to implement best practices for optimal outcomes. Our goal is to determine the best approach required to design and implement solutions, and provide best practices throughout RCM operations in coordination with the Advocare transformation project. The RCM work plan with ecw happens in 4 phases: Billing Discovery/Data Collection ecw conducts meetings with the RCM point of contacts to identify all billing requirements, credentialing status, and client specific/unique workflows to identify any billing gaps proactively. Master Data Dictionary Review/Upload This is a review and configuration of all practice management data that is extracted from your existing database which in turn will be loaded to your RCM database. Billing System Setup Based on the identified billing, federal and state requirements, ecw configures and builds the content of the database. This is conducted after the initial data migration upload. RCM Workflow Training RCM training agenda will be identified and coordinated based on the platform setup and specific organizational needs. This is a very exciting time for Advocare and with a pioneering mindset to execute change, our goal of creating the best RCM Practice Management Team in the marketplace will be realized. Thanking you all in advance for your commitment and patience as we undergo this journey together. Data Migration Workstream The Data Migration Workstream has begun work on multiple areas related to the migration process. Most importantly the group has already begun work on the Data Migration Memo which will serve as the overall guide for the conversion effort. Each week, the group is tackling a key section which they review prior to the weekly call and then join for discussion and feedback. We are also beginning the discussions around data migration for those practices who are not currently using the GE EMR to ensure that they are included in the planning for the conversion process. Our workstream has also been fortunate to have Tammy D Amato assist with the preparation of analysis of data for patients who are seen at multiple care centers. To date the group has reviewed findings on problem lists. Communication Workstream The Communications Workstream is dedicated to ensuring all employees have access to up-to-date information. Throughout the next year, we will be utilizing many forms of communication including s, newsletters, audio communication, screensavers with information, and a project website to ensure everyone has access to important information. See page 3 for detailed structure and project description. The Advocare Transformation teams all appreciate your support during this truly exciting time for our organization! 4

5 Updates from the Workstreams (cont d) IT Infrastructure Workstream Network Over the last year, the Technology Committee has reviewed enterprise options for a wide-area-network for Care Centers. After completing that evaluation, the Technology Committee recommended allowing Care Centers to continue to manage their own connectivity. However, due to new web-based applications being introduced into the Advocare environment, The Technology Committee recommended, and the Executive Council approved a minimum bandwidth requirement for all Care Centers. For 2019, Advocare will be requiring a minimum bandwidth of 20 Mpbs for all Advocare Care Centers If you believe your Care Center does not meet this minimum requirement, please have your Care Center Manager or VP reach out to Advocare IT at support@advocaredoctors.com to begin developing a plan to increase your internet service. Hardware Additionally, the Technology Committee has spent considerable time reviewing IT hardware that will not only enhance the performance of ecw but also add the necessary levels of security that is needed in today s environment. As a result of this review, the IT Committee has recommended that Advocare Care Centers should follow certain minimum IT hardware and operating system standards as part of our new IT environment. The two drivers of this decision are: 1. The need for Advocare to move to Windows 10 (from Windows 7). This is required for both security and enhanced functionality 2. ecw Hardware requirements Advocare has identified Laptops, Desktops, Tablets, and Monitors that will be the 2019 standard PCS and Atlantic Tomorrow have been given these standards and the current approved hardware sheet is fully compatible with ecw For all other IT Hardware (Medical and Diagnostic devices), ecw s is compiling the latest list that will be supplied in a future newsletter. If your Care Center is purchasing any new equipment and has questions related to ecw compatibility, please reach out to Advocare IT at support@advocaredoctors.com Thank you for your patience as we continue our efforts to build a best in class IT Support structure for Advocare. Implementation Workstream The Implementation Workstream has started off their work sessions by receiving orientation to key areas of the Implementation process. This has included overviews of System Build process, interfaces and training. Each of these areas have been highlighted during weekly calls. Sub-groups will be formed to allow for deep dives on design, build and other key planning and readiness activities related to the system setup and configuration. Members of the group have also provided system overviews of the current GE system and clinical documentation process for the ecw team to help them understand the transition process. The group has also begun reviewing the list of medical devices that can be integrated with ecw to assess the opportunity to integrate key devices to create a more streamlined future workflow. Recruitment We are recruiting EHR Trainers who will support the entire suite of eclinicalworks (ecw) applications. This role will also conduct training for all system upgrades, builds, test enhancements and upgrades as well as provide ongoing support and training documentation. This role will also assist with system implementation, template design, upgrades, system support, enhancements and report creation. As a trainer, you will work with our physicians, nurse practitioners, physician assistants and other staff to ensure that our EHR enhances physician productivity and the delivery of patient care. The EHR Trainer will identify opportunities for process and quality improvement for patient flow. Apply online at: Physicians-(1)/EMR-Trainer If you have any suggestions, comments or wish to be involved to developing future newsletters, please ttcommunications@advocaredoctors.com 5

6 Press Release from Business Wire Advocare, LLC will transition from GE Centricity to the eclinicalworks cloud-centric EHR and Revenue Cycle Management platform. June 05, 2018 WESTBOROUGH, Mass. eclinicalworks, a leader in healthcare IT solutions, announces that Advocare, LLC will transition from GE Centricity to the eclinicalworks cloud-centric Electronic Health Record (EHR) and Revenue Cycle Management platform. Advocare has nearly 600 providers across 183 locations in New Jersey and Pennsylvania, representing pediatrics, adult primary care, and specialty practices. eclinicalworks was selected because its technology best meets the needs of Advocare s multi-specialty and geographically diverse enterprise, promoting more efficient, accessible, and integrated patient care. In 2017, Advocare began the process to identify a bestin-class EHR, PM, Population Health and RCM platform, said Dr. Howard Orel, CEO and President of Advocare. It was important that we were aligned with a future strategic partner s mission, vision, culture, and philosophy and we found that with eclinicalworks. Advocare will transition from GE Centricity to the eclinicalworks cloud-centric EHR and Revenue Cycle Management platform After an extensive due diligence, Advocare selected eclinicalworks, said Jon L. Mackler, MPA, Chief Strategy Officer and Project Sponsor for Advocare. We were pleased and impressed with the features and applicability of eclinicalworks, and the technology will be an important asset in supporting our organization s transformation. As we continue to expand, the cloud-centric technology has the flexibility to continually meet our goals of delivering effective valuebased care. eclinicalworks V11 will provide Advocare with the latest version of the core EHR to streamline and improve overall efficiency and communications and encourage preventive care for its patients. V11 empowers organizations to meet the challenges and opportunities of value-based care by establishing a fully connected office, with key features: Eva, the eclinicalworks Virtual Assistant, improves usability and efficiency, letting users interact with eclinicalworks technology in a conversational manner. V11 puts interoperability at the forefront of medical care. The days of laborious, point-to-point connections are over. eclinicalworks customers can now self-activate for seamless integration with both CommonWell Health Alliance and Carequality. Through these connections, practitioners enjoy access to comprehensive patient data from any participating organization. eclinicalworks V11 includes hundreds of new features for Revenue Cycle Management, including credentialing, patient insurance eligibility, collections, and analytics. healow TeleVisits leverages the power of the eclinicalworks EHR to expand access to care by offering providers and patients greater efficiency while ensuring the highest standards of medical quality are met. eclinicalworks is committed to assisting Advocare in meeting its goals of delivering outstanding service to its patients, while adhering to the highest medical standards, said Girish Navani, CEO and co-founder of eclinicalworks. V11 is the next step in ushering in the evolution of healthcare IT and will help Advocare remain at the forefront of medical care. With our ongoing commitment to improving human health, we look forward to working with Advocare to enhance the breadth of functionality and empower its patients to become managers of their health and improve communication between patients and their providers. eclinicalworks is a trademark of eclinicalworks, LLC. All other trademarks or service marks contained herein are the property of their respective owners. 6