Challenges to EMR/Clinical IT System Acquisition. Gloria Austin CEO, Brown & Toland Medical Group

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1 Challenges to EMR/Clinical IT System Acquisition Gloria Austin CEO, Brown & Toland Medical Group

2 Problem Identification Evolve to a Fully Integrated Community Medical Group Provide Greater Efficiency within the Community Practice Model Enhance the Value/Quality Equation for Purchasers and Consumers

3 Integrated Community Medical Group Characteristics Member view of clinical record Personal disease management Self help General Health Information Patient Education Administration Eligibility Management Care Management Claims processing Revenue management General financials Decision support Case management Concurrent review Wellness management Preventive management Disease management Patient Intervention Patient Advocacy Customer service PCP assignment Demand management Credentialing Protocols Pathways Medical policies Practice guidelines Clinical decision support Alerts & Reminders Journals Medical Knowledge Population Management Outcomes Best practices Research Medical Delivery Patient Access Primary care Specialty consulting Acute Post acute Ancillary Services Core Features Patient centric Care & care management is coordinated across the continuum Clinical & administrative data is accessible enterprisewide/emr Enterprise-wide reporting with feedback loops Support for wellness and medical quality improvement Scheduling Online Nurse advice Physician access eoffice Visits Rx Renewals

4 Provide Greater Efficiency to Physician Groups Patient Eligibility & Benefit Plan Verification Direct Claims Submission & Contract Rate Verification Reconcile Patient Schedule with Charge Capture Increase Coding Accuracy Increase turnaround time for authorizations and Referrals - Rules Integrated Decrease Charting Time & Eliminate Dictation Cost Reduce Office Labor Decrease Record Storage

5 Network Efficiency & Cost Savings Patient Information Available at the Point of Care Network Diagnostic Results Reporting & Shared Data between Primary Care & Specialty Care Eliminate Unnecessary Duplication of Diagnostic Testing Increase Efficiency of Referrals and Authorizations Improve Patient & Physician Satisfaction Reduce Medical Errors

6 Enhance the Value/Quality Equation for Purchasers and Consumers EMR/Clinical IT Infrastructure Care Coordinated across Network Clinical Data Accessible Enterprise Wide Outcomes Analysis Purchaser Decision Support Consumer Decision Support

7 Process Leadership Vision & Strategic Priority Technology Needs Assessment Product Evaluation & Selection Implementation Plan

8 Building the Strategic Priority Success depends on building a solid foundation Reliable Information Management User Benefits Applications Systems Integration & Control Physician focus is typically at the surface & on their own expected benefits How well systems provide these benefits depends upon a solid, below the surface foundation Durable Infrastructure and Sound Standards Appropriate IT Leadership, Skills, and Staffing Levels Senior Management Support, Joint-Ownership, and Communication of IT Strategic Vision and Plans Business Unit-wide Synchronization of Business Plans, Processes and Systems Clear and Sound Corporate Strategic Direction Shared IT Vision and Road Map Appropriate Context and Confidence

9 Technology Needs Assessment Internet Intranet Wireless Web Foundations Recommendation: Based on estrategy, develop earchitecture plan and coordinated design across all stakeholders. Depending upon anticipated content needs, may want to create publishing templates. A tertiary priority may be to assist non-wired physicians to get wired. Clinical & Care Management Recommendation: Evaluate physician portal products; a combination of 1-2 products can fulfill the following functionality requirements. Post existing or to-bedeveloped clinical guidelines and reference material. Roll-out strategy for EMR may include hand held devices, another way to make decision data readily accessible. Decision Support Recommendation: Determine reporting objectives and post on Website for stakeholder access. Governance structure, staffing, funding earchitecture and site re-design Portal development Guidelines, standards & template development MD einfrastructure Developing the EMR Clinical Messaging Prescriptions Clinical Look Up Information Clinical Advice Preventive service reminders Q & A - PCP and Non PCP Patient Access Scheduling online Reporting Physicians Monthly Utilization Employers Quality/status

10 Staged IT Strategy: Operational Efficiency & Regulatory Risk Assessment IDX Optimization & Data Quality RACER Replacement Data Warehouse/Data Marts InterQual Implementation Web Foundations Portal Development & earchitecture HIPAA Risk Assessment Statewide Initiative-Assess IT Impact Disaster Recovery Planning Help Desk Differentiate HIPAA Remediation Web EMR Options Analysis & System Selection Point of Prescribing, Clinical Alerts, Results Reporting Pilot Physician/Patient Connectivity Decision Support Reporting Case/Disease Management System Evaluate CRM Options Expanded Network Services End User Device Standards Remote Access Control Operational Improvements Transformation Physician Services Integrated PMS & EMR All Product Offering Sustainability and Competitive Advantage $8 Million $10-12 Million

11 Applications Suites Brown & Toland Solution Access Management Master Patient Index Scheduling Visit Management Eligibility Verification Referrals Ambulatory Payment Classification Patient Financials A Single Financial Solution Claims Editing Software Combined business Services EMR Charge Capture Clinical Results E-prescribing Scan Order Authorization Risk management Dictate Self-Service Web Transcribe BTMG will also provide sophisticated Portals Document Advance reporting Benefit systems for physician use Workflow Notice TECHNOLOGY FOUNDATION Delivers operational benefits across the organization

12 Implementation Imperatives Solidify Early Adopters Flexible Critical Path Resource Management Enterprise Alignment

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