2. Why did we go paperless
Improve
efficiency
Improve documentation
Patient Safety
Improved information access
Care-Coordination
Blue Cross grant support
Reporting
3. The Brockton Neighborhood
Health Center Story
Started
in a church parking lot 1 physician
19 years ago
Expanded to 2 story office with 10
providers. Administrative and dental
office in separate building
Moved to new building 6 years ago- 40
providers, 26,000 patients and 150,000
visits per year.
4. MAEHC-Mass E-Heath
Coalition
Founded
in 2004 with a BCBS 50 million $
grant to bring EHR technology to 3
communities
Brockton chosen as 1 community (also
North Adams and Newburyport
2005- vetting of systems,
2006 GOLIVE with NextGen EMR/EPM
5. System Choice
Practice
size/scalability
Specialty support
Reporting- quality and business reports
User friendliness
Plays well with others
Meaningful Use certified
Amount of IT support needed
6.
7. PRE-GO LIVE
Choose a system- and pay for it
Map workflows- translate to EHR processes
TRAIN,TRAIN,TRAIN!
Decide on infrastructure
Decide on go live scheduling modificationsDecide how much data to abstract
Data conversion if using another EHR
Play with/test system in test environment
Pick a EHR Champion
Get a super-user group together to guide process
8. GO LIVE
Cut
schedule by 50% for 1-4 weeks
Have experts/superusers on hand to
trouble shoot and provide support
Expect some problems- have backup
methods ready to go
9. Lessons Learned
Keep
on track of workload(chart
completion, task completion, ect)
Make sure reports are correct- vet them
You cannot train too much
Communicate- superuser group is a good
venue
Try to keep template modifications to a
minimum- complicates upgrades
10. When the system goes down
DON’T
PANIC
Have backup worflows in place before
this happens (downtime packets)
Have processes in place to backup data
Don’t throw away paper forms (archive
them)
Make sure data gets back into EHR when
it is back up (RX,problem lists, visit notes)
12. EHR incentives
Meaningfull
use:
$44,000 for medicare eligible providers
$63,750 for medicade eligible providers
Initial attestation that you are using a MU
certified system
Stage 1: some thresholds, some measures
simply require that you be able to report
data
Stage 2- more and higher thresholds
Stage 3- stay tuned!
13. Medicare ERX Incentive
Thresholds
for # of ERX’s sent (low)
Penalties for not participating (2%)
Incentive is 0.5% of medicare billing
Must submit G8553 code when submitting
and ERX on a medicare patient
15. What can MeHIdo for you?
Funds
IOO’s (Implementation
Optimization Organization) to help
implement EHR use
Funds consulting services to reach MU
(REC program)
Implementation grants to help with care
coordination
Educational services
(webinars/conferences/site visits)
16. Mass HIway
The Massachusetts Health Information Highway (The HIway) will further
advance the Commonwealth’s goal to electronically connect all of its
health care community. The Commonwealth is working with public and
private partners to extend its existing technology infrastructure. The
HIway will be implemented in three phases.
Phase One will support the direct connectivity among health care
providers.
Subsequent phases will support the analysis of protected health
information (PHI) to better manage the quality and cost of care
delivered; and query and retrieval of information across the health care
community to achieve the best possible care coordination for
Massachusetts residents.
When fully developed, The HIway will provide a mechanism for the
Commonwealth’s entire health care community—
residents, providers, public health officials and others—to have
appropriate access to health information
17. FUTURE DIRECTIONS
Mass
HIway connection- case
management project with Network
Health
MU Stage 2
Patient Portal
Electronic Dental Record (go live 10/1)
UPGRADE
Improve patient education software
Improve quality reporting
capacity/accuracy
