Networking Your Way to an Interoperable EHR · 2010: Dental health record implementation, imaging,...
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Networking Your Way to an Interoperable EHR Minnesota Rural Health Conference June 28, 2010 Anne Schloegel Minnesota Department of Health Office of Rural Health and Primary Care
Transcript of Networking Your Way to an Interoperable EHR · 2010: Dental health record implementation, imaging,...
Networking Your Way to an
Interoperable EHR
Minnesota Rural Health Conference
June 28, 2010
Anne Schloegel
Minnesota Department of Health
Office of Rural Health and Primary Care
Health Information Exchange and
Interoperability
Definition of health information exchange:
Mobilization of health information electronically
across organizations within a region or community
according to nationally recognized standards
Interoperability is comprised of:
technical: transmitting of data accurately and securely
from one point to another
semantic: sender and receiver understand what the data means
process: ―best practices‖ between the sender and receiver
Why Interoperable EHRs?
• To improve health care quality, increase patient
safety, reduce health care costs and improve
public health
• Part of Minnesota’s 2015 EHR mandate
• To be ―meaningful users‖ must exchange health
information
4
Minnesota Model for Adopting
Interoperable Electronic Health Records
Assess Plan InteroperateReadinessEffective UseImplementSelect
Achievement of
2015 Mandate
Continuum
of EHR
Adoption
Adopt ExchangeUtilize
Breaks achieving interoperable EHRs into
manageable steps
Applies across organizational settings
5
Meaningful Use
Minnesota health care providers and hospitals could access $450-$800 million in incentives if they can successfully demonstrate ―meaningful use‖ of an EHR system. The three core elements for demonstrating meaningful use are:
– Use of nationally certified EHR systems
– Submission of clinical quality measures
– Electronic exchange of health information
Health Information Exchange and
Meaningful Use
Health Information Exchange Transactions
Required for Meaningful Use
–Electronic Prescribing
– Immunization Information Exchange
–Laboratory Results Reporting
–Exchange of Clinical Summaries
–Public Health Surveillance and Case Reporting
Health Information Technology
Resources and Tools
• Office of Rural Health
and Primary Care
– Webpage for
HIT/Telehealth
– Monthly Update
– Quarterly
Health Information Technology
Resources and Tools
Minnesota e-Health Web Page
www.health.state.mn.us/e-health
Minnesota e-Health Weekly Update
―Gov Delivery‖ email distribution list
Monthly HITECH Update Calls
– Third Thursday of the month from 4:00-4:45 p.m.
Related Sessions at the Conference
Session 3B—Navigating Medicare and
Medicaid HIT Incentives
Session 4B—Finding EHR/HIT
Opportunities and Support
Session 5A—Health Information Exchange
Opportunities
On Their Way-
Session Speakers
• Mark Roisen
Executive Director, Lac qui Parle Health Network
2007 Planning and 2009 Implementation Grants
• Jackie Moen
Executive Director, Northern Minnesota Network
2008 Implementation Grant
Lac qui Parle Health Network
Non-Profit tax-exempt hospital services cooperative
Appleton Area Health ServicesAppleton
Johnson Memorial Health Services Dawson
Madison Lutheran HomeMadison
Figure 1
EHR Due Diligence
Governance Structure> AAHS, JMHS, MLH Board
of Directors
> LqPHN Board of Directors
> LqPHN IT SteeringCommittee
- Clinical- Administrative- IT
EHR Due DiligenceVision
>Affordability:
>Compatibility:
>Interoperability:
>Data stewardship:
EHR Due DiligenceStrategic Plan
Functionality
Business Case
Other Factors
EHR Due Diligence:Functionality
3 dimensional Chess MatchEnd Users
Existing Software &
Systems
EHR Software
Communication Infrastructure
Production Servers / Backup
Systems & Maintenance Plan
Third Party
Vendors & Payers
EHR Due Diligence:Functionality
Steering Committee
RFP
Goal Setting
Process Mapping
EHR Due Diligence:Business Case
>Total Cost of Ownership
>Benefits
EHR Due Diligence:Business Case
5 year Total Cost of Ownership
Vendor A Vendor B (current vendor)
$5,259,319.00 $4,588,669.00
EHR Due Diligence:Business Case
Benefits
>Improved Patient Outcomes
>Cost Savings>Productivity Improvements>Cost Avoidance>Revenue Increases>Contribution to Profit
EHR Due Diligence:Other Factors
Cost of Conversion from Current Vendor Applications to different vendor
6-12 Month Conversion timeframe during which you need to license both
systems.
Historically Accounts Receivable go up and cash flow goes down during this
transition time frame
Staff training increases significantly due to learning new systems
EHR Due Diligence:Other Factors
Both Vendors are considered Premier Vendors for our Market
Both are Hospital based Health Information Systems with modules for clinic
and long term care settings
Both Vendors are CCHIT Certified
Both hospitals have good references
Consultants all agree either system will work well, if our staff is willing and
capable of making the transition from a paper to electronic environment
EHR Due Diligence:System Maintenance LqPHN received 2 grants totaling over $1.6 million
specifically for the planning and implementation of EMR software and hardware
The LqPHN will be applying for several additional Grants:
MDH State E-Health Grant/Loan ProgramBlandin Broadband ConnectionsHRSA Outreach GrantMicrosoft HealthCare Grant
Group Purchasing bring down cost of ownership LqPHN User Group meetings will facilitate adoption
of best practices in achieving meaningful use
Networking Your Way:
Interoperable EHR
NORTHERN MINNESOTA NETWORK
Jackie Moen – M.A.
Project Director
OUTLINE
1. NMN - who we are
2. Our path to health information technology
3. Our HIT system
4. Lessons learned
5. Future plans
NMN - Who We are…
501(c)3 HCCN organization
Health Center Controlled Network
Started 2001 – incorporated 2004
Mission:
provide health information technology systems,
resources and support to our Members to assist
in delivering quality patient care
NMN – Our Members
Currently three members - FQHCs
Sawtooth Mt. Clinic, Scenic Rivers Health
Services, Migrant Health Services, Inc.
Operate 20 medical and dental sites in
Minnesota and eastern North Dakota
Patients served: 25,866
Encounters: 104,756
NMN – Our Collaborators
Medical : 17 physicians, 8 mid-levels,
19 others – lab, imaging, therapeutic.
Oral Health: 4 dentists, 4 hygienists, 8 support
Exchange information with Cook Hospital,
BigforkValley Hospital, Cook County North
Shore Hospital
NMN – Our HIT Path….
2004: Incorporated, secured funding, selection
team and project plans
2005: Due diligence, RFP = eight responses, four
demos, two site visits, contract negotiations….
GE Healthcare Centricity Practice Solution
CySolutions Applications
SISU Medical Systems
What A Crew !
Site Visits
NMN – Our HIT Path….
2006: Developed infrastructure, phased implementation of Practice Management
2007: EHR Planning - readiness assessments, process mapping, workflows, connectivity issues, interface planning
2007: Converted Practice Management 2004 to Centricity Practice Solution 2006 (only PM)
NMN – Our HIT Path….
2008: EHR – ―flip the switch!‖
SMC - ―live‖ in April
MHSI - ―live‖ in June
SRHS - ―live‖ in September
2008: Eleven clinical sites ―live‖, three lab
interfaces, and many tired, battle-weary folks!
2009: Brought up nine additional sites, one
lab interface, and went from this…..
Relative calm…..
Eye of the Storm…..
CURRENT STATUS
2010: Dental health record implementation,
imaging, HL7 interface Dentrix to Centricity
Additional interfaces
Optimize functionality
QI – Data Reporting
Expand infrastructure
Our HIT System
Electronic Health Record
Practice Management System
Dental Health Record
Voice Recognition
E-faxing
HIE Bridge
Expanded Reporting Applications
Interface Applications – Meditech, Quest
Our HIT System
HIE Bridge
Query patient demographics between hospitals
and health center databases, participating
patients
Expanded Reporting Applications
Crystal Reports
CCC (Chronic Disease Management)
MQIC
MN Community Measures Program
Our HIT System
Interface Applications
Quest Diagnostics Lab
OE and results
Meditech Hospital Information System
Lab results only
Documents Management (ITS) - surgical
procedures, discharge summaries, rehab, ER,
H & P, OT, PT.
Transcribed report immediately goes electronically
through the interface to patient record
LESSONS LEARNED
Use a team approach
Must have physician champions
Dedicated clinical and IT support
Plan change management strategies
Address negativity right away
LESSONS LEARNED
Be sensitive to your workplace culture
Set a standard people agree to live with
Pay attention to observation terms during set up
Process maps help avoid ―paving the cow path‖
Provide LOTS of training, multiple formats
LESSONS LEARNED
Double estimates for interface development
Determine financial impact – initial productivity
costs and ongoing costs
Be flexible – this is a LONG process
Celebrate the early wins!
What Next?
Plans for the Network!
Projects and Plans
Complete major upgrade v8.0 to v9.0
Implement Sure Scripts e-prescribing
application
Develop additional interface applications
Expand data collections – reporting
applications
Projects and Plans
Increase NMN membership
Implement systems with new members
Expand health information exchange
applications
Northern Minnesota Network
Looking for more information?
Contact
Jackie Moen
Project Director
763-444-8283
