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Achieving the Vision of Interconnecting the Community Through an EHR

Achieving the Vision of Interconnecting the Community Through an EHR. “A WORK IN PROGRESS”. Gregg T. Martin, MBA, CPHIMS CIO, Arnot Health gmartin@aomc.org HIMSS, 2006. ARNOT OGDEN MEDICAL CENTER Elmira, NY. Presentation Agenda. Thumbnail of Arnot Health

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Achieving the Vision of Interconnecting the Community Through an EHR

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  1. Achieving the Vision of Interconnecting the Community Through an EHR “A WORK IN PROGRESS” Gregg T. Martin, MBA, CPHIMS CIO, Arnot Health gmartin@aomc.org HIMSS, 2006 ARNOT OGDEN MEDICAL CENTER Elmira, NY

  2. Presentation Agenda • Thumbnail of Arnot Health • Why we’re pursuing a community EHR? • Obstacles • Our Approach, and Why? • Conclusion

  3. Regional, IDS in Elmira, NY, serving southern NY and northern Pennsylvania • 256 bed hospital & affiliated multi-specialty practice • 200+ physicians on staff (65 employed) • 10,200 IP admissions: 28,600 ED visits: 206,000 OP visits, 112,000 office visits • Competitive, Independent Environment • IT budget 2.8% of operating budget 3

  4. Why Pursue a Community EHR? Historically: • Impact on patient care? • To reduce costs, be more efficient? • Clinician Satisfaction? • Patient Satisfaction? • Internal Forces? • Regulatory & Public Mandates? • Reimbursement Incentives/Penalties? New Factors in Play:

  5. Federal InitiativeNATIONAL COORDINATOR for HEALTH INFORMATION TECHNOLOGY • Creation of “Strategic Framework” • Informing Clinicians • Interconnecting Clinicians • Personalized Care • Improving Population Health • “Pay for performance” agenda • Encourage creation of “RHIO’s” • Focus on standards and a health information exchange infrastructure • EHR certification • Patient/Consumer portals • Surveillance/Monitoring

  6. Obstacles We Face • Cost • Reimbursement environment • Regulatory environment • Lack of IT expertise in practices • Competitive issues • Systems & infrastructure • Apathy

  7. Being a leader always has its risks, butsometimes it’s the right thing to do

  8. Mitigating the Obstacles • Involving community clinicians during our search/review of EHR systems • Providing independents feedback on benefits obtained by affiliated practice • Providing technical advice on office infrastructure and contract negotiation • Working with IPA to educate members • Working with payors to discuss incentives • Searching for grant funding to help offset acquisition costs of EHR’s • Being a cheerleader of efforts like the IHE, and working with its partners to encourage collaboration and help them understand how the standards, and system integration needs to be designed to meet the business and operational challenges we face • Starting small, but implementing solutions that show value along the way

  9. KEEPING OUR EYE ON THE BALL National focus and development of standards vital, but.. 90% + OF THE VALUE IS WITHIN ORGANIZATION, AND 90% + OF THE OBSTACLES ARE, TOO ACUTE Standards increasingly more important as you work outwards AFFILIATED AMBULATORY COMMUNITY RHIO NHIN

  10. Our Approach & WhyMONOLITHIC VS. DISTRIBUTED ARCHITECTURESMSO VS. STANDALONE“Eating the elephant one bite at a time” • Medical Center EHR (Misys CPR - 2000) • Affiliated Practice Group EHR (Misys EMR- 2004) “SHOW ME THE MONEY” STAGE” • Integration of acute & ambulatory EHR’s (Misys Connect - 2006) • Independent Group “Pilot” (Misys Tiger/EMR - 2006) • HEAL NY Grant funded expansion ? (Misys Tiger/EMR – 2006) • IPA/Vendors/Community Coalition (2007) • Search for additional grant funding (2007) • Integration of other third party EMR’s using IHE model (2007)

  11. Formulary Compliance Medication Error Reduction Medication & Other Ordering Efficiencies Reduced Chart Mgmt Cost Decreased LOS Reduced Transcription Cost Increased Reimbursement Health Screening Reminders Improved Disease Mgmt Reduction in Duplicate Orders Increased Retrospective Analysis Increased provider and patient satisfaction BenefitsExpected & Realized“the sky is really the limit”

  12. Conclusions • Data sharing standards will be vitally important in the long run, and will increase adoption rates, but no need to wait for them to be in place to get started. • Funding opportunities are few and far between… waiting for more to appear may cost you. • Distribution of costs vs. benefits unlikely to shift in the near term, and performance based reimbursement appears to be on the horizon. • While proposed changes to Stark are a start, more safe harbors will be needed to minimize uncertainty and increase collaboration. • Despite the issues, the “tail wind” for community EHR’S has never been stronger.

  13. QUESTIONS ? Gregg T. Martin, MBA, CPHIMS CIO, Arnot Health gmartin@aomc.org HIMSS, Feb, 2005

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