THE HITECH EFFECT

1. THE HITECH EFFECT

2. The HITECH Effect • Watching, Waiting, Listening • What Does The Money Mean? • “I Didn’t Need It, And Now You’ve Interrupted Me” • “Great, Now I Can Do A Little More” • “Finally, I Can Move Forward” • “You Didn’t Really Give Me Any Money. So Thanks, I Guess”

3. What’s Holding Up The Market? • KLAS Says Major Vendors See Lowest Sales In Years • Hospitals Must Finish Research Phase • MU Definition Crystallizing, But … • Situation Around Certification Still Cloudy • Reporting mechanisms to qualify for payments unclear (more later)

4. First Wave: The Consultants • Research First • Consulting Tsunami – “It’s Like Y2K” • KLAS Reports – Understanding The Choices • Calling Your Vendor/Partner – “It’s A Marriage, Right?” • What’s Your Budget? Nordstrom Or TJMAXX

5. Pay For Help Or Get “RECked” • Are Some Waiting For The RECs? • Strange Timelines – Operating By December 2010, But • CMS Will Start To Pay Incentives In October 2010 • “HIT Consulting Medicaid” • Staffed By? AHIMA’s Call to Arms For HIT Professionals

6. Second Wave: The Vendors • Renew The Vows Or Divorce Court? • In Most Cases, Clients Will Stick It Out • Major Upgrades Just Like Switching Vendors • Vendor Versions And CPOE – It’s All About The Front End • Getting To The Front Of The Line: “Have I Told You Lately That I Love You?”

7. Getting Up And Running • Development Of Order Sets • Implementing The IT, Writing The Interfaces • Workflow Redesign • Training And Support • The Holy Grail Of CPOE (Slow Them Down, Reduce Their Revenue, What’s Not To Like?) • A Tray Of Baked Ziti And An Empty Room

8. A Competitive Environment • Being Sensitive To The “Book Of Business” • Carrots And Sticks – Playing The 10 Percent Game • Keep The Top Docs Happy As Long As Possible • Having A Good Hospital Down The Block Is Different Than 100 Miles Away

9. Beyond Transactions • The Data Mgt. Challenge – Warehouses And Repositories • Rolling It Up For Reporting – CMS/P4P • The Questionable Wisdom Of A Document Scanning Strategy • The Dream Of Discrete Data – To Get It Out You Have To Put It In, And That’s Not Easy • Must Know What You’ll Need To Do With The Data In Order To Manage It Correctly

10. MU & The Continuum Of Care • CEO Sets the Vision, and Vision Determines Vendor • Tying In The Practices (Stark & HITECH) • Can You Afford To Let Them Fail? • Full Boat “X” Inpatient, Owned Ambulatory, Offer It To The Independents • Some Vendors Have Gaping Ambulatory Hole

11. Tough Business To Be In • CFOs Aren’t Happy • P4P Programs Still Not Large Enough To Be A Game Changer • Administrative Burden Of Reporting Not Inconsequential • “Must Revamp Reimbursement For This To Work” – Cannot Simply Add Financial Burden And Reduce Revenues

12. Not To Mention… • Redundancy, Reliability And Uptime • Disaster Recovery Technologies And Planning • CPOE And The Need For Wireless • Wireless Demands And The Wired Network • Voice Recognition To Get Physician Documentation Into EHR • Integrating EHR, PACS & RIS

13. And … • Integrating Biomedical Devices Into The EHR • Privacy, Security And Audit Trails – HIPAA On Steroids • Proper Hardware To Foster Adoption • Tablet PCs • COWs • Empowering Handhelds Of Choice • Physician Portals

14. New Business Opportunities  … • HITRC (My Favorite) – “Assemble And Disseminate” • Regional Centers • HHS Certification Testing Facility • Monetize Your EHR Support By Offering Services To Other Hospitals And Practices • Monetize Your Data Center

15. Moving Forward • Little Clarity Yet Around Reporting Mechanisms • What Data Will Be Required? • What Form Will It Be Required In? • Who Must Sign/What Are Penalties? • Will There Be Audits, Like The IRS?

16. 2010 Will Be A Big Year • Key Information Revealed • Develop Systems To Support Payment Of Incentives • Develop Final Rules To Establish Policies Needed To Pay Incentives • Develop Systems To Monitor And Evaluate Incentive Payments

17. Prognostications • RECs Will Yield Little • Implementation Failures Start In Late 2010 • Will Be Blamed On Providers When Fault May Lay With Timelines • Fewer Small Practices • Fewer Small Hospitals

18. Prognostications • Rise Of The Hospitalist And CMIO • Rise Of The Mega-Hospital • More Physician Practices Purchased By Hospital • Overall, There Will Be A General Leap Forward With Serious Casualties Along The Way • Making The Best Out Of Bad Legislation

19. Questions/Comments Anthony Guerra Editor-In-Chief Healthcare Informatics aguerra@vendomegrp.com