Davies Award Winner, 2005 Southeast Texas Medical Associates, LLP (SETMA)

1. Davies Award Winner, 2005Southeast Texas Medical Associates, LLP (SETMA) Dwane J. McGowan HTM 680 13 June, 2013

2. CASE OVERVIEW: SETMA • Sought change from document management to data management using NextGen technology • Multiple clinics, ER, hospitals, hospice, level II laboratory, and a nursing home • Desires an Enterprise Practice Management (EPM) system, starting with an EMR • Vendor chosen bases on reputation, financial stability, support/training provided, and scalability • Phased go-live, 1 work area at a time

3. SETMA’s Objectives • Improve care quality • Improve patient safety • Increase patient/provider communication • Enhance reporting efficiency • Raise provider production and satisfaction • Develop a comprehensive clinical document • Improve workflow/billing practices

4. ONC MU GOAL 1Improving quality, safety, efficiency, and reducing health disparities • Adoption of e-prescribing • Improved billing with ICD-9, CPT codes • Recorded demographics, vital signs-capture of notes and basic data about patients • Incorporated lab results into the EHR • Met public health reporting requirements for diseases and immunizations • Reported to patient registries

5. ONC MU GOAL 2Engage patients and their families • E-mail communication with patients • Send lab results if authorized and security in place • Clinical summaries of visits available • Phone calls electronically sent to physicians for review- improved inquiry documentation • Patient portal established

6. ONC MU GOAL 3Improve care coordination • One time registration/data capture • Sharing of data system-wide • Decreased duplication of testing, requests for personal data

7. ONC MU GOAL 4Improve population & public health • Transmit data to immunization registries • Increased immunization rates from 20% to 80% • Created disease specific clinics • Use of templates with best practices

8. ONC MU GOAL 5Privacy & Security of PHI • Security in place 24/7 for transmission of emails and lab results • Use of an established vendor to meet HIPAA requirements

9. Benefits Realized by EHR • Increased efficiencies system-wide • Streamlined referral process for specialists • Improved clinical documentation, workflow • Net annual revenue increased $3 million • Charting and transcription costs down $352,000 • Patient safety improved, medication errors down • Physician satisfaction, and production increased

10. Lessons Learned • Focus on full-scale implementation essential and “high tech will promote high touch” • All capabilities of the EHR must be employed • Need a respected physician champion for provider buy-in • Don’t delay starting an EHR initiative- benefits entity, payors, and the public • Ongoing training for all levels of staff essential • Establish a defined timeline for implementation

11. QUESTIONS?

12. References • Healthcare Information and Management System Society (2007). Improving quality and reducing cost with electronic health records: case studies from the nicholas e. davies awards. Chicago, IL: HIMSS