HMS & HomeTown Health: ROI of an EHR

1. HMS & HomeTown Health: ROI of an EHR Integrated Clinical and Financial Hospital IT Solutions 12/10/09

2. HMS AGENDA • Identifying Opportunities to realize ROI • A simple case study for a 30 bed hospital • How the technology solutions reduce risk, enhance quality of care and impacts financial performance • Realizing your ROI • Qualifying for Funds • Roadmap to the Electronic Health Record • Focus on Adoption • Maximizing your reimbursement • Timeline to convert INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

3. HMS HMS Customers • Complete focus on community hospitals • 650 hospitals nationwide who believe in the integration approach • 100+ are Critical Access Hospitals • Hospitals that are typically the sole provider of care within their community • Understand the urgency of reaching an EHR and are planning accordingly • 50 customers are on their way with CPOE • Believe in the benefits of an integrated system • Believe in the importance of CCHIT/ARRA certification • Value flexibility and vendor relationship INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

4. HMS Simple Case Study • A community hospital requested assistance to predict possible ROI that could be realized with a technology investment • Baseline statistics • Average Census 25 patients • Average LOS 2-3 days • Data collection method and sources • On site one day survey to observe and discuss current processes • Simple survey to collect basic hospital statistics such as admissions statistics, nursing staffing levels and labor costs, order statistics, etc. • Industry Sources- HIMSS Analytics, Cost Report data INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

5. HMS Potential Inpatient Savings • With conservative estimates, we typically see $300K of ROI Year 1… • Where are the savings? • Eliminating addressograph and chart set up times • Common database for sharing of allergies and home meds • Single electronic record that multiple care givers can view eliminating chart wait times • Elimination of hand written MAR processes • Streamlined patient assessment and care planning processes • Potential savings not included • Pre printed forms expense- typically 50- 70% reduction with eForms • Enhanced charge capture from nursing point of issue charging • Reduction in overtime due to quicker shift report and post shift documentation • Automated Vital Sign capture from monitoring equipment • Accounts receivable and collections impact INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

6. HMS Potential Inpatient Savings INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

7. HMS Potential Inpatient Savings INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

8. HMS Identification of Other Potential Inpatient Savings -in one day, didn’t have time to get hard $ INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

9. HMS Qualitative vs. Quantitative Challenge • Qualitative is difficult to measure • If the system alerts and prevents a possible medication error, you do not have a crystal ball to predict the outcome or cost to the hospital • In many instances, near misses are not documented. Without having a baseline to start, it is challenging to show immediate improvement. INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

10. HMS HMS Clinical Value Delivered • Reduce risk • Medicare Never Events • Pressure Ulcers- Braden Skin Scale, auto orders • Acute Renal Failure- Pharmacy monitoring • Deep Vein Thrombosis- Multi disciplinary worklist alerts care givers when ambulation is due or PAST due • Physician Alerts • Critical results alerts and acknowledgement • New medication orders alert for nursing INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

11. HMS HMS Clinical Value Delivered • Improved Patient Safety through eMAR Implementation • Average annual preventable ADEs= 25 • Average Treatment Cost per ADE= $7000* • Annual Treatment Cost for all preventable ADEs= $175,000 • Percent of ADEs med administration related (38%) • Annual Treatment Cost for Administration ADEs= $66,500 • Late and missed dose reporting • Clinical Screening- Allergies, Weight based dosing INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

12. HMS Qualitative Value of HMS: clinical implementation • Increased Patient Satisfaction • Streamlined admission process • Increased bedside care and nursing interaction (40/60 OR 60/40?) • Quicker discharge process • Increased Physician Satisfaction • Web enabled access to the patient chart from home or office including PACS images • Outreach scheduling availability • Digital Patient Record allows electronic chart signature to occur from any location INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

13. QUALIFYING FOR FUNDS INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

14. ARRA HIT Policy Update • ONC & HIT Policy Committee Chair, Dr. Blumenthal Opening Remarks • 2011 MU criteria… “…your work is done…” ARRA/HITECH legislation totally separate from health reform INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

15. ARRA QUALIFYING FOR FUNDS Step 1: Implement Certified EHR Technology Step 2: Adopt Technology & Achieve Meaningful Use Step 3: Submit Application for Payment -2007 CCHIT Certification -2011 Comprehensive -Inpatient & Ambulatory Certification -Willing to Reengineer Current Processes -Ongoing Education/Training -ARRA Dashboard -CMS INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

16. 1 2 3 ARRA CERTIFIED EHR • ARRA, CCHIT and HMS • Proactive Approach • CCHIT 2011 Comprehensive Inpatient and Ambulatory Certification • Contains all of the 2011 ARRA, “meaningful use”, requirements • Goes above and beyond these requirements • HMS will resubmit for certification in 2010 (Spring) • Programming cut off is December 31, 2009 INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

17. 1 2 3 ARRA ADOPTING EHR TECHNOLOGY EHR Big Picture: Improving Outcomes with an Integrated EHR INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

18. MAXIMIZE ROI THROUGH ADOPTION INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

19. 1 2 3 ARRA What You Can Do to Prepare - PPT INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

20. 1 2 3 ARRA What You Can Do to Prepare • PPT • People • 100% Executive buy in • HIT vision team or steering committee • Includes department leaders • Clear goals and objectives • Do you have the right resources • Timeline to get there (How, When, Where, Why and Who) • Physician champion • Believing in the benefits of a complete EHR • Internal communication plan • Ongoing education • HMS Learning Institute INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

21. 1 2 3 ARRA What You Can Do to Prepare • PPT • People • Process • Moving from paper to electronic system • Dedicated account manager from your vendor • Operational, financial, clinical and technical assessments • SWOT analysis • Strengths • Weaknesses • Opportunities • Threats INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

22. 1 2 3 ARRA What You Can Do to Prepare • PPT • People • Process • Technology • HMS has the complete solution for you to obtain a certified EHR and achieve meaningful use • How complete is your current solution? • Do you have CPOE? INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

23. 1 2 3 ARRA ADOPTION TIMELINE • Future Release Schedule and MU Criteria • 2011 MU Criteria • HMS Release 9.0: June 2010 • 1st year hospital incentive begins October 2010 • 10% CPOE utilization • 2013 MU Criteria • HMS Release 11.0: June 2012 • 100% CPOE utilization • 2015 MU Criteria • HMS Release 13.0: June 2014 INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

24. MAXIMIZE YOUR REIMBURSEMENT INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

25. 1 2 3 ARRA Path to Meaningful Use • For Those with a Certified EHR and use it in a Meaningful Manner • PPS hospitals • $2million base plus $200 based on number of discharges • Medicare share and yearly transition factor • Example: $3.5million over 4 years • HMS EHR • $1.2million proposal: your incentive $3.5million • $2.3million remains • What could your hospital do with an extra $2.3million • Network upgrade, construction project • New computers, pen tablets, COWs • Ongoing education, recruiting/retainment • The time is now: 12 months remain for 1st year’s reimbursement INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

26. 1 2 3 ARRA MAXIMIZE YOUR REIMBURSEMENT • Maximize Your Investment • Benefits of an integrated approach • Community hospitals typically have fewer IT resources • Lowers your cost of ownership as system requires less IT resources • Eliminates costly interfaces and staff needed to maintain • Fewer points of failure and having to deal with multiple vendors INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

27. TIMELINE AT A GLANCE INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

28. ARRA TIMELINE INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS

29. THANK YOU INTEGRATED CLINICAL AND FINANCIAL HOSPITAL IT SOLUTIONS