CoArtha Technolsolutions IT for Meaningful UsePresentation Transcript
Shivaji Mukthavaram, CEO Email: firstname.lastname@example.org http://linkedin.com/in/shivajimukthavaram
Healthcare: Our Domain Focus
CoArtha Service Offerings
Healthcare IT (HIT)
Outsourced Product Development (OPD)
Remote Infrastructure Management (RIM)
CoArtha Technosolutions is
HL7 Organizational Member
Physicians group count (Internal medicine, Family Practice, Pediatrics, OBGYN, Anesthesiology which is covering 52% of the doctors)
Healthcare source of revenue (FOCUS on Medicare, Medicaid, Private Insurance)
Physicians density (>240 physician density states with least operational expenses)
Based on the Insurance coverage across the nation
Source: US Census Bureau, Service Annual Survey 2007
Conceptualized in 2010
15yrs outsourcing experience
End2End Business Execution ($20 Mn/year)
Operations rigor, Real-time visibility & execution transparency a way-of-life
Unflinching customer orientation
Domain experience 2 to 7 yrs
Managed team sizes (80 to 250)
Strong results orientation
Excellent communication skills
Team size (10 Now, 50 – Dec’11)
Vision: Geared to Deliver
Your benefit is our achievement
IT for Meaningful use
Reduced Cycle time at a fraction of cost
Infrastructure Availability & Scalability
Reduced AR days
Internet bandwidths (2 – 3 Mbps)
Power back up, Disaster Recovery
HIPPA standard access privileges
Provider End Customer ISV
Meaningful Use: The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use: 1. The use of a certified EHR in a meaningful manner, such as e-prescribing. 2. The use of certified EHR technology for electronic exchange of health information to improve quality of health care. 3. The use of certified EHR technology to submit clinical quality and other measures.
* Hospital-based professionals excluded from incentives Eligible Providers - Medicare Eligible Providers - Medicaid Eligible Professionals (EPs)* Eligible Professionals (EPs) Doctor of Medicine or Osteopathy Physicians (Pediatricians have special eligibility & payment rules) Doctor of Dental Surgery or Dental Medicine Nurse Practitioners (NPs) Doctor of Podiatric Medicine Certified Nurse-Midwives (CNMs) Doctor of Optometry Dentists Chiropractor Physician Assistants (PAs) who lead a FQHC)or rural health clinic Eligible Hospitals* Eligible Hospitals Acute Care Hospitals Acute Care Hospitals, Critical Access Hospitals Critical Access Hospitals (CAHs) Children’s Hospitals
Two required components under HITECH statute
EHR Functional (operational) metrics
15 Core measures (Required of everyone)
10 Menu Set measures (You choose five that best fit within your practice)
Clinical Quality Metrics (CQM)
Eligible professionals must report on 6 total CQMs:
3 required core measures (substituting alternate core measures where necessary) and 3 additional measures (selected from a set of 38 clinical quality measures).
Eligible hospitals and CAHs must report on all 15 of their CQMs.
Measures of EHR Use: Interoperability Tests Electronic data exchange with provider not in the same organization 1 Test Submission of reportable lab data to PHD* 1 Test Submission of immunization reports to PHD 1 Test Submission of syndromic surveillance to PHD 1 Test
Summary of Stage 1 Meaningful Use Objectives and Measures for Eligible Professionals (July 13, 2010) Core Objectives (All must be satisfied) Functional Requirements Objective / Condition 1. Computerized Physician Order Entry (CPOE) • At least one medication ordered via CPOE for >30 percent of unique patients seen with at least one medication on current medication list 2. Drug-drug, Drug-Allergy Checking • CPOE drug-drug and drug-allergy checking features are enabled 3. Generate and Transmit Electronic Prescriptions • >40 percent of all permissible medication orders (excluding controlled substance orders) are electronically prescribed 4. Maintain up-to-date Problem/Diagnosis List • For >80 percent of unique patients seen (at least one structured entry, ICD-9-CM or SNOMED CT) 5. Maintain Active Medication List • For >80 percent of unique patients seen (at least one structured entry) 6. Maintain Active Medication Allergy List • For >80 percent of unique patients seen (at least one structured entry) 7. Record Vital Signs • For >50 percent of unique patients ≥ 2 years old seen, record and chart changes in vital signs (as structured data): – Height, weight, blood pressure – Calculate and display BMI – Plot and display growth chart, including BMI (patients 2-20 years old) 8. Record Demographics • For >50 percent of unique patients seen, record demographics (as structured data): – Gender – Ethnicity, race (federal guidelines), preferred language – Date of birth 9. Record Smoking Status • For >50 percent of unique patients seen ≥ 13 years old 10.Report Quality Measures to CMS and the States • Report ambulatory quality measures — per data captured and calculated by the EHR — to CMS or the states for specified core and specialty measures – For 2011: attest to accuracy and completeness of aggregate numerator and denominator – For 2012 (and beyond): submit (at least one measure) electronically 11. Implement Clinical Decision Support • Implement one rule (with high clinical priority for or relevant to the specialty of the EP) and track compliance Health Information Exchange (HIE) Requirements Objective / Condition 12. Provide Patients with Clinical Summary of Office Visits • Satisfy more than 50 percent of requests for a clinical summary of an office visit (via Personal Health Record (PHR), portal, other electronic media, or printed output) within 3 business days 13. Provide Patient with Electronic Copies of Health Information • Provide >50 percent of patients who request copies with electronic copies of their health information (lab test results, problem, medication, allergy lists) within 3 business days 14. Implement Capability to Exchange Key Clinical Information • Perform at least one test of the capability of the certified EHR system used by the EP to electronically exchange key clinical information (for example, problem list, med list, allergies, test results) with another EHR (not shared) HITECH Privacy And Security Objective / Condition 15. Implement Systems to Protect Patient Data • Conduct or update a security risk assessment per 45 CFR 164.308 (a)(1) and implement security updates as necessary
Summary of Stage 1 Meaningful Use Objectives and Measures for Eligible Professionals (July 13, 2010) Menu Set Objectives (5 Must Be Satisfied) Functional Requirements Objective / Condition 1. Incorporate Test Results into EHR • Incorporate clinical laboratory test results into EHR as structured data for >40 percent of all clinical lab tests ordered with positive/negative or numeric results 2. Medication Reconciliation • Performed at >50 percent of relevant encounters and transitions of care 3. Drug Formulary Checking • Drug-formulary check functionality is enabled (with access to at least one internal or external formulary for entire period) 4. Generate Patient Lists • Generate at least one list of the EP’s patients with a specific condition to use for quality improvement, reduction of disparities, and/or outreach Health Information Exchange (HIE) Requirements Objective / Condition 5. HIE: Patients • Provide >10 percent of unique patients seen with electronic access (available on-demand at any time) to their health information (lab test results, problem, medication, allergy lists) within 4 business days of the information’s availability to the EP 6. Patient Follow-up/Preventive Care Reminders • Send reminders for preventive/follow-up care (per patient preference) to >20 percent of patients who are ≥65 or <5 years old 7. HIE: External Providers • Provide summary care record (via electronic exchange, secure portal, secure e-mail, CD, USB drive or printed copy) for >50 percent of patient transitions of care and referrals 8. HIE: Immunization Registries • Perform at least one test of the capability to submit electronic data to immunization registries • Actual submission where required and accepted 9. HIE: Syndromic Surveillance Data • Perform at least one test of the capability to provide electronic surveillance data to public health agencies • Actual transmission according to applicable law and practice 10. Identify Patient-Specific Educational Resources • Use EHR technology to identify and provide >10 percent of unique patients seen with patient-specific educational resources
We will work with you throughout the process
Meaningful use Registration (Provider or 3 rd Party on behalf of Provider)
Stage 1: 90 day continuous Meaningful use first year
Use the system at least for a month before the 90 day continuous usage
Stage 2: 1 year subsequent Meaningful use
What if I already use an EHR?
Ensure your EHR Vendor guarantees ARRA Certification!
Assess the Meaningful Use Gap: Criteria vs. Current use
Utilize ePrescribing functionality
Be specific—use the data fields—no data, no queries
What if I’m “in the process”?
Captain your ship: encourage all to row the same direction
Current paper records: scan to import into new system
Inform all third party businesses of your transformation
Can I stop and restart participation?
Under Medicare, if you skip a year, you will return to a later payment year
E.g., skipping second year would mean forfeiting $12,000
Under Medicaid, you can pass on a year of proving Meaningful
Use and return as if you didn’t skip
Can I reassign incentive payments?
Yes - to your employer or an entity with which you have a valid employment agreement
Reassignment to only one entity will be allowed
Nothing precludes reassignment of only the allowable charges for professional services to the employer/entity but not the incentive payment, or vice versa
Dependent on the details of the contract
How will they decide if I’m a Hospital-based physician and thus excluded?
Congress acted in April of this year to clarify that only inpatient activities are excluded from “allowable charges” If you work in a practice closely affiliated with a hospital but deliver outpatient care, you are now eligible However, if you spend time in the hospital or ED, the hospital based definition still matters
What kind of Flexibility does MU have on the required measures?
If a core measure cannot be met, attest to an acceptable reason for its “exclusion,” and your total number of required measures is reduced: you do not have to substitute another !
Example: What if the majority of your patients live in rural areas with no access to a Pharmacy that accepts eRx – you cannot meet the threshold
Simply attest to that reason and your number of 20 Stage 1 requirements is now lowered to 19.
Can I collect HITECH
incentives & others?
Focused on healthcare domain only with end-to-end offerings (Healthcare IT, Product Development, Web portals development, RCM, MT, etc.)
Extensive number of years (more than a decade) in serving the Healthcare providers
Deep healthcare/application knowledge and bench strength
Excellent technical resources
Good exposure in terms of meaningful use
Last but not least… Economical cost, Global Delivery, Meaningful Use result-based charges (70-30 model) *** Offer applies to HITECH Act Medicare reimbursement payments only
Benefits of working with our team:
System Selection - research and recommend the best certified system for your needs
Overall Strategy - provide you with a road map for attaining Meaningful Use
Project Planning - establish tasks and reasonable timelines for your Meaningful Use strategies
Project Management - assurance that targets are met to get you one step closer to your incentive payment
Development of Gap Analysis - assessing each of the Meaningful Use criteria
Recommended Action Plan - relative to each relevant Meaningful Use criteria
Address Technology/Interoperability with other systems and operational practices
Vendor Management - work as a liason between your organization and your / our vendor of choice
Incentives are based on demonstrating Meaningful Use of the system, which goes beyond the EMR Product implementation
Capture the Data
Establish Effective Workflows to Reinforce Data Entry (Including Medication Reconciliation)
Drive Provider Involvement in Adoption of the EHR
Computer-Based Provider Order Entry (CPOE)
Start E-Prescribing — as Soon as Possible
Develop a Process for Managing Clinical Decision Support (CDS)
Implement Patient Health Information Exchange Workflows
Formulate a Provider Health Information Exchange Strategy
Ensure Privacy and Security Compliance
Initiate EHR-Based Quality Performance Measurement Support
Our holistic view (Stage 1 interoperability, Stage 2, HIE, Clinical Decision support, and potential subsequent stages 3 and beyond).
Practice Readiness Assessment, Office Staff Survey, Computer Knowledge Evaluation
2. Hold regular staff meetings and create the project team
Review practice data:
Migrating patient data into the EHR
Managing incoming documents that cannot be directly imported into the EHR
2, identify and target improvement opportunities 3. Define EHR implementation goals
4. Prepare practice for change 5. Utilize project tools and optimize shared learning
Selection 1. Understand and renew available EHR solutions, 2. Define EHR system requirements 3. Begin to prepare staff and office for an EHR system 4. Select EHR system, solution and vendor 5. Prepare practice for change 6. Utilize project tools and optimize shared learning Implementation 1. Create EHR system implementation plan and timetable 2. Install and configure hardware 3. Install and configure EHR system 4. Prepare staff and office for EHR 5. Complete pre implementation baseline evaluation 6. Journal experience 7. Go-live with EHR system 8. Utilize project tools and optimize shared learning Perform 1. Conduct post go live reviews of implementation 2. Conduct post go live . EHR staff training 3. Journal experience 4. Complete post-implementation evaluation 5. Utilize project tools and optimize shared learning Attest & Payment 1. Review EHR implementation impact analysis, 2. Utilize EHR to practice evidence based medicine 3. Identify and target additional care management and process improvement opportunities 4. Utilize project tools and optimize shared learning 5. Attestation health check and incentives
Clinical workflow – does software accommodates your practice style?
Practice to EMR fitment
Document Templates, Codes, etc.
On-Premise, Web based, Remote server models
Data storage, User experience, Connectivity, CAPEX
Computer skills survey and training
Organizational Readiness Assessment
Meaningful Use training
Security Risk Analysis
Complete EHR Implementation in < 2 months Costs vs. Payments by the Calendar Year
It is our pleasure to help you!!
Shivaji Mukthavaram, CEO
Haricharan Juvvadi, VP – Operations
www.CoArtha.com CoArtha Technosolutions Pvt. Ltd. Hyderabad, India