Digitizing the mobile_workforce_electronic_health_records_for_hospice
Digitizing the Mobile Workforce: Electronic Health Records for Hospice George Zimmerman, Brian Lincoln St. Peters Healthcare Services Xerox CorporationAIIM 2011
The old problem – Information andApplication overload Complexity of Healthcare Many application areas exist in a healthcare organization – EHR/EMR, patient management, health information management, education/training, diagnostics, billing, etc. etc. Hospitals typically have a multitude of IT systems – •Multiple EHR/EMRInformation (and paper) overload: •PACS •Lab systems Healthcare workers spend almost twice as much •Payroll/Finance/Scheduling time with documents as in other industries (and •Compliance 33% of information searches are unsuccessful). •Patient Accounting IDC, 2007 •Specialized clinical systems – for ER, Pathology, MentalIn a 2010 survey of healthcare providers, Forrester Health, Obstetrics, Hospice,found over 50% of providers were still driven by etc. etc.paper-paper-based processes and had not committed processes,to an enterprise wide EMR.
2011 Technology Challenge and Driver:‘Meaningful Use’•Healthcare providers striving to support: • Electronic Medical Records (EMR) • Health Information Exchange (HIE) • Cross-provider Electronic Health Records (EHR)•2009 American Recovery and Reinvestment Act (ARRA), HiTECH Act • Accelerate EMR/EHR via incentive payments; but providers must also show “meaningful use” of EHR, meeting a matrix of objectives Example ‘Meaningful Use’ requirements: Better process capabilities Improved patient engagement, communication Quick patient access to records on request Transmittal of prescriptions electronically Cross-system coordination Participation in HIE networks Compliance – Strong auditing and reporting
And the next frontier – Going Mobile•Use of PDA devices, tablets, Web applications has exploded GPS, 3G, Wi-Fi, Bluetooth all growing at over 40%In Healthcare:• New media tablets with better screen size and availability mean more effective use by physicians, clinicians • Mobile tool must match the purpose – laptops, smart phones, wireless devices are acceptable for different clinical activities • Security and compliance requirements are key• Emerging mobile technologies give Healthcare providers new options for supporting Hospice workers and other mobile teams
Internet Administrator/Webmaster, St. Peters Health Care Services George Zimmerman Senior Product Line Manager, Xerox Corporation Brian Lincoln
• Who we are• About Hospice• Relationship to St. Peter’s• Relationship to the area health care community• Special Regulations regarding patient information
George ZimmermanInternet AdministratorSt. Peters Healthcare Services Manage Internet and Web Services at healthcare centers around Albany, NY. St. Peter’s Hospital recently became part of the Catholic Health East network extending along the entire eastern United States. I have been instrumental in implementing IT solutions and policy- setting to address regulatory guidelines related to HIPAA and JCAHO, disaster planning, and many other healthcare-related initiatives. I have advised and contributed best practices to many healthcare centers across the nation.
• First founded by the ReligiousSisters of Mercy in 1869 as St.Peters Hospital, St. Peters HealthCare Services today provides NewYorks Capital Region with acomprehensive, integratedcontinuum of care.• Hospital has 442 beds, 4,600employees (currently merging withtwo additional acute healthcaresystems).• 25 Facilities with a wide range ofprograms and services, from birthto LTC.• Member of Catholic Health East(CHE).
• Currently expanding our Acutecare with a $250 millionexpansion.• Regional announcement tomerge with 3 upstate areahealthcare systems, making usone of the largest in the region,expanding to 125facilities,1,200 beds and 12,000employees.
The Community Hospiceprovides expert care tothose who are very ill withany disease, plus help andsupport for their families.We show patients and theirloved ones how to focus onthe things that mattermost, and we encouragethem to set goals andembrace life.
St. Peter’s HealthcareServices’ Web Servicesgroup provides criticalinfrastructure, network,application, and internetrelated support to helpthe foundation reach itsgoals.
The Community Hospice is a non-profitserving 7 counties: Albany, Rensselaer,Columbia, Greene, Schenectady, Saratogaand Montgomery and employeesapproximately 500 staff.Of the approximately 8600 deaths lastyear, 39% were receiving hospice services.The Community Hospice set a record for“patients under care,” caring for averageof 658 patients per day.Approximately 64% are homecare, 33%are residents of local nursing homes,and about 3% are hospital patients andreceive inpatient hospice care.Services are provided at little or no cost topatients.Patients often keep their current doctors,and we work with them to ensure they arereceiving the best care possible.
The Health Insurance Portability andAccountability Act of 1996 (HIPAA) PrivacyRuleHealth information technology (health IT) involves the exchangeof health information in an electronic environment. Widespreaduse of health IT within the health care industry will improve thequality of health care, prevent medical errors, reduce health carecosts, increase administrative efficiencies, decrease paperwork,and expand access to affordable health care. It is imperative thatthe privacy and security of electronic health information beensured as this information is maintained and transmittedelectronically.Community Health Accreditation ProgramCHAP is an independent, not-for-profit, accrediting body forcommunity-based health care organizations. Created in 1965,CHAP was the first to recognize the need and value foraccreditation in community-based care. CHAP is the oldestnational, community-based accrediting body with more than5,000 agencies currently accredited nationwide.
The dangers of not having document management:• Don’t let HIPPA guidelines or JCAHO eat you up
St. Peters Background:Document Management Solutions to date Diagnosis: Many Hospital-related documents #1 – Key Challenges to manage and keep up to date #2 - Benefits New compliance, disaster recovery initiatives required information to New compliance, disaster recovery initiatives required information to be available, accessible anywhere anytime :: be available, accessible anywhere anytime HIPAA Policies (frequent versions) HIPAA Policies (frequent versions) Disaster/Emergency Preparedness Manual Disaster/Emergency Preparedness Manual
St. Peters Background:Document Management Solutions to date Prescription: Centralized management of documents across all hospitals, clinics Administrative /Health Policies Nursing Generic Standards Manual HR Personnel Policies & Forms HIPAA, JCAHO Guidelines * Emergency Preparedness * Pharmacy Policies & Formulary Document Facilities documentation Management Hospice documentation System IT Online Request forms IT Customer Support documents Other Document Management applications: Integrated Faxed Prescriptions to a secure repository for review and fulfillment Document Archiving
St. Peters Background:Document Management Solutions to date #1 – Key Challenges #2 – Benefits Polices , ,Procedures and forms ––Now “Up to date” Polices Procedures and forms Now “Up to date” Printing cost savings ––High volume printers downsized, huge paper $$$ savings Printing cost savings High volume printers downsized, huge paper $$$ savings IT cost savings ––Email Inbox & Storage downsized IT cost savings Email Inbox & Storage downsized Trash savings and Privacy ––Less trash Trash savings and Privacy Less trash Quicker access to updated information ––no more binders, nurses can read and text- Quicker access to updated information no more binders, nurses can read and text- search Nursing Manual instantly at desktops search Nursing Manual instantly at desktops Employees can download HR Forms from Web --Massive reduction in printed forms Employees can download HR Forms from Web Massive reduction in printed forms Emergency Preparedness Manual ––readily available Emergency Preparedness Manual readily available Up-to-date HIPAA Guidelines are on-line Up-to-date HIPAA Guidelines are on-line Remote clinics and affiliates can access centralized documents from St. Peters’ intranet Remote clinics and affiliates can access centralized documents from St. Peters’ intranet Hospice organization can share documents with International affiliates Hospice organization can share documents with International affiliates
• What Hospice does• How services are delivered• Administrative vs. Clinical Staff• Overhead associated with process
The Community Hospiceprovides round the clockmedical services to terminalpatients.Working with the patientsdirectly in their homes,Hospice provides doctorvisits, nursing care, comfortcare, and emotional supportwhen needed.
Often our nurses anddoctors will travel the 7counties across citiesand towns to provideservices to patients.They must beingeverything needed forcare with them, as wellas be informed of thepatient’s diagnosis andcondition.
The Community Hospicehas both an administrativestaff and clinical staff inorder to help manage itspatients.With patient informationspread across both theoffice and the field, theyare able to provide careseamlessly.
Every day the CommunityHospice deals with patientdata and the need to havecurrent information withthem at a site.With a largely mobileworkforce this informationneeds to be available nearlyanywhere, secured, and asup to date as possible.
• Providing care remotely from outside the facility walls• How to access records back at the office if needed• Centralized Document Store• Meaningful Use• Security issues- the “open file on the car seat” problem• Disseminating information to employees in the field
Incentive Program for Electronic HealthRecords:Records Issued by the Centers forMedicare & Medicaid Services (CMS), thisfinal rule defines the minimumrequirements that providers must meetthrough their use of certified EHRtechnology in order to qualify for thepayments.Standards and Certification Criteria forElectronic Health Records Issued by the Records:Office of the National Coordinator forHealth Information Technology, this ruleidentifies the standards and certificationcriteria for the certification of EHRtechnology,technology so eligible professionals andhospitals may be assured that thesystems they adopt are capable ofperforming the required functions.
• Transforming paper-based process to electronic process• Facilitating electronic document exchange with other health care providers and insurers • Improves service delivery – support/information for field staff • Improves productivity – Information always available when needed • Easier to secure information
HIXNYCreated through a unique collaborationof health care providers and insurers, thepurpose of HIXNY is to mobilize medicalinformation for the benefit of thepatients that our member organizationsserve. By improving health care deliveryservein our community, HIXNY will promotequality care and reduce costs. HIXNYprovides a secure technologyinfrastructure and services to enablephysicians, hospitals, health plans, andother health care providers to interact,share information resources, andconduct the business of healthcare in acollaborative manner.