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  • 1. Preparing for Implementation of the Mandated EMR (Electronic Medical Records) Copyright © 2009
  • 2. What Should You Know?
    • None of the EMR, EHR, PHR Vendors currently meet the Federal requirements for an EMR, EHR and PHR
    • One of the Primary requirements for EMRs, EHRs and PHRs MUST be interoperable and interconnected with other EMRs, EHRs and PHRs
  • 3. What Should You Know?
    • EMR is healthcare’s Y2K time bomb
    • EMRs are Mandated for 2014. The change is real and mandated.
    • Standards are not available until 2010 - 2011
    • The costs are very high, so are the penalties
    • 1/3 to 2/3 of EMRs implemented have failed
  • 4. What Should You Know?
    • As of yet nobody knows which applications will qualify for certification
    • If you do not use a certified program penalties and fines will be implemented
    • Result of fines would mean lower Medicare reimbursement payments to healthcare provider
  • 5. What Should You Know?
    • Healthcare IT resources to support providers are 50% below the number required
  • 6. What Should You Know?
    • Healthcare providers with in-house IT department has:
    • 1. No experience with EMRs
    • 2. Never built one
    • 3. Never bought one
    • 4. Never installed one
  • 7. Barriers to EMR Adoption
    • Inadequate capital to purchase. Cost of Change
    • Unclear ROI (Value)
    • Maintenance Cost
    • Inadequate IT Staff (Training)
    • Resistance to implement. Meaningful Use
  • 8. Questions you will need Answers to
    • The Cost of Implementation. Level of Funding necessary to successfully implement
    • Funding Sources such as Grants, Federal Government Loans, etc.
    • The Long Term Benefits of EMRs
  • 9. Question #1 - Cost
    • Expensive if purchasing Enterprise Version License
    • Affordable if purchasing SaaS (Software as a Service) Agreement
  • 10. Why go SaaS?
    • SaaS is a software model where the purchaser does not purchase or own the software
    • SaaS replaces the traditional approach where organizations used to purchase software and/or hardware
    • No Maintenance Cost
    • Includes Training
    • No Technical support fees
  • 11. Why go SaaS?
    • Customization Included
    • Available Anywhere Anytime using the Internet
    • No Software Installation needed. Software ready to use after initial payment requirements.
    • No IT Staff to be hired
    • Constant Updates (included)
  • 12. Question #2 - Funding Sources
    • Federal Government Loans
    • Bank Loans
    • Personal Loans
    • Financial Services Loans
    • Grant Availability (Stimulus Money)
  • 13. Grant Availability - Stimulus Money
    • Obama’s 20 Billion Dollars Ear-Marked for EMRs - Available in 2011
    • Non-professional Grant writer - Hardly ever approved for Grant Money
    • Professional Grant Writer - Approval Rate Excellent - Costly - Time to prepare is lengthy
    • e-Healthcare Systems Grant Services - Less Costly - Alliance with Professional Grant Writing Company - Less Time to Prepare
  • 14. Stimulus Money - What it Means Health Stimulus Stimulus 101 On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act.  The health IT component of the Bill is the Health Information Technology for Economic and Clinical Health Act  (HITECH), which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records. The opportunity presented by the Bill is enormous. After literally decades of slow but steady progress towards converting our paper-based record system into an electronic one, we now stand poised for a monumental leap forward.
  • 15. Stimulus Money - What it Means Details of the $19.5 billion One portion of the HITECH Act allocates $36 billion that will be paid to healthcare providers who demonstrate use of Electronic Health Records. The net cost to the Federal government is anticipated to be $19.5 billion after savings are achieved through efficiencies, tax revenue and Medicare fee reductions for non-adopters. Because the government wants to spur quick movement , all of the incentives include payments for up to five years but provide the largest payments early in the program. The incentive payments begin in 2011 to ensure the providers have time to adopt and learn to use the EHR; penalties begin in 2015.
  • 16. Stimulus Money - What it Means Fee reductions: Providers who do not demonstrate meaningful use in 2014 will see, in their 2015 fee schedules from Medicare, a decrease of 1%. An additional decrease will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule; it can further be reduced to 95% if the HHS Secretary determines that total adoption is below 75% in 2018.
  • 17. Stimulus Money – Obama Speech Click on Obama Picture to Activate
  • 18. Question #3 - Long Term Benefits of EMRs
    • Errors & Omissions Greatly Reduced
    • Reduction in Wrongful Giving of Medications
    • Improves quality, safety, efficiency and reduces health disparities
    • Provides access to comprehensive patient health data for patient’s health care team
  • 19. Question #3 - Long Term Benefits of EMRs
    • Seamless communication across the continuum of care and into community based settings - integrates primary care physicians and specialists into community care facilities
    • Redesigning the key business processes, along with change management efforts, education and training
  • 20. Question #3 - Long Term Benefits of EMRs
    • Establishing common data, integration, and communication standards
    • Applying appropriate legislative frameworks for patient privacy and patient consent
    • Improves your facility’s Policies & Procedures
  • 21. e-Healthcare System’s Services
    • EMR Software specifically for the Long Term Care Industry - All segments
    • Help in Grant Writing and submission
    • Project Task Management
    • Issues tracking and resolution
    • Identification of Facility Staffing Skill Requirements & Training
  • 22. e-Healthcare System’s Services
    • Project accountability and visibility
    • Certifiable EMR Software - Adapting workflows - To achieve certification, the vendors must complete tasks in 40 categories
  • 23. Certification Requirements for Approval
    • Standards and Certification
    • Qualified EMR technology means the EMR is certified to meet standards and includes patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to provide decision support for physician order entry, to capture and query healthcare quality information, and to exchange electronic health information with other sources.
  • 24. Certification Panels Healthcare Information Technology Standards Panel (HITSP)
    • Specifications being developed:
      • HITSP Interoperability Specification
      • EMR-Centric Interoperability Specification (IS107) and referenced constructs
  • 25. Certification Panels Healthcare Information Technology Standards Panel (HITSP)
    • Specifications being developed:
      • HITSP Interoperability Specification EMR-Centric Interoperability Specification (IS107) and referenced constructs
  • 26. Certification Panels Certification Commission for Healthcare (CHHIT)
    • Specification Standards being developed:
      • Functional / technical specifications
      • ASTM International Continuity of Care Record
      • ANSI X12 (EDI) (HIPAA)
      • CEN - CONTSYS (EN 13940) - Continuity of Care
  • 27. Certification Panels Certification Commission for Healthcare (CHHIT)
    • Specification Standards being developed:
      • CEN - EHRcom (EN 13606) - European Communication
      • CEN - HISA (EN 12967) - Inter-system Communication
      • DICOM - Radiology Imaging/Report Communication
  • 28. Certification Panels Certification Commission for Healthcare (CHHIT)
    • Specification Standards being developed:
      • HL7 - Encryption & Communication
      • ISO - ISO TC 215 - Architecture Requirements
      • openEHR - Next generation public specifications and implementations for EHR systems and communication
  • 29. Certification Panels ARRA – American Recovery and Reinvestment Act The American Recovery and Reinvestment Act of 2009 (ARRA) is here. $180 billion in federal funding has been set aside for healthcare-related spending. This not only impacts workflow, but could transform the roles of coders and billers. Without a doubt, EMRs are grabbing headlines – as well they should, given the emphasis placed upon them within the ARRA and the revenue-producing potential for vendors associated with implementation. But forward-thinking healthcare leaders will also recognize that “all ships rise with the tide.” In the early stages of technology planning, most practices will plot workflow processes and evaluate internal procedures in order to prepare for optimal use of an EMR
  • 30. Certification Panels Long Term and Post Acute Care ( LTPAC ) Advisory Task Force By 2011, at least 10 percent of all orders processed in a hospital must be entered through CPOE to qualify that institution for CMS incentives under the HITECH Act, according to a proposed matrix of meaningful use released today by ONC’s HIT Policy Committee. Other 2011 hospital requirements are: implementation of drug-drug, drug-allergy, and drug-formulary checks maintenance of up-to-date problem lists of current and active diagnoses based on ICD-9 or SNOMED incorporation of lab-test results into EHR as structured data reporting of hospital quality measures to CMS implementation.
  • 31. Certification Panels Regional Health Information Organizations (RHIOs) RHIOs are multistakeholder organizations expected to be responsible for motivating and causing integration and information exchange in the nation’s revamped healthcare system. Generally these stakeholders are developing a RHIO to affect the safety, quality, and efficiency of healthcare as well as access to healthcare as the result of health information technology.
  • 32. Certification Panels Regional Health Information Organizations (RHIOs) RHIOs are a specialization of health information exchanges (HIE). Health information exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate healthcare information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. HIEs also provide the infrastructure for secondary use of clinical data for purposes such as public health, clinical, biomedical, and consumer health informatics research as well as institution and provider quality assessment and improvement.
  • 33. Bottom Line! Times are a' changing This To This