1. UNCG MBA Capstone
Consulting Project
Examining the Feasibility of an
EHR Implementation at
Greensboro Ophthalmology
Consultants:
Ted Deligianis
Vandana Taneja
David Kutas
2. Today’s Agenda
What Who
Project Scope Vandana
Background of Legislation Ted
EHR Pros and Cons David
Market Analysis Ted
Research Methods Vandana
Change Management Vandana
Recommendation David
3. – EHR: Electronic Health Record
– EMR: Electronic Medical
Record
– PHS: Public Health Service
– ARRA: The American Recovery
& Reinvestment Act
– eRx: Electronic Prescribing
– ASP: Application Service
Provider
– HITECH: The Health
Information Technology for
Economic and Clinical Health
Act (HITECH) Act
Alphabet Soup
Introduction
4. Project Scope
– Evaluation of Government Incentives
∙ Timeline of implementation schedule
∙ Carrot and Stick (incentives turning into disincentives)
∙ Government Legislation
– EHR industry analysis
– Market Analysis
∙ North America market
∙ Live EHR implementation (clinic visits)
∙ EHR Vendors
– Pros and cons of EHR implementation at Greensboro Ophthalmology
∙ Examination of Feasibility
∙ Change Management and implications
– Cost-Benefit analysis for Greensboro Ophthalmology
∙ Potential costs of not implementing EHR
– Recommendation : Chosen Vendor
– Rationale behind Decision
5. ARRA Legislation
Background and Legislation
Table 1: Estimated Impact of Medicare (In Billions)
Fiscal
Year
Low Scenario High Scenario
Hospitals Professionals Hospitals Professionals
2011 $0.2 $0.2 $0.5 $0.6
2012 $0.9 $1.0 $2.1 $2.3
2013 $1.1 $0.9 $2.2 $2.0
2014 $1.2 $0.6 $1.9 $1.3
2015 $0.5 ($0.1) $1.8 $0.7
2016 $0.6 ($0.6) $1.2 $0.1
2017 $0.3 ($1.3) $0.5 ($0.5)`
2018 ($0.2) ($1.6) - ($0.8)
2019 ($0.1) ($1.6) - ($0.8)
TOTAL $4.6 ($2.5) $10.1 $5.0
Adapted From: (CMMS, 2009, p. 44562)
– $787 billion spent Government
under ARRA as Government
Expenditure and Tax Cuts
– $28.5 billion allocated to
HITECH
– Medicare money as incentive
payments
– Government offers “carrot”
until 2015
6. Meaningful Use
Background and Legislation
Stages of Meaningful Use Criteria by Payment Year
First Year of Payment
Payment Year
2011 2012 2013 2014 2015
2011 Stage 1 Stage 1 Stage 2 Stage 2 TBD
2012 Stage 1 Stage 1 Stage 2 TBD
2013 Stage 1 TBD
2014 TBD
Adapted from: (CMMS, 2009, p. 11)
7. HITECH implications for providers
Background and Legislation
•75% of Medicare
reimbursements or
$44,000 as aggregate
benefits
•$216,000 – 5 Years
•$415,042 – 8 Years
MaximumEHRincentiveforHITECH
Calendar
Year
FirstCYforwhichtheEPReceivesanIncentivePayment
2011 2012 2013 2014
2015and
subsequentyears
2011 $18,000 --- --- --- ---
2012 $12,000 $18,000 --- --- ---
2013 $8,000 $12,000 $15,000 --- ---
2014 $4,000 $8,000 $12,000 $12,000 ---
2015 $2,000 $4,000 $8,000 $8,000 $0
2016 --- $2,000 $4,000 $4,000 $0
TOTAL $44,000 $44,000 $39,000 $24,000 $0
Adaptedfrom:(DepartmentofHealthandHumanServices,2010)
8. EHR Pros and Cons
Pros
Increased Efficiency
Cost Efficiency
Process Efficiency
Cons
Increased Costs
Decreased Efficiency
9. – Global market
projected to be worth
$19.7 billion in 2013
– North America market
to grow 9.7%
Market Analysis
10. – Research Objective
∙ Study the process and implementation of EHR
systems
– Research Methods
∙ Client Visits
∙ Site Visits
∙ Vendor Demonstrations
Research Plan
11. – Site Visits
∙ UNC Chapel Hill Eye Clinic
∙ The Moses Cone Health System
∙ Piedmont Retina Specialists
– Vendor demonstrations
– Client Visits
Research Methods
13. – Crucial aspect of change management
– 3 entities: Main practitioner (change leader), clinic
administrator and project manager
– Conviction of change leader
Change Management
Emphasis on Peopleware
14. ₋ Organizational change
₋ Pressure of developing new skills
₋ Fear of job loss
₋ Frequency of changes
Change Management
Resistance to Change
15. – Multifaceted implementation plan
– Potential barriers: financial, physician and workflow
– Assessment of preparedness
– Clinic wide survey
Change Management
Greensboro Ophthalmology
16. ₋ Reinforce goals of organization & consensus
₋ Establish need to implement EHR
₋ Assure support in pre & post stages
₋ Instill confidence in team
Change Management
Greensboro Ophthalmology
17. Recommended Vendor: Practice Fusion
₋ Key Features:
∙ Free for basic service
∙ Includes Practice
Management
∙ E-prescribe function
automates ERx
∙ Award-winning
Security
∙ Customer-oriented
∙ Easy to use
21. Practice Fusion: Greensboro Ophthalmology
Total Cost of Ownership
₋Free Basic Functions:
∙Practice management
∙Charting
∙E-Prescribing
∙Connectivity
∙Customer Service
∙Training
₋Additional Costs:
∙Kareo-Billing Option
∙Service Level Agreement
22. Practice Fusion: Greensboro Ophthalmology
Compliance with Meaningful use
-Practice Fusion is certified to
satisfy all 20 standards
∙15 mandatory
∙10 additional from which the
firm elects 5
,
23. Practice Fusion: Greensboro Ophthalmology
Privacy and Security
₋ Data centers equipped with bank-level
technology, DEM, armed guards,
biometrics, etc
₋ Meets HIPAA requirements
₋ Meets Meaningful Use criteria
₋ Well-defined user roles/ access levels
₋ Greensboro can do live audits
₋ Sharing information with local hospitals
₋ Stage 2 of Meaningful Use
24. Practice Fusion: Greensboro Ophthalmology
Customer Service
₋ Satisfying and educational
₋ Beginning, intermediate, and advanced
training sessions
₋ Courteous, helpful, and willing to
follow-up
₋ The Practice Fusion EHR recently won
#1 EHR for customer service in 2011
25. – Fiscal Year of the Federal Government closes
in September
– Increased Organizational Knowledge
– Market Competition
– Change Management
– Changing Legislation
Rationale
26. – Dr. Sara Stoneburner (Greensboro Ophthalmology)
– Mr. Gary Parker (Greensboro Ophthalmology)
– Dr. Eric Ford (Bryan School at UNCG)
– Dr. Maurice Landers (UNC Chapel Hill Eye Clinic)
– Dr. Bruce Swords (Moses Cone Health System)
– Dr. Jason Sanders (Piedmont Retina Specialists)
– Mr. Jason Bohrer (Bryan School at UNCG)
– MBA Department at the Bryan School of Business and
Economics
Thank you
Editor's Notes
Explain how carrot turns into a stick starting 2016
Explain the 3 entities to be associated with the change management.
