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Helping Georgia Hospitals Prepare for Meaningful Use and Improved Quality<br />Kent Giles, MPPMEric Bartholet<br />Decembe...
Agenda<br />Welcome and Introductions<br />Review Meaningful Use Requirements<br />Review “where we are” in GHA Facilities...
Introductions<br />Kent Giles, MPPM, Partner, CSC Healthcare<br />25 years of Hospital Administration, Physician Practice,...
Adoption of Clinical IT in Hospitals is Low and Even Lower Among Physicians<br />Background<br />Transforming the health s...
EHR Meaningful Use Timetable<br />Meaningful Use and HIT-Enabled Health Reform Targets<br />The “meaningful use” criteria ...
EHR Meaningful Use Timetable<br />Example of Estimated Incentive Payment Schedule<br /><ul><li>Payments are made over four...
Payments start based on when you achieve the Meaningful Use requirements
Compression of incentive payments begins if you don’t achieve Meaningful Use by 2013
Penalties begin in 2015 and are perpetual</li></li></ul><li>EHR Meaningful Use Requirements Summary<br />This is a case st...
EHR Meaningful Use Requirements Summary<br />
EHR Meaningful Use Requirements Summary<br />
What CEO’s Want to Know <br />Meaningful Use<br />Can my application vendor make my hospital ARRA compliant?<br />Can we j...
HITECH Framework<br />HITECH Scorecard: Results Of 17 GHA Hospitals<br />Overall readiness can be determined by totaling t...
MU is an operational and clinical issue rather than an IT issue. <br />Clinical Documentation and Quality Reporting<br />D...
HF on arrival/within 24 hr
Shock on arrival/within 24 hr
Bradycardia day of/before disc
Heart transplant during stay
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GhA Ceo Webinar 12 2009 Final

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Presentation on preparing for Meaningful Use of EHRs.

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GhA Ceo Webinar 12 2009 Final

  1. 1. Helping Georgia Hospitals Prepare for Meaningful Use and Improved Quality<br />Kent Giles, MPPMEric Bartholet<br />December 9, 2009<br />
  2. 2. Agenda<br />Welcome and Introductions<br />Review Meaningful Use Requirements<br />Review “where we are” in GHA Facilities<br />Keys to Success<br />Q&A<br />
  3. 3. Introductions<br />Kent Giles, MPPM, Partner, CSC Healthcare<br />25 years of Hospital Administration, Physician Practice, Payor and Consulting<br />GHA Account Partner and Advisor to C-Level Executives across the SE US<br />Subject Matter expertise in strategy, planning, IT and Margin/Operations Improvement<br />Eric Bartholet, Partner, CSC Healthcare<br />IT Strategy & Planning<br />Over 25 years working with healthcare systems<br />Subject Matter Expertise in It Strategy, Systems Implementation and Architecture<br />
  4. 4. Adoption of Clinical IT in Hospitals is Low and Even Lower Among Physicians<br />Background<br />Transforming the health system will require hospitals and physicians to dramatically increase their use of HIT<br />The latest data from HIMSS Analytics suggests that just over 40 percent of hospitals have basic clinical (nursing) documentation but less than2 percent have physician documentation(HIMSS Analytics, 2009)<br />The level of current EMR adoption will be a major factor in how much investment will be necessary to satisfy the Meaningful Use requirements<br />
  5. 5. EHR Meaningful Use Timetable<br />Meaningful Use and HIT-Enabled Health Reform Targets<br />The “meaningful use” criteria to be phased in, with the criteria building from year to year.<br />2015<br />2011<br />2009<br />2013<br />HIT-Enabled Health Reform<br />HITECH<br />Policies<br />Capture & Share Data<br />Advanced Care Processes with Clinical Decision Support<br />Improved Outcomes<br />Source: Meaningful Use Work Group Presentation at the HIT Policy Committee Meeting on June 16, 2009<br />
  6. 6. EHR Meaningful Use Timetable<br />Example of Estimated Incentive Payment Schedule<br /><ul><li>Payments are made over four years
  7. 7. Payments start based on when you achieve the Meaningful Use requirements
  8. 8. Compression of incentive payments begins if you don’t achieve Meaningful Use by 2013
  9. 9. Penalties begin in 2015 and are perpetual</li></li></ul><li>EHR Meaningful Use Requirements Summary<br />This is a case study from a CSC assessment. The following charts are intended to identify areas where effort and investment may be required: <br />Well positioned to meet Meaningful Use criteria<br />Effort may be required<br />There is no active project to meet the requirements<br />
  10. 10. EHR Meaningful Use Requirements Summary<br />
  11. 11. EHR Meaningful Use Requirements Summary<br />
  12. 12. What CEO’s Want to Know <br />Meaningful Use<br />Can my application vendor make my hospital ARRA compliant?<br />Can we just accept the penalties and not achieve meaningful use?<br />Isn’t this an issue that I should delegate to my CIO?<br />4. How do we achieve MU and keep our medical staff and clinicians happy?<br />What is the financial impact on my organization?<br />What are the major CEO risks that I face?<br />
  13. 13. HITECH Framework<br />HITECH Scorecard: Results Of 17 GHA Hospitals<br />Overall readiness can be determined by totaling the scores of all the categories, 80 is “likely to achieve MU”. To have a good probability of readiness, a hospital needs to score 80 percent or better in a given category. <br />Dimensions of Healthcare Delivery<br />
  14. 14. MU is an operational and clinical issue rather than an IT issue. <br />Clinical Documentation and Quality Reporting<br />DATA ELEMENTS NEEDED FOR:<br />1. INCLUSION<br />3. EXCLUSION<br />2. OUTCOME<br /><ul><li>Principal dx of AMI-6
  15. 15. HF on arrival/within 24 hr
  16. 16. Shock on arrival/within 24 hr
  17. 17. Bradycardia day of/before disc
  18. 18. Heart transplant during stay
  19. 19. LVAD during hospital stay
  20. 20. Patient has pacemaker
  21. 21. 2nd or 3rd degree block on ECG
  22. 22. Allergy to beta blocker
  23. 23. Other contraindication to beta blocker
  24. 24. Arrival date/time
  25. 25. Beta blocker administered (date/time)
  26. 26. Birth date
  27. 27. Admission date
  28. 28. Discharge date
  29. 29. Transfer from hospital/ED
  30. 30. Transfer out soon after arr.
  31. 31. Receiving CMO only
  32. 32. Involved in clinical trial
  33. 33. Discharged to hospice
  34. 34. Expired
  35. 35. Left against medical advice</li></ul>Acute myocardial infarction (AMI) patients without beta-blocker contraindications who received a beta blocker within 24 hr after hospital arrival<br />REG/ADT<br />FACE SHEET<br />(4 data elements)<br />EDDOCUMENTATION<br />(6 data elements<br />MD<br />DOCUMENTATION<br />(7 data elements)<br />RNDOCUMENTATION(1 data element)<br />DISCHARGE<br />SUMMARY<br />(8 data elements)<br />UB-04<br />(3 data elements)<br />SOURCES OF DATA ELEMENTS<br />
  36. 36. Achieving “Meaningful Use” with Accelerated Project PlanOrganizations who address clinical change management and provide disciplined implementation management achieve sustainable results.<br />Success = Right Product x Right Implementation x Right Clinical Adoption<br />Short Term Success (Good, Bad)<br />Milestones Met <br />Low Customer Satisfaction<br />Organizational Readiness is Low<br />Non-achievement<br />Project Success with Long Term Sustainability (Good, Good)<br /><ul><li> Milestones Met
  37. 37. High level of user satisfaction
  38. 38. Expectations are fulfilled
  39. 39. MU Achieved</li></ul>Implementation Management<br />Strong Commitment with Limited Success (Bad, Good)<br /><ul><li>Users are committed to ideas/excited
  40. 40. Project milestones not met
  41. 41. Expectations unfulfilled
  42. 42. MU achievement unlikely</li></ul>Limited Success (Bad, Bad)<br /><ul><li>Milestones not Met
  43. 43. No Project Rigor
  44. 44. Low User Satisfaction
  45. 45. Non-achievement</li></ul>Clinical Change Management<br />
  46. 46. ARRA Costs vs. Incentives (350 bed facility w. limited CIS)<br />ARRA costs (capital vs operating)<br />Capital: $ 2.75 million<br />License and Installation – $1,550,000<br />Project Management - $450,000<br />Training - $150,000<br />Clinical Adoption - $450,000<br />Order Sets (250), Reports (50), Interfaces - $150,000<br />Operating: $3.24 million / year<br />Hosting and Application Management - $850,000/year <br />Help Desk - $90,000<br />Additional FTEs in IT, Departments- $1,500,000/year<br />Back Up and Recovery - $ 800,000<br />ARRA Revenues<br />Incentive Payments of $6,200,000<br />Impact Analysis<br />Initial need to fund $2,750,000 with cash or financing<br />Additional Operating Budget of $3.24 million / ongoing<br />$3,670,000 in annual penalties if MU not achieved<br />
  47. 47. Recommendations for Hospitals and Participating Providers<br />Recommendations<br />Educate - Your Leadership<br />Understand the regulations, rewards, risks and costs. Proforma incentives and ongoing deductions.<br />Form - Steering Committee Chaired by a C-Level Executive (CEO preferred)<br />MU is a major impact on clinical, business office, IT and medical staff<br />Include key clinical, IT, operational and financial leaders (Big Team)<br />Maximize quality improvement, patient safety and cost reduction opportunities<br />Reduce the number of initiatives across the Hospital to provide focus on MU<br />Assess - Current State Assessment w. Road Map (GHA offers one)<br />Determine where you are currently using HITECH Framework<br />Develop overall timelines, major milestones, operational and capital budget<br />Develop measures and accountabilities with responsible parties<br />Implement – CIS and Revise Clinical Processes and Work Flow<br />System Selection based upon criteria not vendor demos <br />Build a detailed project plan with PMO<br />Be honest about your internal capabilities and needs<br />Engage partners (application vendor (s), consulting resources, internal hires)<br />Focus on clinical adoption and implementation in a combined methodology with PMO<br />Focus on best practices and maximize opportunities for improvement<br />Improve – Improve Performance <br />Receive Stimulus Dollars<br />Constant improvement of quality, service and process improvement / cost reduction<br />
  48. 48. Elements of Meaningful Use of EHRs<br />Meaningful Use<br />RIGHTOUTCOME<br />RIGHTADOPTION<br />RIGHT IMPLEMENTATION<br />RIGHT PRODUCT<br />
  49. 49. Q & A<br />
  50. 50. Questions or Comments?Thank you!<br />Kent Giles, MPPM<br />404-483-7000<br />kgiles4@csc.com<br />

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