Ambulatory hio roi_partii


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Ambulatory hio roi_partii

  1. 1. HIMSS HIE inPractice SeriesHIE ROI for the Ambulatory Physician PracticePart II: Benefits to Practice WorkflowThis is the second part of the HIE ROI for the Ambulatory Physician Practice series. The checklistbelow provides useful questions on physician practice workflow, and can be used by an ambulatory orphysician practice in conducting due diligence and evaluating possible health information exchangeorganization (HIO) participation. The goal in asking these types of questions is to identify specific,measurable values for the practice. This should ideally translate into return on investment (ROI),making the participation worthwhile.As you apply this checklist to your decision-making process, please remember that HIO serviceofferings will vary from one organization to another. It will be important to explore the specific servicesoffered by HIOs available in your area as you assess the ROI of participation for your practice.Workflow QuestionsQuestions that will be addressed in this installment of the series include: 1 What are the patient care goals that warrant participation in an HIO? 2 What common frustrations with physician practice workflow could be addressed through participation in an HIO? 3 How will my participation in an HIO benefit my patients? 4 How will I know about a patient’s visit to other care practitioners or health systems? 5 When and why would I access and use the data available to me from an HIO? 6 How will I communicate with other physician practices which are part of the HIO? (e.g., sending referrals or receiving diagnostic test results) 7 How will an HIO assist me in reporting required data to public agencies at the local, state and federal levels? (e.g., Centers for Disease Control, immunization registries) 8 How could an HIO help me to communicate more easily with my patients outside of office hours, if this becomes necessary? 9 What concerns do other physicians have with direct electronic communication with their patients? 10 How easy will it be for me to either submit data to or obtain data from the HIO? How many extra clicks, usernames and passwords will need to be managed for HIO exchange services? 11 Should I just wait until the HIO is up and running to participate? Is this a good option?© 2012 Healthcare Information and Management Systems Society (HIMSS) 1
  2. 2. HIMSS HIE inPractice Series Workflow Questions Examples of Responses & Discussion Points 1. What are the patient care Patient care goals may be determined by each physician participant, goals that warrant specifically for an individual practice, or with all of the collaborating participation in an HIO? physician practices. For example, one drive for HIO services may be a desire for better management of specific diseases within the local healthcare community. Some HIOs are initially funded to achieve specific and measurable patient care improvement goals relating to quality, cost-efficiency and population health. HIOs often describe these capabilities in terms of the various “use cases” or “user stories” that their services support. Goals related to specific healthcare outcomes are typically prioritized by that HIO’s community of stakeholders. 2. What common A few examples: frustrations with  Providers are often frustrated with the variations in data physician practice requirements for specialists to whom their patients are referred. workflow could be Often, each specialist requires that their own unique form be addressed through completed. participation in an HIO?  Providers gain from an organized, standardized process of data exchange across statewide, regional and local exchange initiatives. This differs from some of the current activities that send patient information between healthcare providers involving variations in form, format and data context. The practice saves time through unified and simplified data exchange requirements and support processes.  HIOs can reduce duplication of services, resulting in lower healthcare costs.  An HIO may provide the means to reduce operational costs by automating many administrative tasks and reducing the expenses of software system interfaces to multiple data sources (e.g., eliminating the need for each provider to purchase their own interfaces with labs, immunization registries, etc.). 3. How will my Clinical information sharing improves the quality of patient care participation in an HIO received, as providers are afforded quick access to existing patient benefit my patients? and clinical information for both new and existing patients.© 2012 Healthcare Information and Management Systems Society (HIMSS) 2
  3. 3. HIMSS HIE inPractice Series Workflow Questions Examples of Responses & Discussion Points HIO services may:  Provide quick access to available medical histories, saving staff time and using more efficient workflows to electronically exchange data. → Current workflows may require faxing requests for medical information, following up on requests manually, and filing or scanning the received data into the patient’s paper chart.  Save patient time in requesting medical records to share across multiple providers. → Requests for medical records using HIOs can be made directly between practices, making it easier for a patient to request medical records from previous providers.  Promote more effective clinical decision support among providers by enabling access to a broader range of clinical information on the patient.  Reduce patient frustration and patient financial expenditures by making results of past procedures accessible by all providers, so there is no need to repeat procedures or tests.  Improve patient care quality and reduce potential errors by enabling provider access to all patient information across all care providers, including hospitalizations and discharges, current medication lists, and relevant medical histories. 4. How will I know about a The provider can be alerted, prompted to inquire, or receive secure patient’s visit to other electronic communication about all patient healthcare visits to those care practitioners or providers engaged in that specific patient’s care. Only those health systems? providers who are participating with the same HIO will be able to share patient information with one another.  Secure communication between the HIO’s participating providers delivers timely patient treatment information.  Electronic exchange of Summary of Care Records within the HIO community of care provides electronic information which can be integrated into the individual doctor’s EHR system.  If the functionality exists, a provider can query an HIO to find available health information relevant to a specific patient.© 2012 Healthcare Information and Management Systems Society (HIMSS) 3
  4. 4. HIMSS HIE inPractice Series Workflow Questions Examples of Responses & Discussion Points 5. When and why would I Healthcare providers may need to access information available access and use the data through an HIO for a number of reasons, such as: available to me from the  To learn more clinically relevant information about a current HIO? patient.  To efficiently access and make available clinical information about a patient who is being transitioned to a hospital or other provider of care.  To submit performance reports on specific quality measures (e.g., number of patients within a defined treatment population who received the prescribed treatment).  To access results of previous tests (e.g., lab or radiology reports), thus avoiding the costs of redundant testing, reducing time required to make effective clinical decisions, and reducing patient overexposure to unnecessary testing procedures and/or radiation.  To review aggregated data from various sources on specific diseases within a patient population, improving the practice of evidence-based medicine.  To analyze their own clinical performance compared to state and national guidelines, based on the data captured in EHRs and submitted to the HIO.  To access data available from public health agencies (e.g., immunization history and recommendations). 6. How will I communicate Various capabilities are available for sharing relevant patient with other physician information. Depending upon individual HIO service offerings, one practices which are part or more of the following communication methods may be used: of the HIO?  EHR applications which are fully integrated with the HIO’s software could offer one-click access to relevant and accurate (e.g., sending referrals or patient information. receiving diagnostic test results)  Providers who do not use EHRs but do have Internet access may utilize the HIO’s web portal to request relevant health information (e.g., specialist reports, test results) by logging in as an authenticated user.  The doctor could send a referral to another doctor within the HIO© 2012 Healthcare Information and Management Systems Society (HIMSS) 4
  5. 5. HIMSS HIE inPractice Series Workflow Questions Examples of Responses & Discussion Points network either directly from an integrated EHR, or as an attachment through a secure electronic messaging capability. Benefits to these methods over traditional paper and fax processes include:  Ease of sharing  Reduced administrative costs  Simplified processes without the need for multiple point-to-point interfaces between different systems  Speed of sending and receiving referrals, test results and other patient information 7. How does an HIO assist The HIO may offer services that support reporting public health, participating providers in population surveillance, immunization and other data to identified sharing required data registries and other through data collection, redirection services and with public agencies, data exchange services. such as immunization registries or the CDC? 8. How could an HIO help Not all HIOs provide communication services between physicians me to communicate more and their patients, and physicians may not require or desire to have easily with my patients electronic communication with their patients outside of regular office outside of office hours, if hours. this becomes necessary? However, if such communication is desired or becomes necessary, there are several approaches to electronic communication channels between physicians and patients, including:  Patient Portals → Normally web-based and tethered to a specific HIO. → Patients can review and comment on possible discrepancies in their medical history. They cannot make edits such as changing, adding or deleting history. Providers will be able to review these comments. → Can provide secure messaging between provider and patient.  Personal Health Records (PHR) → Some PHRs can be tethered to specific provider, payer and third-party organizations. → May not have an interface with the HIO. → Can provide secure messaging between provider and patient.© 2012 Healthcare Information and Management Systems Society (HIMSS) 5
  6. 6. HIMSS HIE inPractice Series Workflow Questions Examples of Responses & Discussion Points 9. What concerns do other Some concerns include: physicians have with  Privacy concerns direct electronic communication with  Inclusion and integration of email volume into their workflow their patients? and clinical practice activities  Chargeable services for electronic consults → Online / electronic consults are not necessarily reimbursable by payers. However, it should be noted that some providers have embraced electronic consultations by charging a fee for each e-consult, or requiring an annual fee for online communications. 10. How easy will it be for The ease of data submission to the HIO is governed by the specific me to either submit data types of interfaces, which are developed between the HIO and EHR to or obtain data from the vendors. HIO? Some vendors have a high level of integration with HIOs, which means the provider is able to click from within a displayed patient How many extra clicks, chart to request additional patient information of clinical relevance. usernames and A “click-through” capability from within the EHR enhances the passwords will need to practice workflow, and saves time and effort. This eliminates the be managed? staff time and labor costs involved in faxing, copying, scanning, uploading and relabeling of patient records into a paper-based system. Other EHR vendors have a less robust integration, which may require a separate user ID and password in order to log into an HIO portal. 11. Should I just wait until Providers should aim to be involved from the earliest stages of the HIO is up and development, in order to help identify and prioritize the services of running to participate? highest value to them. This can set the priorities for the HIO, so that Is this a good option? the services delivered are not only of high clinical value, but also smoothly integrate with the provider’s workflow so as to improve the efficiency of delivering medical care.The remainder of this ROI series provides additional information on questions that may be asked by aphysician practice evaluating HIO participation. Continue to Part III for questions that help to identifydata management benefits through the use of HIE services.© 2012 Healthcare Information and Management Systems Society (HIMSS) 6
  7. 7. HIMSS HIE inPractice Series Acknowledgements Primary Author Marie Richards, Ed.D., PMP TMF Health Quality Institute Contributing Authors Balaiah Balasubramani Chris Clark, MBA GE Healthcare State of West Virginia Martha Dameron, RN, MSN, FHIMSS Jeff Hoy Huntsville Hospital R. Lenel James, MBA, CPHIT, CPEHR Robert Levy, MA, PMP Blue Cross and Blue Shield Association ASM Research, Inc. Nancy Lush Anthony Nuzzo Lush Group, Inc. Prosch Consulting Helena Taylor Wayne Thompson MedAllies The Commonwealth Medical College HIMSS Staff Pam Matthews, RN, MBA, CPHIMS, FHIMSS Julie Moffitt Senior Director, Regional Affairs – HIMSS Coordinator, Regional Affairs – HIMSS jmoffitt@himss.orgThe inclusion of an organization name, product or service in this publication should not be construed asa HIMSS endorsement of such organization, product or service, nor is the failure to include anorganization name, product or service to be construed as disapproval. The views expressed in this whitepaper are those of the authors and do not necessarily reflect the views of HIMSS.© 2012 Healthcare Information and Management Systems Society (HIMSS) 7