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eClinicalWorks ASP | 2009 Medical Summit


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eClinicalWorks ASP | 2009 Medical Summit

  1. 1. Adoption and Use of Electronic Medical Records (in Federally Qualified Health Centers) and Supporting an ASP Community Care Network of Virginia, Inc.
  2. 2. Outline <ul><li>Who is Community Care Network of Virginia (“CCNV”) </li></ul><ul><li>Technology Goals </li></ul><ul><ul><ul><li>Efficient and Productive Use of EMR </li></ul></ul></ul><ul><ul><ul><li>Center for Data and Informatics – Quality </li></ul></ul></ul><ul><ul><ul><li>Medical Home and Health Information Exchange </li></ul></ul></ul><ul><ul><ul><li>Innovation </li></ul></ul></ul><ul><li>eClinicalWorks Deployment </li></ul><ul><li>ASP Hosting </li></ul><ul><li>ASP Architecture </li></ul><ul><li>Challenges and Benefits </li></ul>
  3. 3. Disclaimer
  4. 4. Community Care Network of Virginia (CCNV) <ul><li>Provider Network Incorporated in 1996 </li></ul><ul><li>Owned by all of Virginia’s 24 Federally Qualified Health Centers </li></ul><ul><li>Located in 90 sites across the Commonwealth </li></ul><ul><li>300 providers delivering primary care, dental and behavioral health services </li></ul>
  5. 5. Federally Qualified Health Centers <ul><li>Independent non-profit corporations </li></ul><ul><li>Mission to serve all members of a community regardless of patient’s ability to pay </li></ul><ul><li>Operate in local communities </li></ul><ul><li>Over 1,200 across the country </li></ul><ul><li>Take most if not all third party insurances </li></ul><ul><li>Receive limited Federal grant dollars to cover the cost of serving the uninsured </li></ul><ul><li>Commitment to quality </li></ul>
  6. 6. CCNV Business Purposes <ul><li>Represent providers/practices in third party payer contracting - single signature authority </li></ul><ul><li>Provide cost effective management services information technology, medical and dental billing, NCQA certified provider credentialing, etc. </li></ul><ul><li>Performance Improvement – Center for Data and Informatics </li></ul>
  7. 7. CCNV Technology Goals
  8. 8. Goal 1: Efficient and Productive Use of EMR <ul><li>Shared purchase pricing </li></ul><ul><li>Multiple hosting options </li></ul><ul><li>Readiness evaluations </li></ul><ul><li>Workflow analysis and improvement </li></ul><ul><li>Training, training, and more training </li></ul><ul><li>Central support and ticket management </li></ul><ul><li>User group on line forums and twice yearly meetings </li></ul>
  9. 9. Goal 2: Center for Data and Informatics <ul><li>Establishing clinical outcome measures </li></ul><ul><li>Collection and aggregation of data </li></ul><ul><li>Establishing data validity and reliability </li></ul><ul><li>Reporting and benchmarking </li></ul><ul><li>Network and local performance improvement activities </li></ul><ul><li>Quality forums </li></ul>
  10. 10. Goal 3: The Medical Home and Health Information Exchange
  11. 11. Medical Home [Federally Qualified Health Center] Specialists Hospitals Pharmacy Hospice Payers Home Health Local Social Service Agencies Medical Home and HIE Health Department Labs Patients
  12. 12. Goal 4: Innovation KIOSKS <ul><li>Network wide initiative to fabricate and install waiting room KIOSKS </li></ul><ul><li>Kiosk content integrated into EMR in real time immediately prior to patient entering exam room </li></ul><ul><li>Initial content limited to behavioral health assessment (PHQ-2 and PHQ-9) </li></ul><ul><li>Additional content and functions over time </li></ul><ul><li>Streamlines total patient time in the office </li></ul>
  13. 13. eClinicalWorks Deployment
  14. 14. eClinicalWorks (eCW) Deployment <ul><li>Two year due diligence planning period </li></ul><ul><li>Negotiated network purchase agreement </li></ul><ul><li>Licenses owned by individual health center </li></ul><ul><li>Optional hosting infrastructure (individually or ASP) </li></ul><ul><li>Master implementation schedule based on individual organization readiness </li></ul><ul><li>Network based, eCW certified trainer and support technician </li></ul>
  15. 15. ASP Hosting
  16. 16. ASP Hosting <ul><li>ASP hosting is optional </li></ul><ul><li>Our model is client owned not vendor owned </li></ul><ul><li>Software vendor accommodates both ASP individually hosted architecture </li></ul><ul><li>Reasons for choosing ASP vary </li></ul><ul><ul><ul><li>Small practices with limited capital resources and staff </li></ul></ul></ul><ul><ul><ul><li>Large practices not wanting to make significant hardware investments </li></ul></ul></ul><ul><ul><ul><li>timing </li></ul></ul></ul>
  17. 17. ASP Architecture
  18. 18. ASP Architecture <ul><li>Located in hosting facility in Richmond </li></ul><ul><li>Corporate office approximately 6 miles from hosting facility </li></ul><ul><li>Hosting facility secure, redundant systems, on site technical staff can provide optional services </li></ul>
  19. 19. ASP Architecture <ul><li>Currently have 14 servers </li></ul><ul><li>15 out of 20 organizations are hosted </li></ul><ul><li>Currently installed in a single rack </li></ul><ul><li>Server types - application, data base, document management, reporting </li></ul><ul><li>Fax servers hosted locally </li></ul><ul><li>All servers and drive configurations are redundant </li></ul><ul><li>All sites connect through VPN to data center </li></ul><ul><li>eCW software manages serverdata access </li></ul>
  20. 20. ASP Architecture <ul><li>Local engineering support is outsourced </li></ul><ul><li>Central (CCNV) help desk for triage of problems </li></ul><ul><li>eCW handles all software issues </li></ul><ul><li>Set weekly coordination and management calls with eCW </li></ul>
  21. 21. Challenges and Benefits of an ASP
  22. 22. Challenges and Benefits <ul><li>Internet connectivity issues </li></ul><ul><li>Hardware upgrades driven by growth, vendor specs, new technology (virtualization), maintenance replacements </li></ul><ul><li>Lease vs. buy </li></ul><ul><li>Must have good communications with vendor (eCW) in order to manage software upgrades and fixes </li></ul><ul><li>Individual practice growth must be accommodated by the ASP </li></ul><ul><li>Technical Staffing and Support relationships are local and long term </li></ul><ul><li>Troubleshooting centers on connectivity and performance (latency) issues </li></ul>
  23. 23. Challenges and Benefits <ul><li>Eliminates human resources issues for practice </li></ul><ul><li>Technical expertise available to individual practices that they might otherwise not have access to, or can afford </li></ul><ul><li>The number and types of issues experienced by a large practice that individually hosts are similar to an ASP hosted configuration </li></ul><ul><li>Most issues are not eliminated, the responsibility to address them are shifted </li></ul>
  24. 24. David Selig Chief Executive Officer Community Care Network of Virginia 6802 Paragon Place Suite 630 Richmond, VA 23230 804-237-7686 [email_address]