HEALTH INFORMATION TECHNOLOGY

LEADERSHIP EXCELLENCE:

TONY FANELLI

“The task of the leader is to get Platforms that Enhance Physician and

Patient Experiences through Connected

Communities of Health Interoperability

“The task

"Aspire to Inspire before you Expire."

~Unknown

re before you Expire." ~Unknown "Aspire to

Inspire before you Expire." ~Unknown

My Motto:

The Path To Success

WORK HARD

IN SILENCE,

LET SUCCESS

MAKE THE

NOISE!

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The Patient Comes First: Commitment to the “Voice of the Customer”

“A customer is the most important visitor on our

premises; he is not dependent on us. We are

dependent on him. He is not an interruption to our

work. He is the purpose of it. He is not an outsider in

our business. He is part of it. We are not doing him a

favor by serving him. He is doing us a favor by giving

us the opportunity to do so.”

~Mahatma Gandhi

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My Career by the Numbers:

Track Record & Experience

• 20+ years in vertically integrated networks: primary care physician, specialty physician, IDN &

acute/post-acute hospital sales – Abbott Diagnostics, SBCL/Quest Diagnostics, Florida Hospital &

Florida Drug Screens.

• 20+ years of developing demo data bases; conducting internal and external client training; and

spearheading process improvements per the “Voice of the Customer” – Abbott Diagnostics,

SBCL/Quest Diagnostics, Florida Drug Screens, LLC & Niagara Falls Memorial Medical Center.

• 20+ years in primary care physician EMR sales – SBCL TORO and Quest Diagnostics CARE360 EHR.

Initiated PMS and LIS interfaces and bridges.

• 5+ years in IDN & primary care physician EMR/EHR operations – Florida Hospital and Niagara Falls

Memorial Medical Center.

Progressive Career with Stellar Performance & Recognition: Quest Florida Business Unit Top DSM Customer Satisfaction and Response Awards - 2004.

Quest Florida Business Unit Top DSM Award - 2003.

Quest Florida Business Unit DSM Coaching & Mentoring Award - 2003.

Quest Florida Business Unit Top DSM Awards - 2nd & 3rd Quarters - 2003.

Quest Special Recognition Stock Option for #5 National District - 2002.

SBCL National ABM Presidents Club Award – 1998.

SBCL National ABM Vice President’s Award – 1998.

SBCL National TSM President's Club Award - 1993.

SBCL National TSM Vice President’s Award – 1993.

SBCL National TSM Vice President's Award - 1992.

Abbott Diagnostics Top Boston Region ASPS Award - 1987.

Abbott Diagnostics DSS & ASPS "6th Man" Awards - 1984, 1985 & 1986.

Abbott Diagnostics President's Club Award (#1 DSS National Ranking) - 1986.

Abbott Diagnostics Senior Sales DSS Award - 1985.

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Five Step Pipeline Model: Build a Robust & Sustainable Pipeline

• PROSPECT & ENGAGE: Identify prospects, diagram organizational

chart, qualify prospects and secure appointments. Never be more than one step

from your clients.

• DIFFERENTIATE & ENTICE: Differentiate, develop right needs and

inspire emotion. Align yourself with early adopters and thought leaders.

• BUILD VALUE: Permeate account, present solution and gain technical win

or added value.

• CONFIRM & CLOSE: Sell decision makers and influencers, prove

capabilities and secure the contract.

• MAKE REFERENCEABLE: Deliver value, make referenceable and

discover new needs. Leverage current clients and deliver patient-centric,

knowledge-based care according to the “Voice of the Customer.”

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Knowing Your Audience’s Needs: Primary Care Physician Front-Office Staff

Issues with eCW and most EMRs based on my view from the inside:

• Initially register patients through Cerner (HIS) and have to

re-register through eCW.

• Fax Inbox chart indexing is extremely cumbersome and

time-consuming vs. printing records and scanning to chart.

• Extremely user-unfriendly in most pre-registration and post-

registration tasks due to multiple and redundant data entry

prompts.

• Double charting issues regarding breast cancer and

diabetes screening – non-flow sheet protocols do not

automatically populate patient chart and have to be

manually entered.

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Knowing Your Audience’s Needs:

PCP EHR Administrator

Issues with eCW and most EMRs based on my view from the inside: Users:

• Correct data entry

• Correct use

• Proper security

• Proper use

Timely Updates to Software:

• Bug fixes

• Data base updates – RXs, Tests

Interfaces with Lab and Imaging Results:

• Duplicate test results

• Duplicate orders

• Non-joining results

• Bad tracking

Reporting:

• Garbage-in, Garbage-out

Cerner (HIS):

• Will not create a new encounter for billing based on out coming appointment patient information (ADT)

messages from eCW, causing double registration.

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Knowing Your Audience’s Needs: Population Health Management (PCMH)

Issues with eCW and most EMRs based on my view from the inside: • Concrete and accurate EMR vendor / or tools to extract data quality measures.

• Need new server to support overlay programs like Bridge IT that is designed to pull data that eCW can not

extract – causing a stand-still with PCMH. Currently stuck at Level 1 of 3 regarding DSRIP incentives to reduce

hospital admissions by 25%.

• Care Managers / Case Managers

• Buy-in / commitment from C-Suite to drive compliance at the provider and office staff levels.

• Value-Based Care (Quality over Quantity).

• Appropriate staff / resources

• HealtheLink (RHIO) will not map imaging reports – causes issues regarding mammogram quality measures.

Need to utilize numerous manual “work-arounds” to comply with PCMH and other PHMS criteria and measures.

• HealtheLink was sold as a true interoperability solution and it a very far away from this promise.

• eCW Health Maintenance Screen is not populating correct quality measures for PCMH and other PHMS criteria.

eCW is “kicking the can” down the road.

• eCW communication issues regarding language and culture differences.

• Lack of “real time” data from hospital reports – ER, D/C Summaries, Medication Lists, et. al.

Each hospital has different EMRs.

Each hospital has different policies for transcription criteria and coding.

• Insurance companies are incentivizing providers to code most patient encounters as Wellness Visits to reflect

true risk, maximize Medicare reimbursements and force providers into providing Value-Based Care in order to

flush out & stratify high-risk patients and appropriate diagnosis codes.

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Knowing Your Audience’s Needs:

Primary Care Providers

Issues with eCW and most EMRs based on my view from the inside:

• Experiencing extreme resistance from providers regarding EMR initiatives.

• Primary Care Physicians are being over whelmed with numerous CMS and government

initiatives like: PQRS, Meaningful Use, VBP, ICD-10, Open Payments, TCM Code, CCM

Code, ePrescribe, DSRIP, PCMH, HEDIS, Triple Aim Health Care Roadmap, etc.

• PCP’s must center their efforts on the 4 main areas with increasing focus on clinical and

population improvements over time: Infrastructure Development (Process), System

Redesign (Process), Clinical Outcome Improvements (Outcomes), and Population Focused

Improvements (Outcomes).

• Requires C-Suite “buy-in” to change culture and drive compliance.

• eCW and other EHRs are not user-friendly – ePrescribe, I-Stop & Lab Ordering.

• EMR efforts are cumbersome and time-consuming and take away from physician / patient

interaction.

• Requires too much physician time to input patient information compared to manual RXs and

lab requisitions.

• Providers are frustrated by lack of interoperability and real-time availability of data regarding

referral processes, consults, hospital D/C summaries, medication lists, telemedicine

capabilities, and ER reports.

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Knowing Your Audience’s Needs: The C-Suite & Practice Administrators

• Provide high-value, cost effective healthcare; share risk through strategic partnerships.

• Decrease hospital admissions / re-admissions.

• Minimize costly ER visits that can be addressed at the PCP level.

• Generate revenue and decrease costs – government and state incentive programs

(Meaningful Use, Patient-Centered Medical Homes, Health Homes, DSRIP).

• Enhance its footprint as a trusted community partner, providing knowledge to optimize

decision making, reduce treatment costs, improve health outcomes, increase patient

access and engagement through community and value-based care.

• Stratify risk and manage high-risk patients through real-time, user-defined Population

Health Management Algorithms.

• Outcomes management and continuous quality improvement with increasing focus on

clinical and population improvements over time through 4 main areas: Infrastructure

Development (Process), System Redesign (Process), Clinical Outcome Improvements

(Outcomes), and Population Focused Improvements (Outcomes).

• Revenue Cycle Management – billing claims to denial management.

• Concerns regarding the security of data once it is warehoused by the Health Information

Service Provider. Main reason why mental health and chemical dependency patient

records are not included. Consent, ownership and safety is “lost” once it reaches the

Health Information Exchange. 10 of 10