The Paperless

PathA story of a little CHC that

could!

Why did we go paperless Improve efficiency Improve documentation Patient Safety Improved information access Care-Coordination Blue Cross grant support Reporting

The Brockton Neighborhood Health Center Story Started in a church parking lot 1

physician 19 years ago Expanded to 2 story office with 10

providers. Administrative and dental office in separate building

Moved to new building 6 years ago- 40 providers, 26,000 patients and 150,000 visits per year.

MAEHC-Mass E-Heath Coalition

Founded in 2004 with a BCBS 50 million $ grant to bring EHR technology to 3 communities

Brockton chosen as 1 community (also North Adams and Newburyport

2005- vetting of systems, 2006 GOLIVE with NextGen EMR/EPM

System Choice Practice size/scalability Specialty support Reporting- quality and business reports User friendliness Plays well with others Meaningful Use certified Amount of IT support needed

PRE-GO LIVE Choose a system- and pay for it Map workflows- translate to EHR processes TRAIN,TRAIN,TRAIN! Decide on infrastructure Decide on go live scheduling modifications- Decide how much data to abstract Data conversion if using another EHR Play with/test system in test environment Pick a EHR Champion Get a super-user group together to guide process

GO LIVE Cut schedule by 50% for 1-4 weeks Have experts/superusers on hand to

trouble shoot and provide support Expect some problems- have backup

methods ready to go

Lessons Learned Keep on track of workload(chart

completion, task completion, ect) Make sure reports are correct- vet them You cannot train too much Communicate- superuser group is a

good venue Try to keep template modifications to a

minimum- complicates upgrades

When the system goes down

DON’T PANIC Have backup worflows in place before

this happens (downtime packets) Have processes in place to backup data Don’t throw away paper forms (archive

them) Make sure data gets back into EHR

when it is back up (RX,problem lists, visit notes)

Success Story

EHR incentives Meaningfull use:

$44,000 for medicare eligible providers $63,750 for medicade eligible providers Initial attestation that you are using a MU

certified system Stage 1: some thresholds, some measures

simply require that you be able to report data

Stage 2- more and higher thresholds Stage 3- stay tuned!

Medicare ERX Incentive Thresholds for # of ERX’s sent (low) Penalties for not participating (2%) Incentive is 0.5% of medicare billing Must submit G8553 code when

submitting and ERX on a medicare patient

MEHI MEDICAID PROGRAM

What can MeHI do for you? Funds IOO’s (Implementation

Optimization Organization) to help implement EHR use

Funds consulting services to reach MU (REC program)

Implementation grants to help with care coordination

Educational services (webinars/conferences/site visits)

Mass HIway The Massachusetts Health Information Highway (The HIway) will further

advance the Commonwealth’s goal to electronically connect all of its health care community. The Commonwealth is working with public and private partners to extend its existing technology infrastructure. The HIway will be implemented in three phases.

Phase One will support the direct connectivity among health care providers. Subsequent phases will support the analysis of protected health information

(PHI) to better manage the quality and cost of care delivered; and query and retrieval of information across the health care community to achieve the best possible care coordination for Massachusetts residents.

When fully developed, The HIway will provide a mechanism for the Commonwealth’s entire health care community—residents, providers, public health officials and others—to have appropriate access to health information

FUTURE DIRECTIONS Mass HIway connection- case

management project with Network Health MU Stage 2 Patient Portal Electronic Dental Record (go live 10/1) UPGRADE Improve patient education software Improve quality reporting

capacity/accuracy