EMR IMPLEMENTATION PANEL DISCUSSION

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EMR IMPLEMENTATION PANEL DISCUSSION

• All The Reasons You Should Incorporate EMR into
  Your Practice

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PRESENTERS

• Jean Aldrich, Practice Administrator for Eye and
  ENT Specialists, PLC in Hastings, Michigan
• Stefanie O. Ardoin, Practice Manager for Acadian
  Ear, Nose, Throat Facial Plastic Surgery Center
  in Lafayette, Louisiana.
• Jolene Eicher, Practice Administrator for
  Commonwealth Ear, Nose, and Throat, and The Sinus
  Center in Louisville, Kentucky.
• Kelly Ladd, C.O.O. for Northwest ENT and Allergy
  Center in Marietta, Georgia.

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TOPICS OF DISCUSSION

• Industry Statistics
• Reasons to Implement EMR
• Return on Investment
• Contract Negotiation
• Implementation
• Open Discussion

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Electronic Medical Records (EMR)

• 17.2 percent of practices have EMR
• The larger the practice, the more likely of
  conversion.
• Average cost of software per physician is
  15,000.00
• Average monthly maintenance cost is 1500.00

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Why Should I Get EMR?

• Easier and Faster Access to Patient Medical
  Information
• Neat and Precise Documentation
• Better Care Management
• More Efficient Prescribing Medicine
• Enhances Employee and Physician Productivity
• Increases Income and Decreases Expenses
• Great Return on Investment
• Gets Claims out the door real time

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Access to Patient Data

• Instant Access to Patient Data
• 24/7 Access to Patient Data
• Multiple Access to the Same Chart
• An end to lost charts
• No Waiting for Transcription to Come Back

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Precise Documentation

• No more illegible handwriting
• No loose paper
• Documentation neat and orderly
• Ability to update medications and problems lists
  at each visit
• Exportation of Orders
• Importation of Test Results

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Better Care Management

• Ability to Track Pending Orders
• Automated Reminders
• Ability to Print Patient Educational Materials
• Ability to Print or Fax Progress Notes referring
  MD immediately upon request
• Instant Clinical Alerts

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Efficient Prescribing

• E-Scribing
• No more calls from pharmacy cant read the
  doctors writing
• Ability to fax Rx refills directly to pharmacy,
  no more calls
• Electronic drug interaction alerts
• Ability to incorporate insurance formularies into
  EMR system
• Instant Allergy Alerts

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Enhances Productivity

• Instant Messaging
• Electronic Work Lists
• Less Time Chasing Charts, More Time With
  Patient/Patient Care
• Instant Information
• Patient Education Materials at Finger Tips

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Higher Income/Lower Expense

• Eliminates Cost of Paper Records
• Eliminates Chart Filing
• Reduces Transcription Costs
• Coding Assistance
• Charge Passing
• Hidden Paper Medical Record Costs
• Reduces Postage/Mailing Costs

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Paper Chart Costs New Patient/Chart

• Chart Cover 1.31
• Chart Dividers set of 6 1.68
• Progress Note Forms 0.15
• Medication Sheets 0.15
• Allergy Alert Stickers/Sheets 0.01
• Prescription Pads (w/copy) 0.50
• Patient Name Label 0.04
• Alpha Labels 3 Letters 0.04
• Clear Protective Label 0.04
• INITIAL COST PER NEW PATIENT CHART 3.92

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Medical Records Clerk

• Hourly Rate 10.50 x 40 hrs 420.00/wk
• Health Insurance with Rx Card 320.00/month
• Dental Insurance 38.00/month
• Pension Plan Contribution 5
• of Gross Annual Pay 1092.00/year
• Uniform Allowance 200.00/year
• Life Insurance 25.00/month
• 2 Weeks Paid Vacation 840.00/year
• Payroll Taxes 1638.00/year
• TOTAL ANNUAL EXPENSE 30,406.00

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Other Hidden Medical Record Costs

• Patient Medical Calls
• - Take Message 2 Minutes/0.50
• - Pull Chart 5 Minutes/1.25
• - Back Office Intervention 10
  Minutes/2.50
• - Physician Direction/Documentation 5
  Minutes/10.00
• - Chart Back to Back Office/Action 10
  Minutes/2.50
• Total Per Incident 16.75
• 20 Incidents Per Day 335.00
• 420 Incidents Per Month 6700.00
• 5040 Incidents Per Year 80,400.00

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More Hidden Costs

• Missing Chart Syndrome
• Cant Read the Doctors Writing
• Papers Misfiled in Wrong Chart
• Medical Records Out of Order
• Charts Fall Apart
• Lost Productivity Time
• Estimated Cost 18,000.00

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and the TOTAL PRICE IS

• ANNUAL PRICE TAG 128,806.00
• Average generated costs of new patients per year
  in Paper Chart Costs.
• Estimated Employee Cost of 1 Full Time Medical
  Records Employee
• Estimated Staff/Employee Cost in Lost
  Productivity
• Other Hidden Costs

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Contract Negotiation

• Identify contract issues and the desired outcome
• Identify the deal-breaker/s
• Know their payment terms
• Identify fixed costs vs. ongoing costs
• Identify cost for adding providers
• Identify cost for training
• Identify how to terminate the relationship
• Do a ROI analysis

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Contract Negotiation

• Identify contract issues and the desired outcome
• Identify the deal-breaker/s
• Know their payment terms
• Identify fixed costs vs. ongoing costs
• Identify cost for adding providers
• Identify cost for training
• Identify how to terminate the relationship
• Do a ROI analysis

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Why the One Size Fits All approach Does Not
work.
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EMR Implementation

• Deployment
• Documentation Utilization
• You will need to rethink your workflow processes
• EMR Practices What is your experience?

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Preparing for Deployment

• Preparing the Physicians and Staff
• Hold an EMR celebration party inform the staff
  they are going to be instrumental in the success
  of this project
• STRESS that the process of template editing can
  be very labor intensive, learn as much as you can
  before implementation
• Load the templates for each provider and or
  template administrator
• Have the providers review the templates
• Choose the 10 templates of the most
  common/routine problems seen. Represents about
  80 of their total patient encounters.

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Deployment Tips

• Start with a combination of NEW and ESTABLISHED
  patient visit types. These should be on
  templates the providers have created/modified
  prior to go live.
• Have face sheet data entered for ALL patients on
  the schedule.
• Assign a Super User to be with the clinical
  support staff.
• Document and refine templates as needed.
• Debrief with the Project Leader at the end of
  each day.
• Make any needed changes prior to the next day.

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Deployment It is a Work in Progress

• Workflow re-design intake, forms, HH,
  Assessment and Orders data
• Scanning what gets scanned and what doesnt
• End User Training (EUT)
• Data entry of patient histories
• Template administration and template modification
• Incorporation of Transcription
• Physician Sign Off
• REMEMBER Rome wasnt built in a day. The
  same goes for EMR Implementation.

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Elements of The Deployment

• Introduction
• Confirm contact person, site address and phone
  numbers
• Exchange phone s and e-mail addresses
• Establish and set the expectation of how
  communication will occur
• Confirm of providers, end users, locations,
  specialties and labs
• Expectations
• Discuss and Outline the Phases of Deployment
• Confirm who will be the practices Project Leader
• Discuss the training schedule options
• Discuss deployment expectations
• Schedule date(s)

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Elements of Deployment

• 3. Hardware
• A discussion of your current hardware, software
  and interface needs
• 4. House Keeping Tasks
• Discuss EMR companys travel policy
• Confirm travel expenses

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Milestone Check-Up

• Hardware
• Template Administration
• Workflows
• End User Training
• Document Management/Scanning
• Orders Tracking
• Superbill Summary
• Lab Interface Issues

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• Remote Access
• Terminal Server
• VPN
• Wireless
• Touch Screen/ Pen Tablet
• Voice Recognition
• Free Text
• OCR
• Graphics
• CT Images/Photos
• Interoffice Communication
• Prescription Writing Module
• Correspondence
• Electronic Signatures
• Transfer protocol for electronically transmitting
  lab requests (RX, HL7)

• Support Forms (Return to Work)
• Can we export information if agreement is
  terminated?
• Data Storage/Back Up
• Software/Hardware Costs
• Practice Management Integration or Interface?
• Hardware/Software Maintenance Costs
• Setup/License/Training/Support Fees
• License Renewals
• Ease of updating problem list, allergies, RX, and
  Dx
• Can you search the entire patient/data base for
  matches to any data field?
• Reports
• Go to my PC
• Comprehensive and Condensed Version (ie Summary)
• WATCH FOR NEW CERTIFICATION FOR EMR (CCHIT)

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OPEN DISCUSSION

• Open Forum