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The Paperless
Path
A 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 modificationsDecide 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 MeHIdo 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

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MeHI Regional Health IT Meetings - Success Story - Taunton, MA - Oct, 2013

  • 1. The Paperless Path A story of a little CHC that could!
  • 2. Why did we go paperless  Improve efficiency  Improve documentation  Patient Safety  Improved information access  Care-Coordination  Blue Cross grant support  Reporting
  • 3. 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.
  • 4. 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
  • 5. 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
  • 6.
  • 7. 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 modificationsDecide 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
  • 8. 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
  • 9. 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
  • 10. 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)
  • 12. 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!
  • 13. 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
  • 15. What can MeHIdo 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)
  • 16. 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
  • 17. 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