This document summarizes Beth Israel Deaconess Care Organization's (BIDCO) electronic health record (EHR) and clinical integration efforts. It details how BIDCO has successfully implemented EHRs in 250 provider practices between 2009-2012. It also outlines BIDCO's partnership with Lawrence General Hospital to implement EHRs in 18 of its practices and 32 providers. As a result of these efforts, 35 of the 36 Lawrence General providers qualified for Meaningful Use incentive programs and achieved 100% Meaningful Use.

1. Beth Israel Deaconess Care
Organization
Electronic Health Records and Clinical
Integration
September 2013

2. Beth Israel Deaconess Care Organization
The Beth Israel Deaconess Care Organization is a partnership
between BIDMC and community hospitals, independent physicians
and physician groups.
• organization of individual and groups of physicians and hospitals
who work together to coordinate care delivery, quality
improvement, and care efficiency in order to enhance the care of
individual patients and populations of patients.
 Foundation of that is EHR

3. BIDCO EHR Initiative
• Summary
 Successfully implemented 250 providers in 90 practices
between 2009-2012
• Practice Consulting and Project Management
– MAeHC
– BIDCO EHR Team
• Arcadia Solutions: Service Desk and technical services
 eClinicalWorks hosted by BIDCO via private cloud
 Standardization: eCW version and quality measure capture
 Meaningful Use Stage 1
• 100% of PCPs
• 90% of specialists

4. AVERAGE IMPLEMENTATION TAKES 20 WEEKS (1-5 MDs)
Week
Project phases
Week
Week
Week
Week
Week
Week
0
4
8
12
15
18
20
I
Workflow optimization
Design
System design
II
Site prep
Deploy
System install
and check
EHR customization
III
Pre-training preparation
Train
IV
Support
kickoff
Master
Key dates
MAeHC
Project
Kick-Off
EHR
Vendor
Kick-Off
Clearinghouse
Site
Remediation
Complete
Hardware
Install
Go-Live On-site
Plan
training
Evaluate
Improve
Trainer On
Site
Go Live

5. BIDCO EHR Implementation at LGH
•
•
BIDCO Team had implemented 75 practices prior to LGH joining BIDCO
LGH affiliated providers
 18 practices and 32 providers
•
BIDCO / LGH Partnership



•
BIDCO responsible for EHR implementation and project management
LGH identified providers and obtained legal agreements
Timeline/Schedule Creation
• LGH to prioritize and schedule providers
• Creation of mutually agreeable schedule
Lessons Learned and Applied to LGH practices




Pre-assessments to identify issues prior to commencing implementation
ISP installation, timing of hardware order
Practice engagement/meeting milestones
LGH as point of escalation

6. BIDCO EHR Initiatives: 2013+
•
Interfaces
 Lab/Rad/Discharge Summaries
 Clinical Data Warehouse
•
Viewer to and from BIDMC ambulatory EMR

•
eCWeHX/Health Exchange module

•
Patient consent to share record
Meaningful Use Stage 2 preparation

•
In patient context
Lab interfaces and Patient Portal
State HIE

Phase 1: October 2012: BIDCO provider from Lawrence was one of the “Golden Spikes” of
the Mass HIway
•

Received C32/CCD clinical summary direct from BIDMC into eCW via Mass HIway.
Phase 2: Scheduled to be a pilot for MA State HIE Integration with eCW via the Mass HIway

7. Choice Plus IPA and BIDCO

8. Lawrence General and MeHI
• Lawrence General Physicians of the Choice Plus Network
IPA supported the application submitted November 2009
for MeHI to become the REC for Massachusetts
• Those physicians were some of the first to become REC
members through IPA grants
• First REC regional meeting was held at Lawrence General
Hospital
• Two regional MeHI Meaningful Use meetings held at
Lawrence General
• IOO opportunity with BIDCO and eClinical Works

9. The Organizations
Lawrence
General
Hospital
BIDCO
Choice Plus
Network
IPA

10. The Key Elements
Existing
Relationships
and Local
Support
BIDCO:
Experienced
EHR Team
Successful
Implementation
and 100%
Meaningful Use
Achievement

11. Meaningful Use By The Numbers
• Lawrence General Project now includes 36 Providers:
Started May 2011
– 11 Primary Care Provider Practices
– 4 Specialty Practices
– 3 Pediatric Practices
• 35 of the 36 providers qualified for Meaningful Use
programs; all 35 attained MU for 100% result
– 14 Providers in the Medicaid program
– 22 Providers in the Medicare program
– Incentive dollars earned to date: $642,000

12. Additional LGH-Supported Initiatives
• Massachusetts HIWay Implementation Grant
– Merrimack Valley HIE Collaborative consists of Lawrence General
Hospital, Greater Lawrence Family Health Center, Pentucket Medical
Associates and Home Health VNA
– Awarded grant of $75,000.00 to develop an Emergency Room discharge
notification alert sent over the highway
• Via Choice Plus PHO at LGH, additional community connectivity:
– Established the role of Physician Integration Manager
– Laboratory orders and results delivery
– Radiology results delivery and future opportunities
• Meaningful Use Stage 2 preparation
– Education and Technical Support

13. Lawrence General
Hospital
BIDCO
Success!
Choice Plus PHO
Choice Plus
Network IPA