2. What Should You Know?
• None of the EMR, EHR, PHR Vendors
currently meet the Federal requirements
for an EMR, EHR and PHR
• One of the Primary requirements for
EMRs, EHRs and PHRs MUST be
interoperable and interconnected with
other EMRs, EHRs and PHRs
3. What Should You Know?
• EMR is healthcare’s Y2K time bomb
• EMRs are Mandated for 2014. The change is
real and mandated.
• Standards are not available until 2010 - 2011
• The costs are very high, so are the penalties
• 1/3 to 2/3 of EMRs implemented have failed
4. What Should You Know?
• As of yet nobody knows which
applications will qualify for certification
• If you do not use a certified program
penalties and fines will be implemented
• Result of fines would mean lower
Medicare reimbursement payments to
healthcare provider
5. What Should You Know?
• Healthcare IT resources to support
providers are 50% below the number
required
6. What Should You Know?
• Healthcare providers with in-house IT
department has:
1. No experience with EMRs
2. Never built one
3. Never bought one
4. Never installed one
7. Barriers to EMR Adoption
• Inadequate capital to purchase. Cost of
Change
• Unclear ROI (Value)
• Maintenance Cost
• Inadequate IT Staff (Training)
• Resistance to implement. Meaningful Use
8. Questions you will need Answers to
• The Cost of Implementation. Level of
Funding necessary to successfully
implement
• Funding Sources such as Grants, Federal
Government Loans, etc.
• The Long Term Benefits of EMRs
9. Question #1 - Cost
• Expensive if purchasing Enterprise
Version License
• Affordable if purchasing SaaS (Software
as a Service) Agreement
10. Why go SaaS?
• SaaS is a software model where the purchaser
does not purchase or own the software
• SaaS replaces the traditional approach where
organizations used to purchase software and/or
hardware
• No Maintenance Cost
• Includes Training
• No Technical support fees
11. Why go SaaS?
• Customization Included
• Available Anywhere Anytime using the Internet
• No Software Installation needed. Software ready
to use after initial payment requirements.
• No IT Staff to be hired
• Constant Updates (included)
12. Question #2 - Funding Sources
• Federal Government Loans
• Bank Loans
• Personal Loans
• Financial Services Loans
• Grant Availability (Stimulus Money)
13. Grant Availability - Stimulus Money
• Obama’s 20 Billion Dollars Ear-Marked for
EMRs - Available in 2011
• Non-professional Grant writer - Hardly ever
approved for Grant Money
• Professional Grant Writer - Approval Rate
Excellent - Costly - Time to prepare is lengthy
• e-Healthcare Systems Grant Services - Less
Costly - Alliance with Professional Grant Writing
Company - Less Time to Prepare
14. Stimulus Money - What it Means
Health Stimulus
Stimulus 101
On February 17, 2009, President Barack Obama signed into law
the American Recovery & Reinvestment Act. The health IT
component of the Bill is the Health Information Technology for
Economic and Clinical Health Act (HITECH), which appropriates
a net $19.5 billion dollars to encourage healthcare organizations
to adopt and effectively utilize Electronic Health Records.
The opportunity presented by the Bill is enormous. After literally
decades of slow but steady progress towards converting our
paper-based record system into an electronic one, we now stand
poised for a monumental leap forward.
15. Stimulus Money - What it Means
Details of the $19.5 billion
One portion of the HITECH Act allocates $36 billion that will be
paid to healthcare providers who demonstrate use of Electronic
Health Records. The net cost to the Federal government is
anticipated to be $19.5 billion after savings are achieved through
efficiencies, tax revenue and Medicare fee reductions for non-
adopters.
Because the government wants to spur quick movement , all of
the incentives include payments for up to five years but provide
the largest payments early in the program. The incentive
payments begin in 2011 to ensure the providers have time to
adopt and learn to use the EHR; penalties begin in 2015.
16. Stimulus Money - What it Means
Fee reductions:
Providers who do not demonstrate meaningful
use in 2014 will see, in their 2015 fee
schedules from Medicare, a decrease of 1%.
An additional decrease will be affected in 2016
and 2017 down to a total of 97% of the regular
fee schedule; it can further be reduced to 95%
if the HHS Secretary determines that total
adoption is below 75% in 2018.
17. Stimulus Money – Obama Speech
Click on Obama Picture to Activate
18. Question #3 - Long Term Benefits
of EMRs
• Errors & Omissions Greatly Reduced
• Reduction in Wrongful Giving of
Medications
• Improves quality, safety, efficiency and
reduces health disparities
• Provides access to comprehensive patient
health data for patient’s health care team
19. Question #3 - Long Term Benefits
of EMRs
• Seamless communication across the
continuum of care and into community
based settings - integrates primary care
physicians and specialists into community
care facilities
• Redesigning the key business processes,
along with change management efforts,
education and training
20. Question #3 - Long Term Benefits
of EMRs
• Establishing common data, integration,
and communication standards
• Applying appropriate legislative
frameworks for patient privacy and patient
consent
• Improves your facility’s Policies &
Procedures
21. e-Healthcare System’s Services
• EMR Software specifically for the Long
Term Care Industry - All segments
• Help in Grant Writing and submission
• Project Task Management
• Issues tracking and resolution
• Identification of Facility Staffing Skill
Requirements & Training
22. e-Healthcare System’s Services
• Project accountability and visibility
• Certifiable EMR Software - Adapting
workflows - To achieve certification, the
vendors must complete tasks in 40
categories
23. Certification Requirements for
Approval
Standards and Certification
Qualified EMR technology means the EMR is
certified to meet standards and includes patient
demographic and clinical health information,
such as medical history and problem lists, and
has the capacity to provide decision support for
physician order entry, to capture and query
healthcare quality information, and to exchange
electronic health information with other sources.
24. Certification Panels
Healthcare Information Technology Standards Panel
(HITSP)
Specifications being developed:
• HITSP Interoperability Specification
• EMR-Centric Interoperability Specification
(IS107) and referenced constructs
25. Certification Panels
Healthcare Information Technology Standards Panel
(HITSP)
Specifications being developed:
• HITSP Interoperability Specification EMR-
Centric Interoperability Specification
(IS107) and referenced constructs
26. Certification Panels
Certification Commission for Healthcare (CHHIT)
Specification Standards being
developed:
• Functional / technical specifications
• ASTM International Continuity of Care
Record
• ANSI X12 (EDI) (HIPAA)
• CEN - CONTSYS (EN 13940) - Continuity of
Care
27. Certification Panels
Certification Commission for Healthcare (CHHIT)
Specification Standards being
developed:
• CEN - EHRcom (EN 13606) - European
Communication
• CEN - HISA (EN 12967) - Inter-system
Communication
• DICOM - Radiology Imaging/Report
Communication
28. Certification Panels
Certification Commission for Healthcare (CHHIT)
Specification Standards being
developed:
• HL7 - Encryption & Communication
• ISO - ISO TC 215 - Architecture
Requirements
• openEHR - Next generation public
specifications and implementations for EHR
systems and communication
29. Certification Panels
ARRA – American Recovery and Reinvestment
Act
The American Recovery and Reinvestment Act of 2009 (ARRA) is here.
$180 billion in federal funding has been set aside for healthcare-related
spending.
This not only impacts workflow, but could transform the roles of coders
and billers.
Without a doubt, EMRs are grabbing headlines – as well they should,
given the emphasis placed upon them within the ARRA and the revenue-
producing potential for vendors associated with implementation. But
forward-thinking healthcare leaders will also recognize that “all ships rise
with the tide.” In the early stages of technology planning, most practices
will plot workflow processes and evaluate internal procedures in order to
prepare for optimal use of an EMR
30. Certification Panels
Long Term and Post Acute Care (LTPAC) Advisory
Task Force
By 2011, at least 10 percent of all orders processed in a hospital must be
entered through CPOE to qualify that institution for CMS incentives under
the HITECH Act, according to a proposed matrix of meaningful use
released today by ONC’s HIT Policy Committee.
Other 2011 hospital requirements are: implementation of drug-
drug, drug-allergy, and drug-formulary checks maintenance of up-
to-date problem lists of current and active diagnoses based on
ICD-9 or SNOMED incorporation of lab-test results into EHR as
structured data reporting of hospital quality measures to CMS
implementation.
31. Certification Panels
Regional Health Information Organizations (RHIOs)
RHIOs are multistakeholder organizations expected to be
responsible for motivating and causing integration and
information exchange in the nation’s revamped healthcare
system.
Generally these stakeholders are developing a RHIO to affect the
safety, quality, and efficiency of healthcare as well as access to
healthcare as the result of health information technology.
32. Certification Panels
Regional Health Information Organizations (RHIOs)
RHIOs are a specialization of health information exchanges (HIE).
Health information exchange (HIE) is defined as the mobilization
of healthcare information electronically across organizations
within a region or community. HIE provides the capability to
electronically move clinical information between disparate
healthcare information systems while maintaining the meaning of
the information being exchanged. The goal of HIE is to facilitate
access to and retrieval of clinical data to provide safer, more
timely, efficient, effective, equitable, patient-centered care. HIEs
also provide the infrastructure for secondary use of clinical data
for purposes such as public health, clinical, biomedical, and
consumer health informatics research as well as institution and
provider quality assessment and improvement.