What is the Best Way to Select an EHR What is the Best Way to Select an EHR? Its Time to Upgrade… How Do We Get The Most Out of Our EHR? Presented by: Shelley Samuels Denise Majka

Introduction www.esnjsolutions.com

Vendor Selection Selection Process Selection Team Criteria Will the product accomplish your key goals? Decision Making Process Its not majority rules What is your timeline for “go live”?

Selection/Reselection Negotiations and Contracts Clarify start up pricing Define implementation support Clarify roles for data migration Consider costs of legal review of contracts Will you need an outside consultant to provide Project Management?

Average Timeline Vendor Selection Contracting Months 1-3 Contracting Month 4 Establish team, Culture and Workflow Design Month 5 Implementation and Staff Training Months 6-8 can be up to Month 12 Utilization Begins between Months 9 and 13

Solutions Average Timeline Vendor Selection Months 1-2 Contracting Month 2 Establish team, Culture and Workflow Design Month 3 Implementation and Staff Training Months 3-4 Utilization Begins between Months 4-5

Implementation Establish Expectations Clearly define agency’s expectations for staff utilization of software Access to Equipment and Tools Determine what type of equipment end users will need in order to accomplish agency’s goals. Ensure that you have the appropriate bandwidth to support the software

Strategic Purpose What is the goal your agency would like to accomplish? Assess Agency Readiness Financial Readiness Technical Readiness EHR Culture Its not a tool it’s a culture Staff investment

Team Selection and Leadership Buy-In Team should include clinical, administrative and billing staff Executive leadership must be responsible for setting EHR goals. Dedicated System Administration Who will be monitoring the system? Who will be updating system as regulations change? Who will be assisting end users with questions or concerns?

Full Organization Implementation Cost savings Interdepartmental training Decrease duplicative workflows and documentation Increase ability to provide more comprehensive person centered services

Realistic Project and Implementation Plan Data migration including staff and consumers Will service plans need to be manually entered? Will external documents need to be scanned and uploaded? Forms need to be configured Workflows need to be mapped, standardized and tested Reimbursement rate need to be entered and tested Develop workflows that decrease duplication in data Review current processes in order to reevaluate and restructure for better efficiencies.

Staff Training Training needs to begin prior to “go live” Training plan needs to include specific goals and objectives Train staff in the workflows they will be using Provide detailed step action guides Give staff specific homework

Internal policies and procedures need to be in writing such as: P&Ps Internal policies and procedures need to be in writing such as: Adding and removing staff Protecting ePHI information Who has access to EHR at what privilege level Operational policies and procedures Compliance with Meaningful Use

Utilization-Roadmap to User Adoption Technology Literacy Does the staff have basic computer literacy? End User Support and Feedback Who will provide end user support on a daily basis? Implement a system for end users to provide feedback They have valuable information on what will make their workday more efficient All requests must be answered in order to keep end user engaged in the process.

Utilization-Roadmap to User Adoption Practice, Practice, Practice Adequate training time must be afforded to staff to learn to maneuver the system Hardware Support IT support must be available to support operational staff to ensure equipment is working properly Utilization Fatigue Plan for minimal time of duplicative paper and electronic documentation

Successful Billing EHR MUST SCRUB CLAIMS FOR ERRORS Clinical scrub Billing rule scrub Set up billing rules to maximize revenue Test billing prior to sending in live claims Develop procedures for interdepartmental collaboration between billing and services Second signatures?

Continuous Quality Improvement Reports? Review workflows regularly for evaluation of improved efficiency Utilize system for review of services rendered and consumer progress Develop a procedure for internal chart review Monitor staff productivity

Measuring Outcomes Does the system measure outcomes? Is there an ability to configure for the outcomes your agency wants to capture? Are you able to develop reports to capture outcomes?

Emerging Model: Triple Aim Value Payments Current Model Emerging Model: Triple Aim HEALTH STATUS OF THE POPULATION • PERCEIVED VAUE / SATISFACTION • COST PER CAPITA FOR PROVIDING CARE Future Model: Healthcare Movement Value = Quality Cost Value = Effectiveness + Experience Efficiency Value = Consumer meets outcomes + satisfaction + functional status Cost of service + consumer investment (time/effort)

What We All Want to Know How will we bill Medicaid and other payers? Choosing a comprehensive flexible billing platform to bill all payers electronically and developing internal procedures that incorporate and service lines working collaboratively. How will we clinically document in a compliant manner? Choose a system that is capable of: (1) concurrent documentation; (2) flexibility and (3)safeguards to assess all clinical documentation prior to it reaching the claim engine. How will we meet the ever changing requirements? Leveraging the opportunity to switch from paper to electronic documentation by: (1) review documentation for duplication; (2)optimize workflows and (3) provide staff with adequate training and support to maximize user adoption. How do we optimize service delivery and maximize revenue? Ensure software has the ability to track authorized service units and reporting capabilities to track and monitor utilization. Develop procedures: monitoring & reporting service utilization How do we prepare for the future of value based payments? Establish outcomes for services: review and update annually. System flexibility to manage/report on outcomes that directly tie to your ability to bill in a value based payment model.

Questions/Need more info? Denise Majka DMajka@esnjsolutions.com 732.955.8367