Piedmont Community Services Electronic Health Record Project Team

Our Current Data System (Pros) Developed and maintained in-house Implemented in 1995 Tailored to PCS’ operational processes. Ability to make system changes without waiting on a vendor. Local understanding of data storage and structures. No maintenance and support costs. 11/13/2018 EHR Project Team

Our Current Data System (Cons) Uses outdated technology. DOS Based Does not interface well with new operating systems. Databases are reaching capacity. Does not meet EHR (CCHIT) standards. Does not interface with: Accounts Payable Human Resources Clinical Processes Other CSB’s or DMHMRSAS 11/13/2018 EHR Project Team

New Health Data Standards Coming In April 2004, and every year since, President George W. Bush has called for widespread use of health information technology (HIT), and for electronic health records (EHRs) to be in use for most Americans by 2014. “Within the next ten years, electronic health records will ensure that complete health information is available for most Americans at the time and place of care, no matter where it originates.” “HL7” refers to Health Level Seven: Formed in the United States in 1987, HL7 has the goal of developing an international set of open standards for data format and content that allows different health information systems to easily and effectively communicate with one another. 11/13/2018 EHR Project Team

Work at the State Level Consumer Service Workgroup Developing the design of an EHR. Working with Licensure & Medicaid to assure consistency. Modules Identified Screening √ Completed Assessment √ Completed Planning Medical Legal / Notification 11/13/2018 EHR Project Team

Electronic Health Record Screening Module Information related to determination of eligibility for services & identification of the need for & link to services Assessment Module Documents physical, mental and behavioral status; life skills, strengths; service needs & preferences; community, family & other resources & supports Electronic Health Record Individual Planning Module Identifies service needs & preferences; goals, objectives & interventions directed toward addressing those needs. Provides a single integrated plan for multiple problems, goals and strategies, and an integrated review of services. Documents progress and consumer outcomes, consumer participation, & discharge disposition. Legal and Notification Module Diverse collection of documents that address legal status, judicial history, & authorizations that support privacy & other legal mandates. Medical Module Documents & communicates the history, evaluation, & current status of medical functioning; significant active & chronic medical conditions, medications, orders & treatment in response to those conditions. Demographics Billing - Appt.s Reporting

Electronic Health Record (Pros) Real-Time data access. Standardization of current “paper” processes. Elimination of duplicate data collection. Legible, accurate, non-redundant data. Simultaneous access by multiple users. Structured data entry and access. Reminders and alerts. Quality Assurance & Monitoring. HIPPA compliance, reduced paper needs. 11/13/2018 EHR Project Team

Electronic Health Record (Cons) Staff accepting the paradigm change to EHR. Training and Implementation. Cost of purchase and ongoing maintenance and support. Full implementation takes a long time 12 – 18 months after complete implementation before seeing R.O.I. 11/13/2018 EHR Project Team

EHR Proposal Board of Directors adopt the concept of moving toward an Electronic Health Record. Establish a project team to oversee implementation. Board Member(s) Managers Clinicians Consumers Support Staff / I.T. / H.R. Finance Staff Q.A. Manager Begin orientation of staff to EHR. 11/13/2018 EHR Project Team

EHR Project Team Amy Givens Ann Minnix Audrey Buck Bonita Vipperman Caroline Pilson Darwin Honneycutt Frances Scoggin Greg Sykes Kippy Cassell Mary Kay Berger Ray Dietz Sam Petty Susie Sizemore Theresa Scott 11/13/2018 EHR Project Team

WHERE DO WE BEGIN? Organization Information Selection Implementation 11/13/2018 EHR Project Team

Organization Select Project Manager Select Project Team Create a Successful Environment Commitment from Leadership Create & Educate Project Team Mission Statement for the Project Establish Project Plan Define the Objective and Overall Goals What is the highest priority 11/13/2018 EHR Project Team

Information 11/13/2018 EHR Project Team

What is an Electronic Health Record? An electronic record of consumer health information generated by one or more encounters in any care delivery setting It has demographics, progress notes, problems, treatment plans, medications, labs, etc. It Automates and Streamlines the Clinician’s Workflow The EHR has the ability to generate a complete record of a clinical encounter, as well as supporting other care-related activities directly or indirectly. 11/13/2018 EHR Project Team

What an EHR is NOT! An EHR is not simply a repository of data. An EHR should not be a barrier to services An EHR is not a simple conversion from paper chart to the electronic medium An EHR is not simply duplicating current paper processes 11/13/2018 EHR Project Team

Goals of an EHR Quality and Productivity are Improved Reduce Cost Automated workflow saves time Consumer services are improved Clinician productivity is enhanced Quality of services are improved Reduce Cost Reduction in Overhead can be significant Economic Benefits of EHR Better manage the Health of the Consumer Management and Quality Assurance Support health wellness and quality goals 11/13/2018 EHR Project Team

New Terminology Electronic Health Record (EHR) Interoperability Open Architecture HL7/X12 Standards Certification Commission for Health Information Technology (CCHIT) Electronic Health Initiative (IHE) Connection to Regional Health Information Organizations (RHIO) ePrescribing 11/13/2018 EHR Project Team

Selection Software Vendors 11/13/2018 EHR Project Team

Selection Steps Create a Short List (The world is too big to see it all) Determine Evaluation Criteria (cost, features, performance, etc.) Create RFP (Request for Proposal) Plan Site Visits Demonstrations Narrow down to two or three vendors Create selection process 11/13/2018 EHR Project Team

Implementation Secure revenues - funds Start small Basic system – demographics Phased in approach Set realistic goals Communicate … Communicate Training … Training … Training 11/13/2018 EHR Project Team