Overview Information Technology Overview and Planning Guide Course Two – June 7 Patrick Gauthier and Linda Hagen

Learning Objectives 1.Overview of IT Adoption Life-Cycle Ten Steps on the Critical Path 2.Review ARRA HITECH Incentives 3.Next Steps – A Guide to Your Planning 4.Questions and Answers

Information Technology Not your father’s IT anymore Hardware Software and SaaS Interface Networking Storage and Disaster Recovery Information Exchange Privacy and Security Compliance Informatics Expert Staff Resources

1. IT Strategic Planning Developing and implementing short and long-range IT strategic plans to align technology with business objectives. Assessing IT infrastructure needs. Conducting cost/benefit analysis.

2. IT Outsource Evaluating the potential and the cost effectiveness of outsourcing all or a portion of your information systems needs. With respect to billing, a clearinghouse or other billing option may make sense. Outsourcing IT services like desk-top support, maintenance and training may make sense.

3. Workflow and Process Analysis Document and analyze current workflow and business processes then explore the opportunity for process improvements in a future state design with your team of experts. Newly refined workflow and business processes become the basis for new technical and operational requirements software vendors need to satisfy.

4. Requirements Documentation Based on final business processes and workflow, develop and document your system’s functional and technical requirements. Requirements will help identify vendors and systems that are best suited for your unique environment and needs.

5. Vendor Evaluation Develop standardized scoring tools based on requirements. Assess vendors consistently across technical, operational, functional, financial, and business relational dimensions. Pre-script demos so vendors have to show you what you want to see. Not the other way around. Ask for references where “live” sites have been on the system 1+ years and call them!

6. System/Vendor Selection Selection depends on scoring process which depends on requirements and workflow documentation. Did you do your homework? Price is an issue but understand hidden costs and Total Cost of Ownership. Be clear about costs of upgrades and patches and maintenance. Reputation and viability are essential.

7. System Configuration Identifying and documenting system modifications that the vendor has agreed will be configured. Configuration is the result of analyzing current system functional capabilities against actual business process and workflow requirements. If you can live with, don’t reconfigure it.

8. System Conversion System conversions involve identifying and carefully mapping data that will be moved or “migrated” from a current or legacy system into the new system in order to preserve information. Conversions are common when vendors go out of business/merge, when providers merge, and when new certification requirements have to be met.

9. System Implementation Developing comprehensive implementation approaches and work plans to assure optimum “go live”. Managing your implementation team through installation, configuration, parallel processing, testing and quality assurance. Conducting thorough training. Developing “super users” and joining user groups

10. System and Data Integration Analyzing data sharing and system connectivity needs and designing/selecting and implementing an infrastructure to achieve required integration. May include interface engines, data warehousing, analytical tools and reporting tools.

ARRA Incentives AMERICAN RECOVERY AND REINVESTMENT ACT of 2009 $50B for Health IT (HIT) Goals –Improve rate of certified EMR adoption –Enhance infrastructure and interoperability –Improve quality, safety, & efficiency –Engage patients & their families –Improve care coordination –Improve population and public health; reduce disparities –Ensure privacy and security protections

Medicaid Provider Incentives Medicaid providers (including MH/SUD) can receive incentives (total $63,750/EP) through non-hospital based eligible professionals (EPs) –Physicians –Nurse Practitioners –Physician Assistants in an FQHC Medicare incentive is $44,000

Medicaid Criteria for Incentives –Percentage of Medicaid encounters must be 30%+ for each EP over a representative 90-day period –EP must have 50% of their encounters at facilities using a certified EHR –EP must be non-Hospital based (Hospital based means the professional furnishes 90% of services in either inpatient or emergency room of Hospital) –Organization meets certified Meaningful Use EHR requirements –EPs must assign their incentives to the organization

Medicaid Incentives Eligible for EPs who –Adopt certified EHR (acquired and installed) –Implement certified system (started using) –Upgrade a certified system (expand or upgrade to certified system)

Registration and Tracking Registration –Providers must register on CMS website –Enrolled in Medicare FFS or Medicaid (FFS or managed care) –National Provider Identifier (NPI) Tracking –Self attestation –Other ways to be determined at state level

Next Steps What is our vision for our IT? –Clinical pathways? –Efficiencies? –Performance Management? –Managing Utilization? –Quality Improvement? –Reporting? –ACOs and Health Homes?

Financial Plan Calculate eligibility for incentives Implement electronic billing Develop revenue cycle management and performance metrics Recommend IT budget and financing plan

Team Readiness Buy-in from bottom-up AND top-down Plan for Work-in-Progress Understanding that implementation takes time and things slow down at first Talent and expertise required to execute plan and deploy new systems Job descriptions and staffing plans revised

QI Plan What will you measure? Why and how? How will it change practices and patient experience? How will standards be selected and implemented?

Learn Become a Learning Organization Recruit accordingly Use consultants appropriately Retain the talent and expertise you have Recognize and reward your people Engage your customers

Thank You. Questions? Patrick Gauthier Director x.802