1. Accelerating Recovery Information Technology Maturity Index Presented by: Stephen A. Wood, FHIMSS HealthCare Perspective, LLC

2. Information System Maturity Client Life Cycle – Stage 1 Referral Pre-Registration / Screening Wait List Management Admission/Registration/Demographics Diagnostic Assessment Payor / Financial Data Service Activity / Encounters Discharge or Transfer Paper Based Clinical Records

3. Information System Maturity Scheduling / Census – Stage 2 Scheduling Program Capacity Resource Scheduling (facility, interpreters, transportation) Census (respite, residential, psychiatric inpatient ad state hospital) Caseload Capacity Paper Based Clinical Records

4. Information System Maturity Billing and Accounts Receivables – Stage 3 Credentialing / Provider Set-up Billing Set-up (Codes, Rules / Edits) Payor Authorizations Administrative Case Management All service billing (internal claims and invoices) Electronic billing (HIPAA Compliant – 837P) Posting Payments and Adjustments (835) Manage Accounts Receivables (Gross to Zero)

5. Information System Maturity Client Care – Stage 4 Assessments (Electronic) Progress Notes Templates (Electronic) Treatment Plan / Service Plans (Electronic) Service Authorization (Electronic) Utilization Management (Computer) Case Management / Coordination (Computer) Quality Management (Computer)

6. Information System Maturity Clinical Orders – Stage 5 Medication Management and Administration (Computer) Electronic Prescriptions – (External) Lab tests – Orders and Results (Electronic) Vital signs Therapy Orders

7. Information System Maturity Client Records (eRecords) – Stage 6 Legal electronic health record defined for disclosure purposes Release of Information Disclosure Tracking Disclosure Violation Tracking and Reporting Retrieval and production of digital or paper client record for outside requests Tracking of legacy paper medical records External document storage in imaging system

8. Information System Maturity Health Information Exchange – Stage 7 Ability to send and receive CCR and/or CCD CCR = Continuity of Care Record CCD = Clinical Care Document CCD is Interoperable PDF Browser Fully XML Connected to Health Information Exchange

9. National Perspective ARRA/HITECH Funding is Driving EHR Adoption 2011 Goal – Level 5 2013 Goal – Level 6 2015 Goal – Level 7 Assess Current Status Develop Long Term Plan => 2015 Target Start Process From Where you Are!

10. Issues and Barriers Major Issue is the Leap from a Paper Based Practice Management System to an Electronic Clinical Record. High Failure Rate………Change is Difficult IT Focused Projects => Failure Change Management Focused Projects => Possible Success Clinical Leadership => Success

11. Keys to Success Senior Management Must be Involved Establish a Clear Charter and Value Statement Set Expectations Correctly Throughout the Process Communicate to Everyone – Over and Over Expect Resistance – Good for You is Bad for Them Persevere and Expect Some Failure - Don’t Be Afraid to Fail

12. Keys to Failure Lack of Leadership Commitment to the Project Lack of Planning – Lack of Project Management Failure to Make Decisions – Decision Deadlock Failure to Staff the Right People to Right Tasks Failure to Build Consensus - “Turf” Wars Failure to Create a Positive Environment for Change