NYC REACH
Primary Care Information Project
NYC Department of Health & Mental Hygiene
EHR Vendor Adoption and
Change:
Considerations, Tools & Tips
April 2015
Tabitha Mercado
Primary Care Information Project
PCIP was founded in 2005 as a bureau of DOHMH
Mission
• Improve the quality of care in medically
underserved areas through health information technology (HIT)
Successes
• Nearly 16,000 providers joined PCIP and the Regional Extension Center (NYC REACH), including nearly 9,000 primary care providers.
• Access to data for over 3,000 providers at over 700 practices.
Define
your
needs and
EHR
Criteria
Narrow
your
choices
Actively
Shop
Compare
and
Evaluate
Choose!
Analyze your current work flow
• Efficiencies/difficulties
• How can an EHR help you with practice management?
Establish your EHR criteria
• Support from vendor
• Practice Management options • Can they match your templates?
Are you comfortable with their existing templates?
• Is this vendor popular in your specialty? For what reasons?
Determine Your Specific Practice Needs
Orders
Physician diagnosis of patient MA/Nurse check-in
Patient check-in at front desk Initial appointment setting
Assess Your EHR Needs:
• Identify high-priority needs and EHR features that may meet those needs • Identify what EHR features you will need to achieve meaningful use and
practice goals Set EHR Goals:
• Follow the SMART goals process: specific, measurable, attainable, relevant, and time bound
Make Key Decisions:
• List of potential deal-breakers
• decide whether you want your EHR data to reside in-office, a vendor server, or in web-based storage (“cloud storage”).
• Research vendor websites and speak to colleagues and/or your local Regional Extension Center..
• Narrow the Field using the Certified HIT Product List: http://oncchpl.force.com/ehrcert?q=CHPL
For specialists shopping for the right vendor, the following are some important factors to explore:
• Before implementing, make sure that the EHR you are considering has:
o Appropriate templates you will need for your specialty
o Testing functionalities that accommodate the specific tests you need to run
• Contact your professional society to locate resources they have for choosing the right vendor to fit your specialty type
Considerations for Specialists
If you are a specialist and have additional questions, make sure to contact your professional organization or NYC REACH to get the answers you need before moving forward!
Define
your
needs and
EHR
Criteria
Narrow
your
choices
Actively
Shop
Compare
and
Evaluate
Choose!
• Will my patients be migrated into my new EHR System? • Do I have a data governance plan?
• What do I need to know about this new vendor I am considering? • Does this new vendor offer data merge? How much and what is the
expected timeline for completion? Will there be downtime? • Is this new vendor Stage 2 Meaningful Use compliant?
• Will this EHR system help me with documentation and be able to improve for better care coordination?
• Office of the National Coordinator (ONC) certifies EHR systems for compliance with the Meaningful Use standards
• EHR vendors may have multiple products, or multiple versions of a single product • When selecting an EHR vendor, providers can select from a wide range of prices,
functions, customer support, hosting options, etc.
• There have now been two rounds of EHR Certifications • You must have a 2014 Certified EHR
Criteria for Meaningful Use Stage 2
• All EHR vendors publishing certified electronic health record technology (CEHRT) for Eligible Provider (EP) and Eligible Hospital (EH) use must conform to the 2014 Edition EHR Certification Criteria (45 CFR 170.314) http://www.healthit.gov/sites/default/files/meaningfulusetablesseries2_1 10112.pdf
• All system versions of CEHRT in compliance with certification criteria is listed in the ONC’s CHPL list:
When choosing an EHR, it’s important to consider the various costs associated with adoption. Be mindful of the costs that come with getting up and running on an EHR and maintaining your system!
Cost Considerations
EHR Fees EHR license
Data Hosting Implementation Training
Maintenance and Support Data Migration
IT Costs
(hourly vs. fixed fee) Hardware & Office network IT support (Implementation)
IT Support (Ongoing)
Other Billing clearinghouse
Interfaces (device, lab, imaging, HIE)
Lost revenue during implementation/Training Patient Portal
Data Management and Privacy Considerations
Benefits:
• Patient data access & entry • Templates
• Record consolidation • Electronic prescriptions • Lab interface connectivity • Trending/targeting with
reporting
• Patient follow-up & engagement • Electronic claims
Challenges:
• Privacy concerns • Identity theft • Data loss
Other Considerations
Consider asking your vendor about:
• Disaster Preparedness – what can they offer to keep you protected? • Billing components – are they ready for ICD-10?
• Interfaces with laboratories and registries?
• Are is system able to run special reports for ACOs, PQRS, HEDIS/QARR, PCMH, and others?
• Is the vendor PCMH pre-validated with NCQA? • Are they ready for Meaningful Use Stage 2?
Contract terminations and considerations:
• What if the vendor goes bankrupt? Can you get your data back? • What if they no longer make updates?
• What if they ask you to make an upgrade that’s too costly?
• What are the costs associated with data migration if you do decide to switch systems?
Divorce Clauses
• What happens if you decide not to upgrade? • Will there be an additional cost of support?
• Are you willing to pay the current support fees?
• If you decide to part ways is there a cost for data migration? • Will the EHR company purge all patient records?
• What happens if the EHR company goes out of business?
• Will the EHR you are leaving be willing to assist the new EHR company when switching?
• Will the EHR vendor transfer all the data? • Demographic, clinical & financial data Get all the cost of parting ways in writing. Be firm in your questions!
Define
your
needs and
EHR
Criteria
Narrow
your
choices
Actively
Shop
Compare
and
Evaluate
Choose!
• Balance • Data Quality • Data Access • Data Literacy • Data Content • Analytic Prioritization
• Master Data Management
Define
your
needs and
EHR
Criteria
Narrow
your
choices
Actively
Shop
Compare
and
Evaluate
Choose!
Certifications (ONC) Specialty-based
Success with similar practices --- ask your colleagues! Practice size
Patient volume Location
Language
Compare and Evaluate
Company
Integrity
Benefit
Cost &
Look &
Feel
Features
&
NYC reach offers a Vendor Comparison Worksheet to assist providers while they compare different vendors. Use the worksheet to keep track of EHR specifications and compare!
Define
your
needs and
EHR
Criteria
Narrow
your
choices
Actively
Shop
Compare
and
Evaluate
Choose!
Implementation Support:
• Sharing best practices in IT
infrastructure assessment, project management, workflow analysis, and vendor relations
Clinical Quality Consulting:
• Coaching around EHR-enabled workflow redesign for key disease areas
• Assistance on clinical and
administrative workflow redesign and optimization
Meaningful Use Training and Support:
• In-person and online classes on Meaningful Use, billing best
practices, privacy and security and patient engagement. Classes are both in-person and online
• Online members-only resource library with a variety of self-help tools
You’ve Selected an EHR: What next?
After you’ve become an NYC REACH member and selected the EHR system right for your practice, our staff can work with you to make the necessary next steps:
Stay tuned for more information about additional quality
improvement services from NYC REACH!
Member Digests
• Tips on how to meet the measures • Important changes and deadlines • Upcoming classes and events • Tailored for small and large
practices
• Sent via email, available in resource library
Please contact us at
[email protected] if you are not receiving your Digest
Questions?
Interested in joining NYC REACH?
Thank you!
NYC REACH | Primary Care Information Project New York City Department of Health & Mental Hygiene
