PRISM Regional

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PRISM Regional

• Ambulatory Group Practice

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PRISM RegionalVision

• Leverage Fletcher Allen's Epic installation into
  non-owned regional providers (VT/NY) that share a
  patient population with Fletcher Allen
• Improved coordination of care for patients that
  cross organizational boundaries
• Improved region-wide utilization of health care
  resources Right Care, Right Time, Right Setting
• Accelerated statewide adoption of EHRsassisting
  Vermonts Critical Access Hospitals (CAH) in
  meeting meaningful use

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Ambulatory Meaningful Use

• HIMSS 5 Stages of Clinical Transformation
• Stage 3
• 100 CPOE
• Computers have replaced the paper chart and maybe
  used at point of care
• Basic medication management eprescribing
• Basic clinical decision support interactions,
  etc.
• Electronic import and storage of lab results in
  structured form
• Structured encounter data vital signs,
  immunizations, etc.
• Secure electronic messaging intra-office for
  clinical collaboration
• Connectivity to hospitals for electronic receipt
  of discharge summaries and transmission of
  admission documents
• Reminders for required testing

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EHR vs Data Exchange

• An Electronic Health Record (EHR) includes
• All patient information in digital form, e.g.
• Physician and nurse notes
• Diagnostic images and lab test results
• List of medications
• Tools to enhance care and safety
• Best practice guidelines
• Automatic alerts (e.g., high glucose levels on
  lab test)
• Conflict checks (e.g., drug allergies)

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EHR vs Data Exchange?

• All information is available (under appropriate
  security and privacy guidelines) to treating
  providers regardless of location within the
  institution
• PRISM Regional will provide full access to the
  EHR information and tools to all hospitals and/or
  practices that participate

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EHR vs Data Exchange?

• Data Exchange enables electronic sharing of
  clinical information between and among multiple
  EHRs
• Not complete medical record, but structured data
  sets (lab results, images, continuity of care
  documentation)
• Messages between EHRs may or may not be centrally
  stored

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Data Exchange
Patient is admitted to the hospital and
monitoring devices are attached and also
connected to the computer. An emergency Cardiac
Cath is scheduled, but first the provider wants
to pull information from the outlying providers
EHR, and any other provider the patient may have
seen.
Provider inputs patient information, vital signs,
etc. into his/her physician office EHR. The
application alerts the physician to dangerous
vitals and makes best practice recommendation
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Chart summary (CCD) is made available for
viewing by hospitals EHR
VITL requests chart summary from outlying
providers EHR
Electronic inquiry sent to the Exchange by the
hospital EHR
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Why PRISM Regional?

• Fletcher Allen is the only trauma center in VT
  (and serves upstate NY as well)
• 19 of patients admitted to Fletcher Allen are
  transferred from another health care facility
• 8 of Vermonts 14 hospitals are Critical Access
• Narrow window to select, purchase and implement
  an EHR to benefit from ARRA dollars
• EHR required to meet meaningful use
• very few vendors serve the small hospital market
• Integration with Epic Ambulatory EHRs for
  practices that have majority of referrals with
  PRISM Regional Hospitals

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Transfers to Tertiary/Quaternary Care Centers
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Communicating Among Epic Users
Epics Care Everywhere
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Connecting ALL Providers
Epics Care Everywhere
VITL
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PRISM RegionalA Shared EHR provides

• A single architecture with one look and feel
  supported by a common vocabulary
• Consistent experience for a shared workforce
• Consistent patient experience
• Seamless collaboration
• Best practice workflows across a spectrum of
  care
• Reduces connection points to/from pharmacies,
  payers and data exchanges

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PRISM Region Details

• Same system as Fletcher Allen physicians
• All inclusive pricing
• SW, HW, end user devices, connectivity to data
  center, installation, 5 yrs maintenance
• 57,500 (11,500/yr over 5 years)
• 958 per provider per month
• Access to an experienced team of clinical and IT
  resources shared among regional providers
• Working with vendors to provide bridge financing
• Working with VT-HITEC for workforce development

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