Maryland HIMSS Ambulatory EHR Case Study

1
Maryland HIMSS Ambulatory EHR Case Study

• October 12, 2007

2
Agenda

• Overview of FredMed Organization
• Overview of Practice EMR Evolution
• Overview of EMR Business/Technology Model
• Implementation Status
• Lesson Learned (To Date)
• Benefits Anticipated

3
FredMed Mission

• Leverage FMH IT Investment to Provide Cost
  Effective IT Services to Frederick Area
  Physicians
• Provide Cost Effective Connectivity to Frederick
  Memorial Hospital
• Provide Building Blocks for Community Health
  Information Exchange

4
FredMed Governance Board of Directors

• 3 Elected Physician Members
• 1 Serves as Board President
• 2 Year Staggered Terms
• 2 Appointed FMH Staff
• CFO Bill Pugh
• CIO David Quirke

5
FredMed Benefits

• Meditech and Other FMH Applications from Any
  Workstation for Any Staff Member
• Practice Management Software (Misys)
• Internet with Filtering and FMH Firewall
• Centrally Managed Antivirus Software

• Auto Print or Fax of FMH Lab Results, Radiology,
  Transcription Reports
• Email Accounts for Staff
• Local Technical Support Focused on Medical
  Offices
• Wireless Networking
• FMH Transcription Service
• Vendor Alliances

6
FredMed History

• 1998 - Planning Started, MSO Site Visits
• 1999 May - First Employee Hired
• 1999 July - Organizational Meeting
• 1999 October - First Practice on WAN
• 2000 WAN Rollout, Transcription Pilot
• 2001 Misys PM Pilot, Transcription Rollout
• 2002 Rollout Misys with Master Files,
• Auto Print/Fax Results from Meditech
• 2003 First EMR Assessment, T1 Pilot, Antivirus
• 2004 Physician Websites, HIPAA Security
  Briefings, FredMed Quarterly Newsletter, PACs
• 2005 Voice/Data Bundled Service Rollout,
• Heat Implementation
• 2006 Electronic Prescription, Bring Your Own
  Internet Option, FMH Basic Service Level

7
Membership Statistics
8
Membership Satisfaction

• April 2007 (Scale 1-5)
• 26 Practices Represented
• Technical Services
• Overall - 4.9
• Responsiveness 4.9
• Sensitivity to Your Needs and Environment 5.0
• Misys Practice Management Software Support
• Overall 4.6
• Master Files 4.6
• Cost Effectiveness 4.7
• FMH Transcription
• Quality 3.9
• Turnaround Time 3.3
• 92 Would Recommend FredMed to Another Practice

9
FredMed EMR Initiative History

• 2002 - Contracted Superior Consultants to Assist
  in Vendor Identification and Evaluation
• June 2002 Vendor Expo
• January, April 2003 Finalist Vendor Fairs
• October, November 2003 LSS
• Company and Site Visits
• November 2003 Board Decision
• to Focus on Component-Based Solution
• Transcription Seen as Poor Mans EMR
• Pursuit of Electronic Prescription Solution

10
FredMed EMR Initiative History

• 2005 FredMed Board Voted to Revisit EMR Product
  Line and Evaluate Two Options
• LSS Integrated with Meditech Environment
• Misys Existing FredMed Investment with 16
  practices/60 physicians LIVE on Practice
  Management Software
• 2006 Misys EMR Solution Selected and Contract
  Negotiations Begun
• July 2007 Misys Contract Signed

11
FredMed EMR Model

• Leveraging FMH IT Infrastructure
• Data Center Server Housing
• Terminal Servers
• SAN Storage
• Backups
• Exchange/Enterprise Fax Solution
• FredMed Purchases Bulk Misys Licenses
• Practices Pay Per Provider/User per Month
  Utilization Fees
• Practices Purchase All Site Equipment (Tablets,
  Scanners, Thin Clients)

12
Misys EMR Overview - Schedule

• Infrastructure Development Fall 07
• 2 Pilot Practices with Misys Project Management
• Continuing Rollout with FredMed Project
  Management/MisysChannel Partner Agreement

13
Misys EMR Overview Practice Implementation
Methodology

• Practices Using Misys for Practice Management
  Take Priority
• Phased Rollout for Each Practice
• Document Management/Messaging Initially
• Caregiver Documentation Ramped Up Over Several
  Weeks
• All Caregivers Do NOT Need To Implement
  Concurrent Visit Documentation
• No Big Bang LIVE
• Basic Implementation 8-12 Weeks
• Phased In Result/Report Interfaces (Meditech,
  LabCorp, Quest)

14
Lessons Learned (To Date)

• Consensus On One Vendor Solution Not Possible
• Todays Practice Management Software Decisions
  are Driven by EMR
• Community MPI Not Soup Yet but Practices Can
  Still Obtain Advantages
• Selection and Contract Negotiation Very Slow
  Process
• Rapid Change in EMR

15
Benefits Anticipated - FMH

• Building Block for Community Health Information
  Exchange
• Improve Results Communication Between FMH and
  Community Physicians
• Limit Integration Platforms for FMH
• Assist with Physician Recruitment to Frederick
  Community
• Facilitate Improved Care in Community

16
Benefits Anticipated - Physicians

• Cost Effective Option to Quality EMR
• Removal of IT Hassle Factor for Practices
  Backups, Updates, Upgrades, Climate Control,
  etc.
• Mitigation of Risks Security, System Failure
• Local Support and Expertise
• Local User Community
• Stable Practice Management Platform