Physician Adoption of HIT:

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• Physician Adoption of HIT
• Barriers Strategies
• AHRQ Annual Meeting
• Wednesday September 26, 2007
• A. John Blair, III, MD
• President, Taconic IPA

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Barriers

• Adoption
• Long Term Use

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Barriers

• Wrong driver
• Prohibitive cost
• Inadequate IT expertise
• Scarce resources
• Limited resolve/tenacity
• Poor integration of products
• Unrealistic expectations

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Wrong Drivers

• Internal
• Increase reimbursement
• Save time
• Cure for dysfunctional processes
• Techie promoter
• External
• Hospitals
• Health plans
• RHIOs

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Strategies

• Automation after thoughtful redesign
• Do not pave cow paths
• Quality improvement
• Improved safety
• Patient satisfaction
• Employee satisfaction
• Practice desire not external promotion

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Prohibitive Cost

• 20,000-30,000/provider up-front
• 500-1,000/provider/month on-going

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Strategy

• Subscription model
• 5,000/provider up-front
• 500/provider/month on-going

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Inadequate IT Expertise

• Practice management system
• Legacy systems
• Older technology
• Less network complexity
• Lower availability requirement
• Lower response time requirement
• Internet connectivity
• ASP

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Strategy

• EHR is a new world
• Availability
• Response time
• Equipment
• Network

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Strategy

• IT support outsourcing
• Connectivity
• Healthcare setting
• Application familiarity
• New understanding of medical practice setting
• Now clinical area and workflow effected in
  addition to administrative
• Preventive maintenance

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Scarce Resources

• Staffing constraints
• Knowledge base

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Ideal Implementation
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Strategy Typical Implementation
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Implementation Services

• Coordinate IT
• Practice Consultant
• MGMA
• Front office
• Billing office
• Implementation
• Project management
• Post Implementation
• CMIO
• Decision support
• Chronic disease management
• Connectivity
• HIE

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Questions?
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Thanks for your time!

• A. John Blair, III, MD
• President, Taconic IPA