Easterseals
New Jersey Solutions
What is the Best Way to Select an EHR?
Its Time to Upgrade…
How Do We Get The Most Out of Our EHR?
Presented by:
Shelley Samuels
Denise Majka
EHR …. Made Easy!
Easterseals
New Jersey Solutions
Introduction
www.esnjsolutions.com
EHR …. Made Easy!
Easterseals
New Jersey Solutions
Vendor Selection
• Selection Process
– Selection Team
– Criteria
– Will the product accomplish your key goals?
• Decision Making Process
– Its not majority rules
– What is your timeline for “go live”?
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Selection/Reselection
• Negotiations and Contracts
– Clarify start up pricing
– Define implementation support
– Clarify roles for data migration
– Consider costs of legal review of contracts
– Will you need an outside consultant to provide Project
Management?
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New Jersey Solutions
Average Timeline
Vendor
Selection
Establish team,
Culture and
Workflow Design
•Months 1-3
•Month 5
Contracting
•Month 4
Utilization
•Begins between
Months 9 and 13
Implementation
and Staff
Training
•Months 6-8 can be
up to Month 12
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New Jersey Solutions
Solutions Average Timeline
Vendor
Selection
Establish team,
Culture and
Workflow Design
•Months 1-2
•Month 3
Contracting
•Month 2
Utilization
•Begins between
Months 4-5
Implementation
and Staff
Training
•Months 3-4
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Implementation
• Establish Expectations
– Clearly define agency’s expectations for staff
utilization of software
• Access to Equipment and Tools
– Determine what type of equipment end users will
need in order to accomplish agency’s goals.
– Ensure that you have the appropriate bandwidth to
support the software
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• Strategic Purpose
– What is the goal your agency would like
to accomplish?
• Assess Agency Readiness
– Financial Readiness
– Technical Readiness
• EHR Culture
– Its not a tool it’s a culture
– Staff investment
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•
•
Team Selection and Leadership Buy-In
– Team should include clinical, administrative and billing staff
– Executive leadership must be responsible for setting EHR goals.
Dedicated System Administration
– Who will be monitoring the system?
– Who will be updating system as regulations change?
– Who will be assisting end users with questions or concerns?
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•
Full Organization Implementation
– Cost savings
– Interdepartmental training
– Decrease duplicative workflows and documentation
– Increase ability to provide more comprehensive person centered
services
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•
Realistic Project and Implementation Plan
– Data migration including staff and consumers
– Will service plans need to be manually entered?
– Will external documents need to be scanned and uploaded?
– Forms need to be configured
– Workflows need to be mapped, standardized and tested
– Reimbursement rate need to be entered and tested
– Develop workflows that decrease duplication in data
– Review current processes in order to reevaluate and restructure for better
efficiencies.
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•
Staff Training
– Training needs to begin prior to “go live”
– Training plan needs to include specific goals and objectives
– Train staff in the workflows they will be using
– Provide detailed step action guides
– Give staff specific homework
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•
P&Ps
– Internal policies and procedures need to be in writing such as:
•
•
•
•
•
Adding and removing staff
Protecting ePHI information
Who has access to EHR at what privilege level
Operational policies and procedures
Compliance with Meaningful Use
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Utilization-Roadmap to User Adoption
•
•
Technology Literacy
– Does the staff have basic computer literacy?
End User Support and Feedback
– Who will provide end user support on a daily
basis?
– Implement a system for end users to provide
feedback
• They have valuable information on what will make
their workday more efficient
• All requests must be answered in order to keep end
user engaged in the process.
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New Jersey Solutions
Utilization-Roadmap to User Adoption
•
•
•
Practice, Practice, Practice
– Adequate training time must be afforded to staff to learn to maneuver
the system
Hardware Support
– IT support must be available to support operational staff to ensure
equipment is working properly
Utilization Fatigue
– Plan for minimal time of duplicative paper and electronic documentation
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New Jersey Solutions
Successful Billing
•
•
•
•
•
EHR MUST SCRUB CLAIMS FOR ERRORS
– Clinical scrub
– Billing rule scrub
Set up billing rules to maximize revenue
Test billing prior to sending in live claims
Develop procedures for interdepartmental collaboration between billing and
services
Second signatures?
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Continuous Quality Improvement
Reports?
•
•
•
•
Review workflows regularly for evaluation of improved efficiency
Utilize system for review of services rendered and consumer progress
Develop a procedure for internal chart review
Monitor staff productivity
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Measuring Outcomes
•
•
•
Does the system measure outcomes?
Is there an ability to configure for the outcomes your agency wants to
capture?
Are you able to develop reports to capture outcomes?
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Value Payments
Current Model
Value =
Quality
Cost
Emerging Model: Triple Aim
HEALTH STATUS OF THE POPULATION • PERCEIVED VAUE / SATISFACTION • COST PER CAPITA FOR PROVIDING CARE
Value =
Effectiveness + Experience
Efficiency
Future Model: Healthcare Movement
Value =
Consumer meets outcomes + satisfaction + functional status
Cost of service + consumer investment (time/effort)
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New Jersey Solutions
What We All Want to Know
How will we bill Medicaid and other payers?
Choosing a comprehensive flexible billing platform to bill all
payers electronically and developing internal procedures that
incorporate and service lines working collaboratively.
How will we clinically document in a compliant manner?
Choose a system that is capable of: (1) concurrent
documentation; (2) flexibility and (3)safeguards to assess all
clinical documentation prior to it reaching the claim engine.
How will we meet the ever changing requirements?
Leveraging the opportunity to switch from paper to electronic
documentation by: (1) review documentation for duplication;
(2)optimize workflows and (3) provide staff with adequate
training and support to maximize user adoption.
How do we optimize service delivery and maximize revenue?
Ensure software has the ability to track authorized service units
and reporting capabilities to track and monitor utilization.
Develop procedures: monitoring & reporting service utilization
How do we prepare for the future of value based payments?
Establish outcomes for services: review and update annually.
System flexibility to manage/report on outcomes that directly
tie to your ability to bill in a value based payment model.
EHR …. Made Easy!
Easterseals
New Jersey Solutions
Questions/Need more info?
Denise Majka
[email protected]
732.955.8367
EHR …. Made Easy!