Erickson Communities

• Developer of large scale retirement communities– 1500 independent apartments– Service rich environment

• Home care (nursing and rehab)• Outpatient rehab

– Extended care• Skilled inpatient nursing and rehab• Long term care• Assisted Living

– Physician Practice on site (one doctor/400 residents)– Sublease to Specialists

– Only CCRC with its own Medicare Advantage Plan

2

Strategy

Optimize the Resident Provider Encounter

Interdisciplinary Care Delivery Model

Automating the Clinical Model

• Erickson committed to automating all clinical transactions in 2003.– Strong interdisciplinary team due to clinical model– Emphasis on customer service due to “Erickson

Living”• Excellence in Geriatrics is defined by whole

person care on their terms– Less testing, less medications, lower

hospitalization rates– More use of rehabilitative and restorative services

Erickson Health IT

Home Health

Renaissance Gardens

Hospital

Care CoordinationOut Patient Rehab

Retail Pharmacy

Medical Center

FunctionalHealth Record

Labs

SpecialistsResident Portal

InstitutionalPharmacy

Solutions

• Ambulatory Practice EMR (GE Centricity)– Custom content for all types of service and levels

of care– Compliance support

• E and M• Risk Adjustment

– Workflow tools• Meds to be avoided in elderly, meds contributing to

falls• Advance Care • PQRI Preventive Measures

Ambulatory EMR

– Reporting• Quarterly provider dashboard on Quality• Registry to CMS for PQRI

• Resident Portal (launched 2005)• Integrations with Care MEDX (The Erickson

Functional Health Record)• Health Risk Assessments

ER Chart Summary

Ambulatory EMR

– Reporting• Quarterly provider dashboard on Quality• Registry to CMS for PQRI

• ER Chart Summary (2004)• Resident Portal (launched 2005)• Integrations with Care MEDX (The Erickson

Functional Health Record)• Health Information Exchange with hub

Hospital (with Health Unity) 2007

Care MEDX “Vision”

• Long Term Care• Assisted Living• Inpatient and Outpatient Rehab• Home Health (to be completed with

occasionally connected solution)

Intel Health Guide

• Resident apartment • High risk patient in skilled care• Complex patients in Erickson Advantage

• 30 devices, Peripherals, Care Management • Very high compliance with care plans• Improved review of critical issues

– Weight gain– Blood Pressure – Medication Compliance

• High patient and care manager satisfaction• Improved patient knowledge of disease

The Functional Health Record

• Integrations across all clinical platforms• Lab Corp electronic order entry• Electronic Prescribing (2009)• Document imaging• Point of care reporting

– Physicians use physicians system at all levels of care– Nursing and Allied health use their systems

» View reporting allows chart review, data mining and decision support

– Advance Directive Project– Interdisciplinary Workflow Alignment Application

Quality Measures

Q1 Medical Group National Benchmark

Pneumococcal Vaccine 95% 62%

Flu Vaccine 90% 67%

Hospital Admission / 1000 Members 272 364

Hospital Readmission Rates within 30 days 8.6% 19.6%

Meds to be Avoided Among Seniors 0.6% 3.0%

Osteoporosis and Vitamin D level 98%

Advance Directives on File

ADVANCDIRECT AMBDNR0

5000

10000

15000

20000

25000

Patients With ObservationPatients Without Observation

National Average < 10%

Long Term Plan

• Close gap on Medication Reconciliation– Single Source for all aspects of medication use,

administration and compliance• Transitions of Care

– Improve patient involvement in HRA– Planned transitions

• Better integration with Specialists through HIE

– Unplanned Transitions• Reduce admission rate from Ere

– Reduce transition rate

Beyond the Gates

• How can community health systems achieve care alignment and quality – Incentives– HIT adoption and Functionality– Patient Expectations– Training