Overview

Information TechnologyOverview and

Planning GuideCourse Two – June 7Patrick Gauthier and

Linda Hagen

Learning Objectives

1. Overview of IT Adoption Life-Cycle• Ten Steps on the Critical Path

2. Review ARRA HITECH Incentives3. Next Steps – A Guide to Your Planning4. Questions and Answers

Information Technology

Not your father’s IT anymore• Hardware• Software and SaaS• Interface• Networking• Storage and Disaster Recovery• Information Exchange• Privacy and Security Compliance• Informatics• Expert Staff Resources

1. IT Strategic Planning

• Developing and implementing short and long-range IT strategic plans to align technology with business objectives. Assessing IT infrastructure needs. Conducting cost/benefit analysis.

2. IT Outsource

• Evaluating the potential and the cost effectiveness of outsourcing all or a portion of your information systems needs.

• With respect to billing, a clearinghouse or other billing option may make sense.

• Outsourcing IT services like desk-top support, maintenance and training may make sense.

3. Workflow and Process Analysis

• Document and analyze current workflow and business processes then explore the opportunity for process improvements in a future state design with your team of experts.

• Newly refined workflow and business processes become the basis for new technical and operational requirements software vendors need to satisfy.

4. Requirements Documentation

• Based on final business processes and workflow, develop and document your system’s functional and technical requirements. Requirements will help identify vendors and systems that are best suited for your unique environment and needs.

5. Vendor Evaluation• Develop standardized scoring tools based on

requirements. • Assess vendors consistently across technical,

operational, functional, financial, and business relational dimensions.

• Pre-script demos so vendors have to show you what you want to see. Not the other way around.

• Ask for references where “live” sites have been on the system 1+ years and call them!

6. System/Vendor Selection• Selection depends on scoring process

which depends on requirements and workflow documentation. Did you do your homework?

• Price is an issue but understand hidden costs and Total Cost of Ownership.

• Be clear about costs of upgrades and patches and maintenance.

• Reputation and viability are essential.

7. System Configuration

• Identifying and documenting system modifications that the vendor has agreed will be configured. Configuration is the result of analyzing current system functional capabilities against actual business process and workflow requirements.

• If you can live with, don’t reconfigure it.

8. System Conversion

• System conversions involve identifying and carefully mapping data that will be moved or “migrated” from a current or legacy system into the new system in order to preserve information.

• Conversions are common when vendors go out of business/merge, when providers merge, and when new certification requirements have to be met.

9. System Implementation

• Developing comprehensive implementation approaches and work plans to assure optimum “go live”. Managing your implementation team through installation, configuration, parallel processing, testing and quality assurance.

• Conducting thorough training.• Developing “super users” and joining user

groups

10. System and Data Integration

• Analyzing data sharing and system connectivity needs and designing/selecting and implementing an infrastructure to achieve required integration.

• May include interface engines, data warehousing, analytical tools and reporting tools.

ARRA Incentives• AMERICAN RECOVERY AND REINVESTMENT

ACT of 2009• $50B for Health IT (HIT)• Goals

– Improve rate of certified EMR adoption– Enhance infrastructure and interoperability– Improve quality, safety, & efficiency– Engage patients & their families– Improve care coordination– Improve population and public health; reduce

disparities– Ensure privacy and security protections

Medicaid Provider Incentives

• Medicaid providers (including MH/SUD) can receive incentives (total $63,750/EP) through non-hospital based eligible professionals (EPs) – Physicians– Nurse Practitioners – Physician Assistants in an FQHC

• Medicare incentive is $44,000

Medicaid Criteria for Incentives

– Percentage of Medicaid encounters must be 30%+ for each EP over a representative 90-day period

– EP must have 50% of their encounters at facilities using a certified EHR

– EP must be non-Hospital based (Hospital based means the professional furnishes 90% of services in either inpatient or emergency room of Hospital)

– Organization meets certified Meaningful Use EHR requirements

– EPs must assign their incentives to the organization

Medicaid Incentives

• Eligible for EPs who– Adopt certified EHR (acquired and installed)– Implement certified system (started using)– Upgrade a certified system (expand or

upgrade to certified system)

Registration and Tracking

Registration– Providers must register on CMS website– Enrolled in Medicare FFS or Medicaid (FFS or

managed care)– National Provider Identifier (NPI)

Tracking– Self attestation – Other ways to be determined at state level

Next Steps

• What is our vision for our IT?– Clinical pathways?– Efficiencies?– Performance Management?– Managing Utilization?– Quality Improvement?– Reporting?– ACOs and Health Homes?

Financial Plan

• Calculate eligibility for incentives• Implement electronic billing• Develop revenue cycle management and

performance metrics• Recommend IT budget and financing plan

Team Readiness

• Buy-in from bottom-up AND top-down• Plan for Work-in-Progress• Understanding that implementation takes

time and things slow down at first• Talent and expertise required to execute

plan and deploy new systems• Job descriptions and staffing plans revised

QI Plan

• What will you measure? Why and how?• How will it change practices and patient

experience?• How will standards be selected and

implemented?

Learn

• Become a Learning Organization• Recruit accordingly• Use consultants appropriately• Retain the talent and expertise you have• Recognize and reward your people• Engage your customers

Thank You. Questions?

Patrick GauthierDirector

pgauthier@ahpnet.com 888-898-3280 x.802

www.ahpnet.com