Presentation to Chinese American Association of Southern California - - PowerPoint PPT Presentation

A project of L.A. Care Health Plan A project of L.A. Care Health Plan

Presentation to Chinese American Association of Southern California

Health Information Technology Extension Center for Los Angeles 1/31/11

This presentation is incomplete without supporting oral commentary

A project of L.A. Care Health Plan

Federal HITECH Act

“To improve the quality of our health care while lowering its costs, we will make immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized. This will cut waste, eliminate red tape and reduce the need to repeat expensive tests… But it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health care system.”

President Obama January 2009

A project of L.A. Care Health Plan

HITECH Program

• Medicare and Medicaid

Incentives & Penalties

• State Grants for HIE
• Standards &

Certification Framework

• Privacy & Security

Framework

$60B HITECH Program: How the Pieces Fit Together

Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery ADOPTION MEANINGFUL USE EXCHANGE Health IT Practice Research

• Regional Extension Centers
• Workforce Training

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A project of L.A. Care Health Plan

Regional Extension Centers

• Not-for-profit organizations established to provide training,

support, and technical assistance to help primary care providers select, implement, and use EHRs in a meaningful way

• Selection, purchase, and implementation of EHR
• Workflow redesign
• Connection to health information exchange
• Attainment of meaningful use
• Compliance with privacy and security
• Goal is for 100,000 priority primary care providers to become

meaningful users of EHRs within four years

• Four years are 90% subsidized by the federal government

A project of L.A. Care Health Plan

Why Did L.A. Care Pursue the REC Program?

• Mission Alignment:

Focus on small and solo practices, community clinics, and public hospitals aligns with core mission to support safety net providers. The REC program leverages past and future investments with additional federal dollars.

• Quality Alignment:

Meaningful use of HIT is an important component of quality healthcare. Providers using EHRs and exchanging health information will improve quality of care for members.

• Business Alignment:

Two-thirds of Los Angeles County primary care providers are in L.A. Care

• network. The REC is an opportunity to strengthen relationships with these

providers, develop relationships with new providers, and increase exchange

• f clinical data.

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A project of L.A. Care Health Plan

Who We Are

• April 2010 – L.A. Care awarded a federally

funded grant to serve 3,000 providers in Los Angeles County

• HITEC-LA formed as a separate division of L.A.

Care

• Experienced 12-person core team; over 100

with Service Partners/EHR vendors

• We are not vendors; we are a neutral party

advised by providers

A project of L.A. Care Health Plan

Our team plus:

• A set of hand-selected Service Partners who will assess, project

manage, help you achieve meaningful use, and train

• Certified EHR vendors who will install, implement, train, and support
• Hardware vendors who will install, implement, and support

150 of us working together with you!

Meet the Team

We’re ready to help you from start to finish

A project of L.A. Care Health Plan

Members

• 1400 providers have enrolled to-date including:

Aids HealthCare Foundation Denise A. Albury, MD AltaMed Health Systems American Indian Healing Center Ali Awada MD Asian Pacific Health Care Venture Lily Balette, MD Clinica Msr Oscar Romero Compton Central Health Lina C. Dela Cruz, MD Eisner Pediatric and Family Medical Center El Proyecto del Barrio Family Health Care Center of L.A. Santosh Garg MD Harbor Community Clinic Mona Iskander MD Wilbert Jordan MD Vigen Khojayan MD Gia D. Le Los Angeles Christian Centers Manuel F. Mendoza, MD Willy Murtidjaja, MD Narinder Nat, MD Oscar Perez, MD QueensCare Family Clinics Alagia Rangarajan, MD Ruben M Ruiz, III MD Saban Free Clinic South Central Family Health Center

• St. John's Well Child & Family

Center Darren Takeuchi MD Terence TZ Tan MD T.H.E. Clinic Inc. UMMA Community Clinic URDC Human Services Venice Family Clinic

• Z. Joseph Wanski, MD

Watts Healthcare Corporation Kong-Tay Wu, MD Raquel M. Ynchausti, MD

A project of L.A. Care Health Plan

Available Monies

• Contracted,

eligible providers can receive $5,000 from HIT incentive programs

• Additional grant

money is available

• Utilize REC’s

Service Partners

• On-site

technical assistance from readiness through MU Stage I, paid for by HITEC-LA program

• Medicare/

Medicaid incentive program

• Medicare:

up to $44,000

• Medicaid:

up to $63,750

L.A. Care HITEC-LA CMS

A project of L.A. Care Health Plan

Provider Eligibility Crosswalk

Provider Type/License Eligible for subsidized REC Services Eligible for Medi-Cal Incentives1 Eligible for Medicare Incentives Medical Doctor (MD) YES2 YES3 YES3 Doctor of Osteopathy (DO) YES2 YES3 YES3 Psychiatrists (MD) NO4 YES3 YES3 Dentist (DDS, DMD) NO4 YES YES Nurse Practitioner (NP) YES2 YES3 NO Certified Nurse Midwife (CNM) YES2 YES3 NO Chiropractor (DC) NO4 NO YES Physician Assistant (PA) YES2 YES5 NO Psychologists NO4 NO NO Optometrists (OD) NO4 YES YES Podiatrists (DPM) NO4 NO YES Residents NO YES3 YES3

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• Minimum 30% Medicaid patient volume
• Minimum 20% Medicaid patient volume and is a pediatrician
• Practice predominantly in a Federally Qualified Health Center or Rural Health Clinic and have a minimum 30% patient volume of needy individuals

• Physician Practices of 10 providers or less
• Community health centers, primary care clinics and rural health clinics
• Ambulatory care clinics associated with public hospitals, critical access hospitals, or rural hospitals
• Other medically underserved settings

A project of L.A. Care Health Plan

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First Calendar Year in Which Eligible Provider Receives a Medicaid Incentive Payment Calendar Year 2011 2012 2013 2014 2015 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 $8,500 2019 $8,500 $8,500 $8,500 2020 $8,500 $8,500 2021 $8,500 Total $63,750 $63,750 $63,750 $63,750 $63,750 $63,750

• Eligible Providers are those that see 30% Medicaid, Medicaid HMO or uninsured patients over any 90-

day period during the year

• Pediatricians must see 20% Medicaid, Medicaid HMO or uninsured patients
• To qualify for the first payment, an EP must implement, upgrade or acquire an EHR
• Payout occurs over 6 years with the last payment year being 2021
• EPs must show $25,000 in expenses in Year 1 and $10,000 in subsequent years for maximum incentive

Medicaid Incentives

A project of L.A. Care Health Plan

12 First Calendar Year in Which Eligible Provider Receives a Medicare Incentive Payment Calendar Year 2011 2012 2013 2014 2015 + 2011 $18,000 2012 $12,000 $18,000 2013 $8,000 $12,000 $15,000 2014 $4,000 $8,000 $12,000 $12,000 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 $2,000 $4,000 $4,000 $0 Total $44,000 $44,000 $39,000 $24,000 $0

• Incentive payments are equal to 75% of Medicare Allowable amount up to the

maximum listed in the table below.

• During 2011, EPs only have to demonstrate meaningful use for 90 days.
• During 2012+, EPs must demonstrate meaningful use for entire year.

Medicare Incentives

A project of L.A. Care Health Plan

Why Enroll Now?

• The program serves the first 3,000 provider

members

• We can help make it easier to pick your EHR
• We can get you money and free service
• Enrolling helps other Los Angeles County

providers get free assistance

• The program ends in 2014

A project of L.A. Care Health Plan

Serving Our Members

• Every practice receives a telephone practice assessment to

determine readiness: – 741 assessments completed so far; 84% of our providers are ready

• Next, a Service Partner is assigned, meets with practice, and

scopes out the work to help onsite from start to finish: – Currently helping 100 providers with vendor selection, infrastructure selection, upgrades to certified EHRs, workflow redesign, and meaningful use achievement

• We are also providing legal advice, answering MU questions,

and processing incentives

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A project of L.A. Care Health Plan

Phases of EHR Implementation

Planning EHR Selection Implementation Integration Post- Implementation Meaningful Use

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A project of L.A. Care Health Plan

Service Partners

• Six Service Partners have been selected; they

provide on-site, local technical assistance to:

– Select an EHR – Determine readiness – Design workflow – Determine hardware and connectivity needs – Manage the vendors – Do additional training – Achieve meaningful use – Develop interfaces

• Highly subsidized assistance for 3,000 members

A project of L.A. Care Health Plan

Group Purchasing of EHRs

• Eight EHR vendors with standard contracts,

statewide pricing, and full-featured solutions including HIE and MU:

– Allscripts – eClinicalWorks – GE (Practice and Advanced Systems) – Greenway – NextGen – athenahealth – McKesson Practice Partner – e-MDs

A project of L.A. Care Health Plan

Vendor’s Implementation Gap

• Lack of practice-focused preparation
• Inadequate training
• Lack of support during implementation
• Poor go-live strategy
• Unclear costs and fees
• Lack of training on achieving meaningful use
• Lack of practice-focused HIE connectivity

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A project of L.A. Care Health Plan

Service Partner Technical Services

Readiness Assessment Vendor Selection Implementation Training Go Live Meaningful Use

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• On-site

Assessment

• Gap Report
• Boot Camp
• Education
• Assist with EHR

Selection

• Arrange Demo
• Coordinates

HW/SW Install

• Oversee/Test

Equipment

• Hand-Holding
• Customizing

Templates

• Onsite Support
• Workflow

Redesign

• Rx Connection
• Lab Connection
• Monitoring MU

Reports

• Vendor Demo
• Price Quote
• Sign Contract

Installation:

• Internet
• Hardware
• EHR
• EHR Training
• Template

Design

• Conversion

A project of L.A. Care Health Plan

EHR Products Selection

• ONC-ATCB Certification (3 certifying bodies)
• HIPAA privacy & security compliant
• Meaningful use reporting
• Ability to generate county, state and federal reports
• Support HL7 messaging standard
• Support Secure Sockets Layer (SSL) digital certificate
• Report writing tool (e.g. Crystal report)
• Audit trail capabilities

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Basic EHR Criteria

A project of L.A. Care Health Plan

Prioritize your Requirements

• ASP/SaaS hosted or client/server on-premise
• Data access and ownership
• List the capabilities you want in an ideal EHR system
• Prioritize the list into “must haves” and “nice-to-

haves”

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Step 1 – Decision Point

A project of L.A. Care Health Plan

EHR Selection Tips

• Determine which EHR system meets your high-level

requirements

• Identify ways that EHR software will make your office

more efficient

• Determine which EHR system falls within your budget
• Rank the vendors based on perceived ease-of-use

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Step 2 – EHR Demonstration

A project of L.A. Care Health Plan

EHR Selection Tips

• Ask for two or three references that share your

specialty

• Ask each reference what they don’t like about the

system

• Ask references how the vendor responded to any

problems

• Assess the vendor’s financial and strategic viability

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Step 3 – Reference Check

A project of L.A. Care Health Plan

The Hidden Costs

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• 1. Interfaces (device, lab, imaging, portal, HIE, PM )
• 2. Third party software
• 3. Claims processing
• 4. Web portal
• 5. Template customization
• 6. Report customization

Avoiding Surprises

A project of L.A. Care Health Plan

EHR Implementation

• Takes planning and time to make an implementation

successful

• Need to be willing to commit the necessary time and

resources

• Need to have buy in from all office staff members
• Create a plan to transition your practice from paper to

electronic records

• Identify a champion or “super-user” to help train and

assist other staff

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Keys to Success

A project of L.A. Care Health Plan

EHR Implementation

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• Plan and prepare for implementation
• Create a tailored project plan for your practice
• Define measurable goals and milestones (scheduling,

EHR and PM go live) and share it with staff

• Use the change as an opportunity to improve processes

in both patient care and administrative areas

• Focus on meaningful use from the outset of the

implementation

Keys to Success

A project of L.A. Care Health Plan

Testimonials

Here is just a sample of what members are saying about HITEC-LA:

“It is good that we have someone well informed and knowledgeable to help us through implementation of EHR.”

Joseph Dianchian Administrator, Helen Rostalmoo MD

“The help we received from the REC was invaluable to us. HITEC-LA found us a great service provider team who worked side by side with us and brought the knowledge and skill we needed to get the job done!”

Tracy Robinson, MD Chief Medical Officer, T.H.E. Clinic, Inc.

“We were impressed with their rapid response to our request for assessment....We are very pleased with HITEC-LA and plan to call on them further as we move forward to achieve meaningful use of our EHR. Thank you HITEC-LA!”

Paula Wilson President and Chief Executive Officer, Valley Community Clinic

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A project of L.A. Care Health Plan

www.hitecla.org

1 (888) 524-4832

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