Beth Israel Deaconess Care Organization

Electronic Health Records and Clinical Integration

September 2013

Beth Israel Deaconess Care Organization

The Beth Israel Deaconess Care Organization is a partnership between BIDMC and community hospitals, independent physicians and physician groups.• organization of individual and groups of physicians and hospitals

who work together to coordinate care delivery, quality improvement, and care efficiency in order to enhance the care of individual patients and populations of patients. Foundation of that is EHR

BIDCO EHR Initiative

• Summary Successfully implemented 250 providers in 90 practices

between 2009-2012• Practice Consulting and Project Management

– MAeHC– BIDCO EHR Team

• Arcadia Solutions: Service Desk and technical services eClinicalWorks hosted by BIDCO via private cloud Standardization: eCW version and quality measure capture Meaningful Use Stage 1

• 100% of PCPs• 90% of specialists

Deploy

Train

Master

AVERAGE IMPLEMENTATION TAKES 20 WEEKS (1-5 MDs)

Workflow optimization

System designDesign

I

II

III

IV

Site prep

EHR customization

System install

and check

Pre-training preparation Go-Live Plan

On-site training

Support kickoff

Evaluate

Improve

Project phases

Week

0

Week

4

Week

8

Week

12

Week

18

Key dates

Week

15

Week

20

Project Kick-Off

EHR Vendor Kick-Off

Hardware Install

Trainer On Site Go Live

ClearinghouseSite

Remediation Complete

MAeHC

BIDCO EHR Implementation at LGH

• BIDCO Team had implemented 75 practices prior to LGH joining BIDCO• LGH affiliated providers

18 practices and 32 providers

• BIDCO / LGH Partnership BIDCO responsible for EHR implementation and project management LGH identified providers and obtained legal agreements Timeline/Schedule Creation

• LGH to prioritize and schedule providers• Creation of mutually agreeable schedule

• Lessons Learned and Applied to LGH practices Pre-assessments to identify issues prior to commencing implementation ISP installation, timing of hardware order Practice engagement/meeting milestones LGH as point of escalation

BIDCO EHR Initiatives: 2013+

• Interfaces Lab/Rad/Discharge Summaries Clinical Data Warehouse

• Viewer to and from BIDMC ambulatory EMR In patient context

• eCW eHX/Health Exchange module Patient consent to share record

• Meaningful Use Stage 2 preparation Lab interfaces and Patient Portal

• State HIE Phase 1: October 2012: BIDCO provider from Lawrence was one of the “Golden Spikes” of

the Mass HIway• Received C32/CCD clinical summary direct from BIDMC into eCW via Mass HIway.

Phase 2: Scheduled to be a pilot for MA State HIE Integration with eCW via the Mass HIway

Choice Plus IPA and BIDCO

Partnership for Electronic Health Record Success

MeHi Regional Meeting - September 12, 2013

Lawrence General and MeHI• Lawrence General Physicians of the Choice

Plus Network IPA supported the application submitted November 2009 for MeHI to become the REC for Massachusetts

• Those physicians were some of the first to become REC members through IPA grants

• First REC regional meeting was held at Lawrence General Hospital

• Two regional MeHI Meaningful Use meetings held at Lawrence General

• IOO opportunity with BIDCO and eClinical Works

The Organizations

The Key Elements

Meaningful Use By The Numbers

• Lawrence General Project now includes 36 Providers: Started May 2011– 11 Primary Care Provider Practices– 4 Specialty Practices– 3 Pediatric Practices

• 35 of the 36 providers qualified for Meaningful Use programs; all 35 attained MU for 100% result– 14 Providers in the Medicaid program– 22 Providers in the Medicare program– Incentive dollars earned to date: $642,000

Additional LGH-Supported Initiatives

• Massachusetts HIWay Implementation Grant– Merrimack Valley HIE Collaborative consists of

Lawrence General Hospital, Greater Lawrence Family Health Center, Pentucket Medical Associates and Home Health VNA

– Awarded grant of $75,000.00 to develop an Emergency Room discharge notification alert sent over the highway

• Via Choice Plus PHO at LGH, additional community connectivity:– Established the role of Physician Integration Manager– Laboratory orders and results delivery– Radiology results delivery and future opportunities

• Meaningful Use Stage 2 preparation– Education and Technical Support