Transcript CCNV Accomplishments January

Adoption and Use of Electronic
Medical Records (in Federally
Qualified Health Centers)
and Supporting an ASP
Community Care Network of Virginia, Inc.
Outline
• Who is Community Care Network of Virginia (“CCNV”)
• Technology Goals
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Efficient and Productive Use of EMR
Center for Data and Informatics – Quality
Medical Home and Health Information Exchange
Innovation
eClinicalWorks Deployment
ASP Hosting
ASP Architecture
Challenges and Benefits
Disclaimer
Community Care Network of Virginia (CCNV)
• Provider Network Incorporated in 1996
• Owned by all of Virginia’s 24 Federally
Qualified Health Centers
• Located in 90 sites across the Commonwealth
• 300 providers delivering primary care, dental
and behavioral health services
Federally Qualified Health Centers
• Independent non-profit corporations
• Mission to serve all members of a community
regardless of patient’s ability to pay
• Operate in local communities
• Over 1,200 across the country
• Take most if not all third party insurances
• Receive limited Federal grant dollars to cover the
cost of serving the uninsured
• Commitment to quality
CCNV Business Purposes
1. Represent providers/practices in third party
payer contracting - single signature authority
2. Provide cost effective management services
information technology, medical and dental
billing, NCQA certified provider
credentialing, etc.
3. Performance Improvement – Center for Data
and Informatics
CCNV Technology Goals
Goal 1: Efficient and Productive Use
of EMR
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Shared purchase pricing
Multiple hosting options
Readiness evaluations
Workflow analysis and improvement
Training, training, and more training
Central support and ticket management
User group on line forums and twice yearly
meetings
Goal 2: Center for Data and
Informatics
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Establishing clinical outcome measures
Collection and aggregation of data
Establishing data validity and reliability
Reporting and benchmarking
Network and local performance
improvement activities
• Quality forums
Goal 3: The Medical Home and Health
Information Exchange
Medical Home and HIE
Patients
Hospitals
Specialists
Local Social
Service
Agencies
Medical Home
Health
Department
[Federally Qualified Health Center]
Labs
Payers
Pharmacy
Hospice
Home
Health
Goal 4: Innovation KIOSKS
• Network wide initiative to fabricate and install
waiting room KIOSKS
• Kiosk content integrated into EMR in real time
immediately prior to patient entering exam room
• Initial content limited to behavioral health
assessment (PHQ-2 and PHQ-9)
• Additional content and functions over time
• Streamlines total patient time in the office
eClinicalWorks Deployment
eClinicalWorks (eCW) Deployment
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Two year due diligence planning period
Negotiated network purchase agreement
Licenses owned by individual health center
Optional hosting infrastructure (individually or
ASP)
• Master implementation schedule based on
individual organization readiness
• Network based, eCW certified trainer and support
technician
ASP Hosting
ASP Hosting
• ASP hosting is optional
• Our model is client owned not vendor owned
• Software vendor accommodates both ASP
individually hosted architecture
• Reasons for choosing ASP vary
• Small practices with limited capital resources and staff
• Large practices not wanting to make significant hardware
investments
• timing
ASP Architecture
ASP Architecture
• Located in hosting facility in Richmond
• Corporate office approximately 6 miles
from hosting facility
• Hosting facility secure, redundant systems,
on site technical staff can provide optional
services
ASP Architecture
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Currently have 14 servers
15 out of 20 organizations are hosted
Currently installed in a single rack
Server types - application, data base, document
management, reporting
Fax servers hosted locally
All servers and drive configurations are redundant
All sites connect through VPN to data center
eCW software manages server\data access
ASP Architecture
• Local engineering support is outsourced
• Central (CCNV) help desk for triage of
problems
• eCW handles all software issues
• Set weekly coordination and management
calls with eCW
Challenges and Benefits
of an
ASP
Challenges and Benefits
• Internet connectivity issues
• Hardware upgrades driven by growth, vendor specs, new
technology (virtualization), maintenance replacements
• Lease vs. buy
• Must have good communications with vendor (eCW) in
order to manage software upgrades and fixes
• Individual practice growth must be accommodated by the
ASP
• Technical Staffing and Support relationships are local and
long term
• Troubleshooting centers on connectivity and performance
(latency) issues
Challenges and Benefits
• Eliminates human resources issues for practice
• Technical expertise available to individual
practices that they might otherwise not have
access to, or can afford
• The number and types of issues experienced by a
large practice that individually hosts are similar to
an ASP hosted configuration
• Most issues are not eliminated, the responsibility
to address them are shifted
David Selig
Chief Executive Officer
Community Care Network of Virginia
6802 Paragon Place
Suite 630
Richmond, VA 23230
804-237-7686
[email protected]