Transcript Title of Presentation

Healthcare EMR Emergence and
Laboratory EMR Strategies for 2009
Eric Q. Reynolds
Vice-President
Atlas Medical Corporation
Eric Q. Reynolds
Currently ATLAS Medical VP of Sales and
Marketing
Twenty (gulp) years in laboratory
industry
Survived a gauntlet of positions
Toxicologist
Client Services
System Deployments and Training
Field Team Management
Sales and Account Management
Joined ATLAS Medical in Fall of 2007
Webinar Agenda
EMR Definition
What an EMR Does
The Role of the EMR in Outpatient Clinics vs. Hospitals
EMR Facts and Industry Trends
EMR Market Adoption
Physician EMR Adoption
Government Gets Involved (Stark, CCHIT, and HITECH)
Physician EMR Requirements for Lab Orders and Results
Lab/EMR Integration vs. “one off” Interfacing
Benefits to Lab/EMR Integration
Outpatient EMR Definition
PMS (Practice Management System) for Administrative Use
Registration
Scheduling
Billing
May be included as part of the EMR or a stand alone product
> 90% adoption nationally *
EMR (Electronic Medical Record) for Clinical Use
Patient charts
Medications, Conditions, Allergies
Results (Laboratory, ECG, Radiology)
17% adoption nationally **
* Source: Physicians Practice, “IT Enhancement: Time, at Last, for an Upgrade?” author Shirley Grace, February
2007
** Source: The New England Journal of Medicine, “Electronic Health Records in Ambulatory Care - A National
Survey of Physicians” July 3, 2008
What Does an Outpatient EMR Do?
Electronic Medical Record
• What was paper, isn’t
• Anytime access to
patient’s charts
• Clinical workflow mgmt.
• Clinical assessment
• Disease management
• Interfaces to/from:
• Labs
• Radiology
• ECG/Cath
• Other EMRs
• Outcomes Reporting
EMR: Outpatient vs. Hospital
Outpatient Clinic
PMS
Administrative
Hospital or IDN
HIS
•Registration
•Scheduling
•Billing
•ADT
•Registration
•Scheduling
•Billing
EMR
Clinical
•Patient Charts
•Meds, problems,
allergies
•Results (Labs,
ECG,Rad)
Administrative
CDR
Clinical
•Enterprise wide
repository
•Generally labs
and documents
EMR Industry Facts and Trends
•Currently over 350 EMRs are available in North America
•32 new EMR vendors have been certified over the past 12 months
•Quest and LCA investing significant $$ in EMR interfacing and have a
head start over hospitals
•2009 Health Information Technology for Economic and Clinical Health Act
(“HITECH”) will spur significant increases in EMR utilization in the
outpatient setting
•Significant challenges will be placed on independent laboratories and
hospital laboratories to integrate with all manner of outpatient EMR systems
EMR Vendor Snapshot
Top 10 EMR Vendors (smaller 1-10 Physician practices)
(largest growth sector):
•NextGen
•AllscriptsMisys (Merger Completed 10/08)
(Allscripts purchased A4 Health in 2006)
•McKesson (puchase Practice Partner 2/07) (PMSI
name change to Practice Partner in 2006)
•e-MDs
•e-ClinicalWorks
•iMedica
•Sage
•Emdeon Intergy EMR (WebMD)
•GE Centricity
•Medinotes
EMR Market Adoption
200,000
180,000
160,000
140,000
120,000
100,000
80,000
60,000
40,000
20,000
0
EM R Adoption
2005
2007
2009E
2011E
EMR
Penetration
# Docs
%
total
2005
2006
2007
2008E
2009E
2010E
2011E
Solo
181,500
33
9,075
10,391
11,898
13,623
15,607
17,898
20,556
2-9
220,000
40
22,000
26,840
32,754
40,000
48,911
59,899
73,470
10-20
55,000
10
9,020
11,095
13,642
16,763
20,592
25,295
31,078
21-49
38,500
7
7,816
9,691
12,021
14,921
18,512
22,929
28,361
50+
38,500
7
10,203
12,855
16,129
20,063
24,600
29,567
34,982
58,114
70,872
86,444
105,370
128,222
155,588
188,477
10.6%
12.9%
15.7%
19.2%
23.3%
28.3%
34.3%
Total penetration
Total # Docs
550,000
Source: CDC, Health Affairs, AC Group, MGMA, SFG Research.
Compiled: Susquehanna Financial Group investor report on Allscripts,
published 3/22/07
Investment (time, tools, etc, …)
Physician EMR Adoption Profile
Lab Results are
required in 90% of
EMR go-lives
Lab Orders are
adopted when
general orders
are adopted
Full Encounter
Documentation
Medication
Management
Office
Communication
View and
Sign
Orders
CPOE requirement
Complete EMR workflow
Face sheet
documentation
E&M Compliance
Billing efficiencies
Disease management
Script legibility
Interaction checks
Formulary compliance
Phone notes
Virtual “to do” list
Office efficiencies
Minimal workflow impact
Populates chart with clinical data; lab results and transcription usually via scanned
documents
Chart review from home
EMR Implementation Timeline
2006 – Uncle Sam Gets Involved
In August 2006, the Department of Health and Human Services (HHS)
published rules that provide an exception under the physician self-referral
prohibition law (Stark), as well as safe harbor under the anti-kickback act
(AKA), for the donation of interoperable EHR technology to physicians and
other health care practitioners or entities.
EHR software is “deemed to be interoperable if a certifying body recognized
by the Secretary has certified the software no more than 12 months prior to
the date it is provided to the physician/recipient.”
CCHIT is an officially recognized certifying body
CCHIT = Certification Committee for Healthcare Information Technology
CCHIT Certification Chronology
CCHIT interoperability requirements that impact laboratory
Currently it’s a Low Bar, 32 EMR vendors have been certified
2009
􀀹Transmit the Lab Test Order Electronically
2008
􀀹Receive Microbiology lab results
􀀹Capture co-signatures for orders
􀀹Associated Images with result
2007
􀀹Receive General Text Reports
􀀹Display normal versus abnormal results
􀀹Display flow sheets
􀀹Provider results notification
􀀹Order lab diagnostic tests
􀀹Associate a diagnosis with a test
􀀹Test specific AOE prompts
􀀹Transmit the lab order – ONLY ON PAPER
􀀹Group, or panel ordering
Still Missing Today:
􀀹Electronic Orders
􀀹Auto-update of Orders
􀀹Rules based Routing
HITECH Begins in 2009
CCHIT expected to be go forward certification body for
healthcare IT
$19 billion in incentives and funding
$17 billion in physician incentives
$2 billion in HHS “discretionary funds”
Aims to dramatically drive interoperability standards across
healthcare IT
90% physician EMR adoption by 2020?*
*2009 Congressional Budget Office
What Physicians Want for Lab
All orders originate from within the physician’s EMR
Must be easy to use! Want the fewest “clicks” to order and
view lab
Dynamically update physicians’ ordering information
Make it part of physicians’ normal EMR workflow
All results returned to physicians’ EMR and matched to their
patients’ record (IP/OP/OR)
Inform the ordering provider of pending results
EMR Integration
Physician Office Perception:
EMR
LIS
Integration…Not the Other “I” Word
Integration vs. “One-off” Interfacing:
•Eliminates costly burden of building, maintaining and supporting
“one off” interfaces from hospital IT dept.
•Eliminates incomplete lab orders: ex) missing clinical, billing, and
business information
•Test and result codes correctly mapped and updated
•Automatic standardized laboratory requisition and label printing
•Order routing based on insurance plan
•Enables EMR to accept unsolicited and/or partial results
Benefits of EMR Integration Platform
Improve customer service and client satisfaction
Make it easier for your customers to order within their EMR
Consolidates inpatient, outpatient, outreach results
Perform test and bill correctly the first time, avoid calling for
missing clinical and billing information
Creates another exit barrier with physician
Increase revenue, improve efficiency, reduce
operational costs
Decrease billing and clinical errors
Eliminate data entry at the lab and PSC
Reduce costly data correction/retrieval activities
Reduce medical necessity denials and write-offs
Healthcare EMR Emergence and
Laboratory EMR Strategies for 2009
Thank You!
Questions?