Tuesday, April 8, 2008

Electronic Health Records for Non-owned doctors - Support

This is my tenth entry about providing electronic health records for non-owned doctors. The previous entries have described the efforts to go from vision to live implementation. The subject of this post is support after go live and ongoing operational funding. As with my post about implementation funding, I've asked all the implementers of EHR projects in Massachusetts to comment on their plans.

At BIDMC, we'll provide a central help desk (Concordant), outsourced desktop/network support (Concordant), and ongoing application support (internal staff, Mass eHealth Collaborative staff and eClinicalWorks). Clinicians will pay a fixed monthly rate for this service. We'll centrally contract for all these services, so the cost will be as low as possible. BIDMC may pay for the ongoing operation of the centrally hosted eClinicalWorks system (i.e. rent in the co-location data center, server support staff) and this is still under discussion.

Cartias is evaluating their strategy for ongoing support. They are considering the possibly of reassigning members of the implementation team to support as implementation is completed. The have not yet identified a specific funding model for support, but are considering an approach similar to BIDMC.

Children's will provide a similar model to BIDMC. The help desk function and first tier application support will be outsourced to a third party vendor (The Ergonomic Group). They will escalate to eClinicalWorks as necessary. Ergonomic will also manage and support network operations at each of the practice sites. Children's will support the central hosting site hardware and infrastructure. Children's will also support all network operations inside the core data center. Clinicians will pay a fixed monthly rate for this service.

Mt. Auburn Hospital/MACIPA
Mt. Auburn/MACIPA will provide a central help desk and ongoing hardware/application support. They are currently retraining clinicians to help them increase the utilization of the product, given that during the initial training there is only so much a physician can absorb. They also intend to also hold classes at the IPA periodically. Post live financial support is still being discussed.

New England Baptist Hospital
NEBH will provide an outsourced help desk, ongoing hosting, and application support. Clinicians will pay for non-Meditech interfaces, software maintenance, and connectivity/support to billing companies.

Partners will follow the same model as BIDMC, with clinicians funding ongoing support services.

Community physicians will fund ongoing software and hardware support. The team in Highland Management (joint venture between the hospital and IPA) will provide guidance in the development of templates and the use of the system for reporting to meet P4P goals and clinical integration. Winchester IT will also be involved in the development of interfaces and the transfer of patient data for care delivery.

This post marks the conclusion of my first series about electronic health records for non-owned physicians.

Today, the BIDMC Finance Committee approved our pilots, so we'll be moving forward with all the plans I've outlined. This is a major milestone for our project that enables all our contracts, service level agreements and spending to progress.

My next series about this topic will start in July as our pilots go live. I'm sure there will be many more lessons learned to share including comments on budgets, practice workflow transformation and loss of productivity. I hope these first 10 posts about planning the project have been useful to you!

No comments: