With PwC, AtlantiCare implemented an HIO linking disparate sites and EMR systems to integrate physician practices. The HIO allows networked medical providers to share patients health information securely and seamlessly.
The combination of the EMR and HIE systems created functionality for:
- Order entry and e-prescribing
- Clinical, evidence-based decision support
- Aggregate patient data reports
- Diagnostic test result and hospital reports (operative reports and discharge summaries)
- Coding and claims submission
- Patient-centered database
- Patient access to personal health records over a secure portal
The pilot program that began in May 2007 with one private practice and a handful of AtlantiCare physicians' offices now includes 70 full-time and 25 part-time AtlantiCare practitioners at their outpatient, urgent care, retail clinic and office facilities, and 28 private-practice physicians. Another 11 private physicians are scheduled to join the third quarter of the year.
EMRs are designed to improve speed, efficiency, and quality of care. AtlantiCare's system enables its users to, automate many tasks that had previously required manual administration, reduce physician error using decision-support features and increase accuracy of documented visits.
Since the system's inception, 80% of participating AtlantiCare doctors are using its electronic prescription capability, helping to avoid serious safety issues, including illegibility, incorrect dosing and interactions. Prior to the ambulatory EMR, all prescriptions were handwritten. Additionally, lag time for billing decreased from five weeks to 24 hours in some cases, thanks to the automated charge entry. When fully implemented, the HIE is expected to enhance overall patient satisfaction by making visits to the practices more timely and efficient and allowing patients to play a more active role in their own healthcare.
Once the system has been in place for a sufficient time, AtlantiCare plans to measure its impact on the quality of patient care. In addition, it intends to quantify the number of pharmacy interventions that occur prior to medication administrationthe more interventions, the less opportunity for error.
For its EMR system, AtlantiCare worked with a vendor to produce a hybrid model. It chose an HIE vendor based on the vendors demonstrated ability to create a health information exchange or regional health information organization (RHIO) with the know-how to build interface capabilities for multiple medical records systems, including hospitals, physicians and ancillary facilities like labs and imaging centers. Later this year, it will expand the program to include additional EMR vendors to interface with the HIE to have the capacity to meet the unique needs of all users.
To date, the system's price tag is approximately $5 million for the EMR and HIE, including the hardware, software, implementation, and maintenance. AtlantiCare has dedicated 10 employees since 2007 to implement and maintain the system.
To encourage private practice physicians to join the community, AtlantiCare executives turned to their joint venture partner, Horizon Blue Cross Blue Shield of New Jersey. Together, they decided to make significant contributions to create a grant fund to subsidize a substantial portion of the private practices' EMR software acquisition and training costs.
Although AtlantiCare had already achieved much progress in its EMR evolution prior to the American Recovery and Reinvestment Act of 2009, or stimulus law, it does expect the incentives to help with its future initiatives. AtlantiCare is working with New Jersey to leverage the stimulus funds to develop a regional health information organization covering 300,000 lives across the state. Additionally, AtlantiCare expects to use the stimulus law physician incentive payments to recover some of its investment in EMR and HIE technology. When the economic downturn began in late 2008, interest in EMR adoption by private physicians dropped sharply. Since the passage of the stimulus law, AtlantiCare has seen an increase in physicians' implementation efforts. In May alone, it received inquiries from eight physicians. That's eight steps closer to reaching AtlantiCares vision of creating a healthier community by enhancing communication between healthcare providers and the patients they serve.
Vice president of enterprise operations