Continuum 3Q 2015

Q&A with Allscripts Leader Martha Thorne

Finding Needles in Health Care’s Big-Data Haystack

What Nurses Like Most (and Least) About EHRs

Is ACO the Way to Go?

Focusing on the Patient

CONTINUUM3Q 2015ALLSCRIPTS MAGAZINE

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3 Executive Insight: Q&A with Allscripts Leader Martha Thorne

President and General Manager of Population Health Martha Thorne discusses Allscripts vision for care coordination and its newly branded solution set, CareInMotion™.

4 Finding Needles in Health Care’s Big-Data Haystack

By Meredith Hilt

Pulling the right insights out of big data has the potential to improve how we care for patient populations. But where do we start?

5 Connecting British Columbia

Fraser Health Authority is using Allscripts dbMotion™ Solution to exchange patient data across care settings.

8 What Nurses Like Most (and Least) About EHRs

By Kerry Bruning, RN, MBA

A recent survey conducted by HIMSS Analytics on behalf of Allscripts drew 626 nurses from all levels — from floor nurses to chief nursing officers. While respondents agreed that EHRs help healthcare providers improve patient safety, many expressed frustration that EHRs reduce efficiency.

11 Is ACO the Way to Go?

By Mike Hofmeister

Independent physician practices are weighing their options as fee-for-service reimbursement models shift to value-based-care models, such as Accountable Care Organizations (ACOs). But how do you know if an ACO model is the right one?

12 Focusing on the Patient: Family Practice Associates Takes a Patient-Centered Approach

Family Practice Associates, one of the largest independent family practice groups in central Kentucky, U.S.A., uses Allscripts Professional™ EHR and Allscripts Practice Management™ to remain independent in today’s competitive marketplace.

Allscripts 222 Merchandise Mart Plaza, 20th Floor Chicago, IL 60654

1.800.654.0889

www.allscripts.com

Editor-in-Chief

Tom Lynch

Senior Editor

Meredith Hilt

Operations Manager

Haley Yanello

Designer

Margaret Puckett

Continuum Magazine

CONTENTS

Copyright ©2015 Allscripts Healthcare Solutions, Inc.

3

3Q 2015

Q&A with Allscripts Leader Martha Thorne

What is CareInMotion?

MT: CareInMotion is a solution-focused strategy that enables Allscripts to partner with clients to address specific population health priorities—care coordination, transitions of care, patient engagement or value-based analytics, for instance. Under the umbrella of CareInMotion, we have created comprehensive, flexible portfolios of solutions that enable clients to home in on a select set of population health objectives to achieve their organizations’ unique goals. With CareInMotion, we deliver capabilities and smarter data to the people who need it, wherever they are in the care network.

How are clients using CareInMotion today?

MT: CareInMotion offers portfolios that have end-to-end capabilities across the care continuum, so that providers and clinicians have the tools they need to better coordinate care, manage their resources most effectively and achieve better outcomes.

For example, Allscripts handles more than 10 million discharges annually. At the point of discharge, clinicians need to know the most appropriate clinical pathway for each patient. Should the patient go to a Skilled Nursing Facility and for how long? Does the patient need homecare services or transportation? We can embed that

information at the point of discharge. Teams can share these care plans across all settings and ultimately out to the patient’s home.

What are the top three challenges that CareInMotion helps solve?

MT: Currently, we offer three specific portfolios through our CareInMotion strategy — each designed to specifically address problem sets we see providers struggling with today.

First, Collaborative Care: Effective collaboration means interacting with more depth than just passing a document back and forth among caregivers. Collaborative care requires discrete roles and responsibilities be defined for each member of the care team. CareInMotion can help identify and execute the best action plan for a patient, from both clinical and financial perspectives.

Second, Precision Transitions: Healthcare organizations don’t just need to execute a transition of care, they need to do it with precision. Managing every transition of care is important, from the hospital to the post-acute setting to the ambulatory space. It’s critical to make precision possible, so that care transitions are data driven and connecting the RIGHT care team.

Last, Value-Based Analytics: As we shift to a value-based care landscape,

providers don’t just need analytics, they need insights and infrastructure for a value-based care world. Connecting the dots between what are traditionally siloed functions, financial and clinical, is hard. CareInMotion bridges these functions to help our clients meet their objectives.

What’s the value for patients?

MT: Everything we do is about better outcomes for patients. With these capabilities, patients will benefit with fewer gaps in care, better care coordination, access to resources for ongoing care, increased preventative care and more opportunity for self-care. ¾

Allscripts is rolling out a new platform for its population health management offerings: Allscripts CareInMotion™. To find out more about what’s behind the concept, Continuum interviewed Senior Vice President and General Manager of Population Health Management Martha Thorne.

EXECUTIVE INSIGHT

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ENTER JOHN DICK, the president of market research firm Civic Science. He works with companies across several industries that want to tackle overwhelming amounts of data, translating it into something decision-makers can use.

Civic Science is the mastermind behind many online quizzes you take. Its polls appear on a variety of websites, such as Facebook, collecting hundreds of thousands of responses per day. It manages the individual anonymous profiles of more than 30 million respondents.

“We need more and more data because the larger the haystack, the more needles we can find,” Dick says. “The challenge is to find the needles, and to do it fast, and communicate that to the end consumer, the decision-maker, or the doctor, in a way that allows them to make an actionable decision.”

Healthcare correlations

Fact: People who use blue cheese on chicken wings are more likely to take prescription medication for stress than people who use ranch dressing. This information is one of several data points from Civic Science’s research.

“We are not proving causality here, they just tend to be closely related to each other,” says Dick.

Correlations invite theories of causality, though. For example, Dick reports that people who think their spouses suffer from sleep apnea are 88% more likely to use coupons. Research also shows that Android phone users are more likely to have heart disease.

Why? “Income, the reason is probably income. Wealthier people tend to have iPhones. They also tend to eat better, exercise more, are less likely to be overweight,” Dick says, pointing to some of the risk behaviors for sleep apnea and heart disease.

In the complex world of population health management, socio-economic factors often influence patient outcomes. Income could affect a patient’s ability to afford asthma medications or his likelihood to make a follow-up appointment to manage the disease. An elderly woman who doesn’t have reliable transportation may be more likely to be readmitted to the hospital within 30 days of discharge. Analytics can correlate these facts, but are they predictive?

Predictive analytics

Let’s say I’m booking a trip to Phoenix, and I search for flights on the Internet. For the next few weeks, I’ll get Phoenix-related ads from airlines and hotels when I log into Facebook.

Predictive analytics takes it one step further. Instead of waiting for me to search for Phoenix, advertisers use my vacation history and Facebook friend list to recognize a pattern about who I travel with and when. They target me with ads before I do my first search, perhaps influencing it.

Imagine the advances in health care if we could predict a chronic condition before a patient reaches the acute state of the disease. Maybe that information would influence the patient’s behavior. Or perhaps it would shape a more effective care plan. Health care isn’t there yet, but no industry is.

“If health care is able to do predictive analytics tomorrow, it would be the first industry to get there…scientists get really skittish about the word ‘predictive.’ Often it’s just correlated or associated,” Dick says.

Allscripts and the next era of big data

According to Allscripts Analytics Chief Analytics Officer, Dan Connors, there have been two eras of big data computing. Allscripts dbMotion™ Solution, which has

been around since 2006, has its roots in the earliest days of big data.

The first era, from 2000 to 2010, was about designing software and hardware systems capable of handling very large amounts of data. Early solutions gained computation power by distributing work across tens of thousands of nodes.

“The true notion of machine learning works just like the pattern recognition you have in your brain, which is multiple parallel processes happening,” Connors says. “The same aspect has to happen within Big Data solutions.”

We’ve entered the second era of Big Data, which is about getting those capabilities into the hands of anyone who wants to use them. Connors agrees that the most valuable information often is also the most complex for analytics tools to mine.

Created in 2015, Allscripts Analytics is honing in on how big data can help meet the needs of clinicians and patients. Allscripts Analytics President Marty McKenna admits it’s not a linear journey.

“We’ve started with risk models, and we’ve started to analyze cohorts,” McKenna says. “The next step we’ll decide together with our clients — how to answer the questions they’re getting…because unless we help clinicians at the point of care, we haven’t done anything interesting.”

Whatever the field, Dick agrees that it’s not the number of petabyte-sized haystacks that is important, but how many meaningful insights you can pull from them.

“What matters in data isn’t how much you have, it’s the ability to find the stuff in it that really matters,” he says. ¾

Finding Needles in Health Care’s Big-Data HaystackBy Meredith Hilt

ANALYTICS

We live in the information age, and data has exploded from megabytes to terabytes to mind-boggling yottabytes. Pulling the right insights out of big data has the potential to improve — well, everything. But where do we start?

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3Q 2015

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Fraser Health Authority is using Allscripts dbMotion™ Solution to exchange patient data across care settings.

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FRASER HEALTH AUTHORITY (Surrey, British Columbia, Canada) uses Allscripts dbMotion™ Solution to make available, at the point of care, all relevant clinical information from multiple source systems. This solution aggregates, harmonizes and displays patient data in a comprehensive record.

Fraser Health is currently using dbMotion to exchange information across the continuum of care from acute to community settings. It will expand interoperability to the ambulatory setting in 2015, with the integration of data from clinical systems supporting community care. At that point, more than 2,600 physicians in British Columbia will be able to view and exchange interconnected patient data without leaving their home clinical system, which will enable Fraser Health to better coordinate care for its patients and reduce duplicative services.

Fraser Health Authority is British Columbia’s largest and one of the fastest growing health authorities in Canada. Like many entities this size, it uses multiple clinical information systems across its organizations to deliver patient care. Fraser Health has one system for acute care in its hospitals, another system for community mental and home health, and a third vendor’s solution for ambulatory and primary care facilities.

“Our clinicians told us they needed to be able to access patient-centered information in all of these systems,” Director for Health Informatics Gregor McWalter says. “They wanted to search patient data with a single click within their home system, without having to re-authenticate.”

Several technical principles guided Fraser Health’s selection process for

a solution. For example, it wanted commercial off the shelf (COTS) software with a service oriented architecture (SOA). Fraser Health looked for a solution that could link to external systems and provincial registries, used HL7 V3 standards, did not require data replication and had a Health Information Exchange (HIE) infrastructure.

After a thorough selection process that included site visits, Fraser Health selected Allscripts dbMotion. Not only did the solution meet COTS and SOA principles, it also could notify users that patient data exists in another application within their clinical workflow, offered semantic harmonization among disparate systems, and logically connected providers without centralizing data.

“Making information available within the clinician workflow was a key thing for us, and other modules within the dbMotion suite fit our roadmap,” Manager for Health Informatics Cindy Convey says. “We also liked that Allscripts has a successful Canadian presence with Manitoba eHealth.”

Aligning with Canada Health Infoway’s Health Information Access Layer (HIAL)

Beyond connecting its own core clinical solutions, Fraser Health understands the importance of connecting with provincial repositories. Its vision aligns with strategies from Canada Health Infoway, an independent nonprofit funded by the federal government

to foster the adoption of healthcare information technology.

For organizations sharing data with each other, Infoway’s HIAL provides common services, such as user authentication, and logging and auditing accesses. Many provincial repositories sit behind the HIAL, for example the Provincial Laboratory Information Solution (PLIS) data.

Fraser Health is using the provincial Enterprise Master Patient Index (EMPI), which contains demographic information and personal health numbers to manage patient identification.

“Using the EMPI within dbMotion works really well,” McWalter says. “The flexibility of dbMotion makes it possible to integrate in a provincial context.”

Eventually, Fraser Health hopes to make its dbMotion information available to clinicians throughout British Columbia.

Preparing for integration

Before starting the integration process, Fraser Health envisioned its interconnected information system with a multi-year strategic plan. “Our plan focused on how we would integrate and get feedback from clinical staff,” Senior Consultant for eHealth Aneet Sahota says. “If technology doesn’t work well for the clinician, we just wouldn’t get good use.”

Sahota explains that Fraser Health obtained input from multiple clinicians, such as nurses, dieticians, unit clerks, physicians. “Each clinical role uses dbMotion differently,” she says. “It’s important to develop high-level use cases beforehand to make sure everyone can use the solution effectively.”

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Fraser Health also conducted a site visit to learn how Manitoba uses dbMotion at a provincial level. “It works so well with the volume of data that they have, it ensures confidence with health authorities our size,” Sahota says.

Gathering this information helped Fraser Health standardize processes ahead of time and prepare with extensive testing, particularly for data validation before going live.

Perhaps the most important aspect of the approach to a large integration project is patience. “Integration is a journey, not simply a destination,” McWalter says. “You can’t achieve everything at once, and it takes a while to reach full potential.”

In its first phase of dbMotion implementation, Fraser Health enabled 100 early adopters to have access to the system in December 2014. “Our early adopters have had a high level of satisfaction,” Convey says. “They don’t have to get frustrated with having to go to multiple sources anymore.”

One early adopter, a nurse in Fraser Health’s Mental Health and Substance Abuse department, remarked, “Love it! I have only used [dbMotion] a couple of times but it was useful.”

In March 2015 Fraser Health enabled 3,000 community users to exchange information across all community sites

using PARIS, a health information system specifically for community care. Shortly after that, an additional 18,000 acute users had access to community data integrated with acute data using Meditech, the hospital health information system.

Fraser Health is just beginning to explore the functionality of dbMotion Collaborate and dbMotion clinical analytics. “As we’re building our repository of data, that is a rich set of information,” McWalter says. “It will enable clinicians to examine wider caseloads than they have in their own practices.”

Future plans include adding relevant clinical systems, such as diagnosis coding, and integrating with provincial repositories, such as the Provincial Laboratory Information Solution (PLIS) data. Fraser Health expects access to this information will help reduce duplicative lab tests, making care more efficient and cost effective.

The value of a good partnership

From selection to implementation, Fraser Health has worked closely with Allscripts. “We especially appreciated connecting with experts at Allscripts, including physicians who were familiar with dbMotion and could talk clinician to clinician,” McWalter says.

“Working with the Allscripts dbMotion team is different than working with other vendors,” Sahota says. “It’s a true partnership, which is very valuable to our team. It’s hard to quantify how important that is.” ¾

BY THE NUMBERS

Fraser Health Authority (Surrey, British Columbia, Canada)

ABOUT

Largest provincial health authority in British Columbia

12 acute care hospitals, one outpatient center

7,760 residential care beds

Mental health, public health, home and community care

1.7 million patients

22,000 staff

2,500 physicians

6,500 volunteers

OUTCOMES

100 early adopters in community settings have access to acute data in December 2014

600 community users have access to acute data in January 2015

3,500 additional community users have access to acute data in March 2015

18,000 acute users to access community data integrated with acute data (July 2015)

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By Kerry Bruning, RN, MBA

What Nurses Like Most(and Least)

About EHRs

When it comes to influence in health care, nursing has the advantage in both numbers and trust. Nursing is the largest segment of the healthcare workforce, outnumbering physicians almost four to one in the United States. Nurses are also consistently named the most trusted professionals in Gallup polls, perhaps in part because they provide the most direct care to patients.

NURSES’ INSIGHTS shape every aspect of health care, and a new survey explores how nurses view electronic health records (EHRs). The survey, conducted by HIMSS Analytics on behalf of Allscripts in 2015, drew 626 nurses from all levels — from floor nurses to chief nursing officers. The survey includes opinions from a variety of care settings using several EHR vendors.

An overwhelming majority of respondents agreed that EHRs help healthcare providers improve patient safety, make it easier for them to access comprehensive health records and enhance collaboration with clinicians inside their organizations.

Many nurses, however, also expressed frustration that EHRs both hinder collaboration with clinicians outside their organizations and reduce efficiency, leading to less time with patients.

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The survey found that the majority of nurses agree that EHRs can help clinicians improve patient safety (73%), reduce medication errors (72%) and provide more complete information about patient histories, conditions and medications (70%). An even higher percentage of nurses whose jobs involve acute care (82%), in which rapid diagnosis and treatment are essential, agreed that EHRs support improved patient safety.

Instead of clinicians having to gather data and make decisions as they get to it, EHRs can help assemble the data and present alternative courses of treatment much faster. EHRs are able to provide the clinical decision support that can help the clinician prevent an acute patient from having a critical event.

Survey respondents were least satisfied with how EHRs impacted the way they do their jobs. Fewer than half of the nurses surveyed (43%) agreed that EHRs eliminate duplicate work, while an even smaller percentage of floor/acute nurses (26%) said EHRs help eliminate duplicate work. Only about four out of 10 respondents (38%) said EHRs help reduce the time they can spend with patients.

Despite the shortcomings of EHRs cited by the survey respondents, 71% said they would not want to go back to paper-based medical records. Still, 15% of the nurses in the survey said they would return to paper-based records if given the opportunity, while another 14% were unsure.

Nurses who would return to paper claim that EHRs make it harder to find information, focus on patients and enter data quickly. But faster data entry is a fallacy, because the ultimate goal should be improved quality and safety.

Medication administration isn’t faster with bar-code capabilities, but it is safer. Documentation isn’t faster, but it provides information to clinical support engines that enable clinicians to better care for patients.

The dissatisfaction with EHRs among nurses may be traced to other factors. For example, the majority of nurses (66%) said that they never have participated in an EHR-buying decision. Of the 27% of nurses who have been part of an EHR-purchasing process, only 11% have been the project leader or decision-maker.

Nursing needs to be involved at the earliest stages of EHR selection, because it can affect future adoption rates. The earlier nurses are engaged in the process of selecting, designing and using EHRs, the better the technology will support their holistic workflow, including how they engage with their patients.

Nurses agree EHRs improve patient safety

Nurses are less likely to agree that EHRs improve efficiency

73%Improve patient

safety

43%Eliminate duplicate

work

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Vendors should be open and flexible• Collaboration with open platforms• Efficient nursing workflows

Users should give nurses a voice• Involve in buying decisions• Continue training

One of the main advantages of EHRs over paper-based health records is the ability to share medical information with other clinicians. EHRs can help enable multiple people to look at patient charts at the same time and foster collaboration.

The level of satisfaction with EHR-based collaboration varied depending on the location of collaboration partners. Nearly three-quarters of nurses surveyed (73%) said EHRs effectively help enable collaboration with other clinicians inside their organization.

Yet only about half of respondents (49%) agreed the EHRs help enable collaboration with clinicians outside their organizations.

Collaboration is only possible among different EHR systems when they can communicate with each other. Having non-interoperable EHRs can hinder collaboration just as much as paper-based record systems. EHRs with an open platform make it possible for disparate systems to talk to each other, freeing information for clinicians to use, no matter where they are.

Nurses have mixed views on how EHRs affect collaboration

The HIMSS Analytics survey shows that while nurses believe EHRs help improve patient safety, they are concerned that the time required to enter electronic data and maintain EHRs takes away from the time they could be spending with patients.

Vendors can improve nurses’ experiences with EHRs with better user interfaces and workflows. If the EHR is not helping to eliminate work and streamlining workflows, that’s a problem.

Perhaps most critically, an EHR must be interoperable with other systems for nurses and other clinicians to collaborate and provide the best course of treatment for patients, particularly in emergency situations where it’s imperative to quickly access and exchange information.

An EHR platform built using open architecture provides the interoperability necessary for outside collaboration. This capability promotes greater efficiency and enables nurses to focus more of their time and energy on patient care. ¾

What EHR vendors can do better

73%Enable

collaboration

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FINANCIAL PRESSURES are growing; U.S. Health and Human Services (HHS) set a goal1 of tying 30% of its payments to these types of arrangements by the end of 2016, and 50% by the end of 2018.

Determining if the ACO model is the right one

Physician practices should be asking themselves questions to assess their situations, such as:

• Are physician incomes going up or down?

• Are your physicians aligned with a value-based-care mindset?

• Does your schedule have room for more patients with complicated health issues?

• What percentage of your income comes from Medicare/Medicaid?

• How well are you engaging your current patient population?

• How do specialists coordinate with primary care colleagues?

• Do your private insurance payers have value-based plans in the works?

Bottom line, if a practice wants to coordinate all care for its patients and is willing to engage with the community beyond its four walls, then the ACO model is probably the right one.

The hardest part of forming an ACO

One of the most common mistakes ACO applicants make is to miscalculate the number of CMS patients, or “attributed lives,” they are responsible for, putting their entire cost structure at risk.

A primary practice may assume that every History and Physical (H&P) it performs for Medicare patients will count toward its attributed lives total, when in fact that is not the case. For example, if that patient sees a specialist who also conducts an

H&P (potentially unnecessary duplication) then provides additional services and fees, that specialist will likely earn the attributed life from CMS.

So it’s not always the primary care provider that earns the attributed life, and it’s very hard for practices to determine ahead of time.

Does the ACO model really improve clinical results?

With an emphasis on care coordination, the ACO model can positively affect clinical outcomes. Coastal Carolina Health Care (New Bern, North Carolina, U.S.A.), an Allscripts TouchWorks® EHR client, is a great example. CMS featured the practice’s ACO as a model program, ranking it among the top quality performers in the United States.

Once physicians began closing the gaps for patients who needed preventative care, screening rates improved significantly. Better preventative care and population health management improved other clinical results, too. For example, CCHC reduced rates for both emergency room visits and hospital readmissions by 10-15% in one year.

Taking the first step to form an ACO

Once a practice determines the ACO is the right model, and it has enough attributed lives, the practice should file a notice of intent to apply with CMS. This may be the easiest step in the process, but it sets the stage for the application process.

To form an ACO in 2016, organizations should have filed a notice of intent with CMS by May 29, 2015, and filed the application by July 31, 2015. The next application process will begin in spring 2016 for ACOs that will start in 2017. ¾

1. U.S. Department of Health & Human Services <http://www.hhs.gov/news/press/2015pres/01/20150126a.html>

2. Becker’s Hospital Review. <http://www.beckershospitalreview.com/hospital-physician-relationships/nearly-93-of-physician-practices-still-use-fee-for-service-payment-models.html>

3. Leavitt Partners via Health Affairs Blog <http://healthaffairs.org/blog/2015/03/31/growth-and-dispersion-of-accountable-care-organizations-in-2015-2/>

4. Becker’s Hospital Review <http://www.beckershospitalreview.com/accountable-care-organizations/acos-by-the-numbers-8-recent-statistics-and-findings.html>

5. Leavitt Partners via Health Affairs Blog <http://healthaffairs.org/blog/2015/03/31/growth-and-dispersion-of-accountable-care-organizations-in-2015-2/>

Is ACO the Way to Go?By Mike Hofmeister

Independent physician practices are weighing their options as fee-for-service reimbursement models shift to value-based-care models, such as Accountable Care Organizations (ACOs).

74%of physician practices are not members of ACOs 2

ACOs in the United States, as of 1Q 2015 3744

of ACOs are led by physicians 451%

payers participate in accountable care, as of 1Q 2015 5

132

PHYSICIAN PRACTICE

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Lexington, Kentucky, U.S.A., independent practice Family Practice Associates takes a patient-centered approach

“PRIMARY CARE IS UNIQUE,” Dr. Jeffery Foxx, founder of Family Practice Associates, says. “We take care of basically everybody with everything. From the cradle to the grave, we take care of whatever ails you.”

Family Practice Associates, one of the largest independent family practice groups in central Kentucky, serves 30,000 patients in the Lexington area, which includes up to 350 patient visits per day. The practice strives for patient-centered medical care, a model that emphasizes coordination and communication. Its goals are to improve quality, enhance preventive services and provide chronic disease management. Family Practice Associates provides a wide range of services, including full lab services, on site.

“We try and make our practice a one-stop shop for our patients,” Lab Manager Gwen Howard says. “We know our patients. We see them on a regular basis, so it’s a very friendly place.”

Family Practice Associates is an early adopter of health information technologies. “We’ve had a long history of computerizing health records, starting 10 to 15 years ago,” Foxx says. The practice started with a program to scan paper documentation in the 1990s.

Focusing

Patienton the

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“We couldn’t continue with all that paper and compete in the marketplace. We had to have an electronic health record,” Foxx says. Family Practice Associates looked for a solution that was easy to learn, provided data capabilities and was affordable.

“We looked at several products,” Clinical Manager Shannon Riddell says. “Allscripts was more user friendly…and the customization options are just phenomenal.”

In 2007, Family Practice Associates implemented Allscripts Professional EHR™ and Allscripts Practice Management™.

“[Professional EHR] helped us remain independent because of today’s marketplace…If you’re going to provide the standard of care and do what you need to do, you have to have an EHR,”

Foxx says. “I can provide better care to patients because I have better data, I’m able to search the data, it’s able to remind me of things that I need to do.”

As examples, Foxx notes that Professional EHR can alert physicians if patients need a mammogram, and the solution makes it easy to follow trends, such as cholesterol or blood sugar levels, over time.

“I’ve used six other electronic medical record systems over

the last 15 years of my career… [Professional EHR] is by far the easiest

I’ve ever had to use,” Nurse Practitioner Todd Martin says. “It’s really easy to customize your own templates...it allows me to focus on the patient.”

Solid integration between Professional EHR and Practice Management also simplifies life for Family Practice Associates staff. “The two systems are able to talk to each other…and from our staff standpoint, they’re relatively easy to use,” Administrator Craig Gillispie says. “Our staff have both solutions up at the same time, and they’re able to quickly maneuver back and forth between the two programs.”

Improving laboratory workflows

The Family Practice Associates lab staff uses Professional EHR to schedule appointments, order labs, search for previous results, send messages to providers and more.

“Having the EHR makes our job easier, because we don’t have to try and decipher a physician’s handwriting anymore,” Howard says. “Now when a physician orders a lab, we look at the order screen and it’s right there with the diagnosis. We drop it into a requisition, get a label, draw the blood, run the test, it comes back through, we verify it, it goes to the provider and he sends it to the patient via the portal. It’s just phenomenal.”

Engaging patients

Family Practice Associates implemented the FollowMyHealth patient engagement platform in January 2014. The practice already had a portal in place with solid participation from its patients, and they needed to convince them to switch over to the new platform.

“We made sure that patients knew that the portal was the easiest and quickest way for them to get test results,” Gillispie says.

Family Practice Associates understands the importance of involving staff in promoting the portal, and encouraged

However, clinicians still relied heavily on paper charts, which sometimes limited clinicians’ access to data. The organization wanted to centralize and improve access to data with an electronic health record (EHR) system.

“Using FollowMyHealth and Professional EHR helps us to better track our patients for better outcomes.”Gwen Howard, Lab Manager, Family Practice Associates

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staff with contests and special events to celebrate enrollment milestones.

Clinicians have been pleased with FollowMyHealth’s capabilities. “[FollowMyHealth] helps us communicate with the patients more efficiently,” Foxx says. “They’re able to get their lab results, request appointments, ask for refills or just ask questions…communication is much easier this way.”

In its first year of using the FollowMyHealth portal, Family Practice Associates enrolled about 7,000 people, representing about 20% of its patients.

“The other day a patient told me, ‘I love being a part of my medical record…being able to see what’s going on in my chart and message you any time of the day.’ The bottom line is that patients are really liking it,” Riddell says.

“We have found that our patients are much more active with the FollowMyHealth portal than before,” Gillispie says. “They are filling out their own information, looking at their notes and results, definitely paying more attention to their healthcare information.”

“Using FollowMyHealth and Professional EHR helps us to better track our patients for better outcomes,” Howard says. “We can make sure that they get their follow-up appointments and labs…Patients can get direct communication with providers, and I think that’s going to change how health care goes in the future.”

A patient-centered approach

Family Practice Associates has taken a patient-centered approach to care for many years, even before achieving its first Patient-Centered Medical Home (PCMH) certification from the National Commission on Quality Assurance in 2012.

“Allscripts new patient-centered medical home piece for reporting makes it easier for practices to achieve that,” Riddell says. “Allscripts knows what’s coming

down the pike. They know that everything is moving towards quality versus quantity, and they are onboard with what’s happening in the future.”

Ready for value-based financial models

“Health care is transitioning into a more value-based payment model where providers…are going to be reimbursed more based on outcomes rather than just straight fee for service,” Gillispie says. “So it’s important to have practice management and EHR systems that are adaptable to that and can grow with the practice.”

“We were recently able to get into two patient-centered medical home programs that pay for performance,” says Riddell. “We’re using Allscripts reporting to do that.”

The solutions also helped Family Practice Associates complete Meaningful Use Stage 1 in 2011 and attest for Stage 2 in 2014. The group has earned about $375,000 in incentive funding so far.

Financial benefits of a healthy core

“A big financial result for us from Practice Management is that our days in A/R (accounts receivable) are six days better than they were prior to Allscripts,” Gillispie says. “Our overall days in A/R run 28 or 29 below the national average, which is very beneficial for our cash flow.”

Howard also observed that Allscripts solutions make it easier to track bills for lab services. With charge import passing, Practice Management automatically pulls together charges for lab services, leading to fewer missed charges. The practice achieved overall net collections of 98%.

Looking ahead

While Professional EHR and Practice Management help Family Practice Associates remain independent in today’s competitive marketplace, the partnership with Allscripts will help support future growth, too. For example, Family Practice Associates plans to open a satellite location in the summer of 2015. “We’ll lean on Allscripts to figure out how to incorporate locations in our reporting,” Riddell says.

“Family Practice Associates has always been a very independent organization and wants to remain that way,” Gillispie says. “It’s important for us to be as efficient as possible and to be on the forefront of new emerging payment models. Allscripts is helping us to do that.” ¾

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CONTINUUM

Nurses’ insights shape every aspect of health care, and a new survey explores how nurses view electronic health records (EHRs). The survey, conducted by HIMSS Analytics on behalf of Allscripts in 2015, drew 626 nurses from all levels — from floor nurses to chief nursing officers. The survey includes opinions from a variety of care settings using several EHR vendors.

Find out what they had to say at http://landing.allscripts.com/nurses-week15.html

“EHRs have the potential to be an incredible tool to GREATLY improve patient care, data collection, ability to share information, etc. It has not reached its potential yet…I just wish technology for healthcare providers — particularly nurses — would catch up to the rest of the world’s technology levels.”

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