Maryland HIMSS Ambulatory EHR Case Study

October 12, 2007

Agenda

Overview of FredMed Organization Overview of Practice EMR Evolution Overview of EMR

Business/Technology Model Implementation Status Lesson Learned (To Date) Benefits Anticipated

FredMed Mission

Leverage FMH IT Investment to Provide Cost Effective IT Services to Frederick Area Physicians

Provide Cost Effective Connectivity to Frederick Memorial Hospital

Provide Building Blocks for Community Health Information Exchange

FredMed Governance – Board of Directors

3 Elected Physician Members

– 1 Serves as Board President

– 2 Year Staggered Terms 2 Appointed FMH Staff

– CFO Bill Pugh

– CIO David Quirke

FredMed Benefits Meditech and Other FMH

Applications from Any Workstation for Any Staff Member

Practice Management Software (Misys)

Internet with Filtering and FMH Firewall

Centrally Managed Antivirus Software

Auto Print or Fax of FMH Lab Results, Radiology, Transcription Reports

Email Accounts for Staff

Local Technical Support Focused on Medical Offices

Wireless Networking FMH Transcription Service Vendor Alliances

1998 - Planning Started, MSO Site Visits 1999 May - First Employee Hired 1999 July - Organizational Meeting 1999 October - First Practice on WAN 2000 WAN Rollout, Transcription Pilot 2001 Misys PM Pilot, Transcription Rollout 2002 Rollout Misys with Master Files,

Auto Print/Fax Results from Meditech 2003 First EMR Assessment, T1 Pilot, Antivirus 2004 Physician Websites, HIPAA Security Briefings,

FredMed Quarterly Newsletter, PACs 2005 Voice/Data Bundled Service Rollout,

Heat Implementation 2006 Electronic Prescription, Bring Your Own Internet

Option, FMH Basic Service Level

FredMed History

Membership Statistics

Membership Satisfaction

April 2007 (Scale 1-5)26 Practices Represented

Technical Services Overall - 4.9 Responsiveness – 4.9 Sensitivity to Your Needs and Environment – 5.0

Misys Practice Management Software Support Overall – 4.6 Master Files – 4.6 Cost Effectiveness – 4.7

FMH Transcription Quality – 3.9 Turnaround Time – 3.3

92% Would Recommend FredMed to Another Practice

FredMed EMR Initiative History

2002 - Contracted Superior Consultants to Assist in Vendor Identification and Evaluation

June 2002 – Vendor Expo January, April 2003 – Finalist Vendor Fairs October, November 2003 – LSS

Company and Site Visits November 2003 – Board Decision

to Focus on Component-Based Solution– Transcription Seen as “Poor Man’s EMR”– Pursuit of Electronic Prescription Solution

FredMed EMR Initiative History

2005 – FredMed Board Voted to Revisit EMR Product Line and Evaluate Two Options– LSS – Integrated with Meditech

Environment– Misys – Existing FredMed Investment with

16 practices/60+ physicians LIVE on Practice Management Software

2006 – Misys EMR Solution Selected and Contract Negotiations Begun

July 2007 – Misys Contract Signed

FredMed EMR Model

Leveraging FMH IT Infrastructure– Data Center Server Housing– Terminal Servers– SAN Storage– Backups– Exchange/Enterprise Fax Solution

FredMed Purchases Bulk Misys Licenses Practices Pay Per Provider/User per

Month Utilization Fees Practices Purchase All Site Equipment

(Tablets, Scanners, Thin Clients)

Misys EMR Overview - Schedule

Infrastructure Development – Fall 07 2 Pilot Practices with Misys Project

Management Continuing Rollout with FredMed

Project Management/MisysChannel Partner Agreement

Misys EMR Overview – Practice Implementation Methodology

Practices Using Misys for Practice Management Take Priority

Phased Rollout for Each PracticeDocument Management/Messaging InitiallyCaregiver Documentation Ramped Up Over

Several WeeksAll Caregivers Do NOT Need To Implement

Concurrent Visit DocumentationNo Big Bang LIVE Basic Implementation – 8-12 Weeks

Phased In Result/Report Interfaces (Meditech, LabCorp, Quest)

Lessons Learned (To Date)

Consensus On One Vendor Solution Not Possible

Today’s Practice Management Software Decisions are Driven by EMR

Community MPI Not Soup Yet but Practices Can Still Obtain Advantages

Selection and Contract Negotiation Very Slow Process

Rapid Change in EMR

Benefits Anticipated - FMH

Building Block for Community Health Information Exchange

Improve Results Communication Between FMH and Community Physicians

Limit Integration Platforms for FMH

Assist with Physician Recruitment to Frederick Community

Facilitate Improved Care in Community

Benefits Anticipated - Physicians

Cost Effective Option to Quality EMR Removal of IT “Hassle Factor” for Practices –

Backups, Updates, Upgrades, Climate Control, etc.

Mitigation of Risks – Security, System Failure

Local Support and Expertise Local User Community Stable Practice Management Platform