Electronic Health Record Proposal Presentation

Electronic Health Record Proposal Presentation

Slide 2: Introduction

The Venice Family Clinic’s (VFC) mission is to provide the highest quality care to the community. VFC offers low-cost to no-cost healthcare to low-income, uninsured people. VFC is a private non-profit organization that opened its doors in 1970 for low-income families in need of affordable care. Their first location was very small, but they have since expanded to twelve locations in California, including Venice, Santa Monica, Culver City, Inglewood, and Mar Vista.

Financial Situation: Third Slide

According to the VFC Annual Report (2018), their total revenue was $53,164,116, and their expenses were $49,239,117, resulting in a $3,924,939 capital gain. According to the Consolidated Statements of Activities (2018), their Interest and Dividend Income increased by $21 626 from $104,279 in 2017 to $125,905 in 2018. The financial information shows that VFC is in a relatively good position and is profitable.

Trends: Slide 4

Patients are more invested in and involved in their health care, and they want to be fully informed about their conditions and prescriptions. Patients also want to be more vocal about their thoughts and expectations for their health care. This has begun to change the quality measures that are being implemented in order to provide quality care at a lower cost. Trends we currently see are the push for more behavioral support due to chronic conditions such as diabetes, substance abuse, heart disease, obesity, and other modifiable behavior. Another trend that has influenced the use of EMRs is the use of both EMR and paper charts. “Over a three-year period, physicians’ combined use of EMRs and paper charts increased from 26% to 34%.” According to the most recent 2010 data, 39% of physicians entered and retrieved clinical patient notes electronically, 20% used electronic reminders for recommended patient care, and 20% used electronic warnings for adverse prescribing and drug interactions” (Biro et al., 2012). Through secure portals, patients can easily access their information, which improves their treatment. EMRs lead to faster, higher-quality care, which increases the number of patients seen and their overall care. The Centers for Medicare and Medicaid Services reward those who use EMRs in conjunction with computerized provider order entry (CPOE) services such as medication, laboratory, and radiology orders (Boland et al., 2019).

Slide 5: Proposal Items

The implementation of an EMR, along with staff training, will allow VFC to save time, money, and resources and improve work ethic. EMRs aid in the reduction of fraud, waste, and abuse while also promoting positive patient outcomes. Because patient safety is a top priority, purchasing a cloud-based EMR system aids in the secure and safe storage of patient records. The site will initially cost around $54,092 and will cost around $154,583 per year in cloud storage and security. To ensure compatibility, updated computer technology will be required. To begin, fifteen new computers will cost around $2,235, plus about $1,404 in accessories. The server and cyber security unit, including installation, cost approximately $15,989. The estimated annual costs for maintenance, staff training, and upgrades are $876,395.

Strategic Objectives: Slide Six

Quicker access to current and previous visits, diagnostic results, and documentation save money. Instant access to the patient’s medical record aids in the reduction of redundant or unnecessary care. E-prescribing reduces errors caused by misreading medications or dosages and facilitates faster drug interactions. It also aids in the detection of missed or incorrect dosages, allowing for a reduction in medication errors. This improves patient safety and care quality. EMRs can be set to produce alerts that help users understand if there is a wrong dose, missed dose, or interaction with the patient.

Slide 7: Proposal Options

There are many options for EMR systems, but the three best prices per quality are AdvancedMD, Athenahealth, and CareCloud. According to AdvanceMD (2020), their monthly price starts at around $420 and can be customized. AdvancedMD provides a complete EMR system for medium-sized medical facilities. Using their single database, the user can access this system from a secure network virtually anywhere. Because this is a web-based product, only one of their packages is required to gain access. They offer secure, dependable databases as well as an integrated workflow to improve patient circulation. This can be accomplished through the use of automated appointment reminders, self-scheduling, patient care, and billing (AdvancedMD, 2020).

According to Athenahealth (2020), the starting price of their system is around $140 per month, but this may change after our facility is entered. This system enables providers to provide high-quality care through efficient and straightforward organization and productivity. This EMR system keeps track of physician orders and allows you to follow patients from the point of care. It includes revenue management, billing functions, care coordination, and other features. It is a simple software that allows for a more straightforward and productive approach to patient care (athenahealth, 2020)

According to CareCloud (2020), their system costs about $279 per provider per month and comes in two flavors: standalone and integrated. This system is similar to both in that it manages billings from patients to payers and other third parties. They provide high-performance software that allows for increased productivity and margins while maintaining a positive patient experience. There are tools for patient management, revenue cycles, EMR, and other aspects of patient management (CareCloud, 2020).

Financial Analysis: Slide Eight

Because of the software, hardware, and training requirements, purchasing new technology can be costly at first. Most facilities recoup their EMR investment in about two and a half years and can receive incentives for using and implementing EMRs. These incentives for full-time employees can amount to approximately $23,000 in net benefits (Jung et al., 2015). Incentives for eligible providers on the proper use of EMR systems can be up to $44,000 through Medicare throughout five consecutive years (Basch et al., 2018).

Slide 9: Organizational Resources

For the accounting department, the bidding process must begin and be evaluated. Accounting must carefully examine and validate these bids to ensure their accuracy. The Information Technology Department would be responsible for continuously ensuring that the system is operating efficiently and correctly, as well as monitoring for cyber breaches. Because EMRs are digital record systems, cyber-attacks are a possibility. All staff members who work with EMRs must go through mandatory training to learn how the system works. Before they are allowed to use the system, they must be able to use it correctly.

Communication: Slide Ten

Staff meetings should be implemented on a monthly or quarterly basis, depending on the success rate of the employees. Training should be consistent, and retraining should be done twice a year to ensure the staff member is properly using the system. There must be open communication between staff, management, units, and the IT department because anything that goes wrong or misfires must be addressed immediately. Emails, staff meetings, mandated posters, and reminders about training-related information should be sent out on a regular basis to ensure that everyone is on the same page.

Statements: Slide Eleven

Budget statements will be available for review at any time. Quarterly statements aid in ensuring that the clinic’s needs are met on a consistent basis. This ensures that no money or funds are lost as a result of unnecessary expenses or theft.

Expenses: Slide twelve

The EMR software, hardware, training, and any other associated equipment would be associated expenses with this proposal. If proper cyber security software is not included, it must be implemented, as well as any repairs or maintenance of the equipment(s) and software (s).

Slide Thirteen: Justification

Because every department will be using this system, the cutback on all departments ensures that there is a uniform cut across departments. Scaling back on all departments eliminates the need to drastically cut one area and allows for a smaller loss in one area.

Slide 14: Ratio Calculations

Profitability is the most significant part of this proposal. Incentives for eligible providers on the proper use of EMR systems can be up to $44,000 through Medicare throughout five consecutive years (Basch et al., 2018). This is per eligible provider and can help with the initial investment with a future payout.

A ROA (return on assets) ratio can be used to calculate the potential increase in revenue with the proposed item. A ROA ratio is calculated by taking the excess of revenue over expenses, dividing it by the net assets, and multiplying it by one hundred. “(ROA) measures a company’s management’s efficiency in generating earnings from its economic resources or assets on its balance sheet.” ROA is expressed as a percentage, and the higher the number, the more efficient management is at managing the balance sheet to generate profits” (Boyte- White, 2019). This is also dependent on the code of the fee for the visit.

Short-Term Impact: Slide Fifteen

Implementing an EMR system adds value and boosts productivity while keeping costs low for a healthcare facility like Venice Family Clinic (VFC). Government incentives are available for businesses that install a qualifying EMR system, which increases revenue. Growth and profits will increase if the budget remains stable. “As efforts to develop and implement EHR-based data sharing platforms mature and scale up globally, there is a need to evaluate the impact of these interventions and weigh their relative risks and benefits in order to inform evidence-based health policies” (Neves et al., 2018).

Slide Sixteen has a long-term impact.

Saving excess revenue rather than spending it can allow VFC to grow and profit in the long run. “EHR implementation is associated with increased revenues—this is reassuring and provides a foundation for additional EHR investment.” While the productivity losses are consistent with field reports, they also show a type of efficiency—practices are receiving more reimbursement for seeing fewer patients” (Howley et al., 2014, p. 450). Profitability demonstrates to banks that this company is financially stable, making it easier to obtain loans or expand in the future. It is important to maintain EMR systems because it allows VFC to grow with its online services, which increases profit. Long-term financial gains can be realized if the budget is properly balanced. This has an effect on patients as well because their healthcare needs can be easily met, and their satisfaction skyrockets.

Cost Advantages: Slide Seventeen

Capital expenditure is provided to ensure that the benefits outweigh the costs of implementation. The initial impact may be difficult to see the long-term outcome, so we must understand all finances. This includes third party reimbursements and other services that provide reimbursement for EMR implementation. Overall, EMRs make healthcare easier. Patients can schedule their own appointments and reorder prescriptions, resulting in more consistent healthcare. This solves problems and allows the facility to see more patients, increasing revenue.

Strategic Planning: Slide Eighteen

When planning, open communication is essential. Staff members who will be affected by this implementation should be involved in the process. First, we must comprehend the mission statement and the direction that VFC intends to take in the future. With an EMR system, VFC can reach more patients, including those who lack transportation or live in rural areas and may be unable to see providers (Kruse et al., 2017). In addition, plans should be in place for any future requirements. VFC can thrive because it already has a community presence by utilizing EMR systems and providing additional care at no cost to the patient. Staffing ratios and training and implementation costs must also be planned for.

Conflicts: Slide Nineteen

Conflicts may arise from providers or others who do not understand the system. There is also the possibility of crashes or unforeseen outages, or breakage. This can be avoided by having insurance or warranties that cover quick repairs. A secure security system allows the facility to operate without fear of widespread cyber-attacks. Other issues may include costly upgrades that are worthwhile in the long run. Their strategic plans include increasing development, establishing a solid financial foundation, and preparing for any future challenges (Venice Family Clinic, 2018).

References

AdvancedMD. (2020). Medical Software Pricing Overview. Retrieved from https://www.advancedmd.com/software-pricing/standard/overview/

Athenahealth. (2020). Cloud computing in healthcare. Retrieved from https://www.athenahealth.com/

Basch, P., & Smith, J. (2018). CMS Payment Policy, E&M Guideline Reform, and the Prospect of Electronic Health Record Optimization. Applied clinical informatics, 9(4),

914–918. https://doi.org/10.1055/s-0038-1676337

Biro, S. C., Barber, D. T., & Kotecha, J. A. (2012). Trends in the use of electronic medical records. Canadian family physician Medecin de famille canadien, 58(1), e21.

Boland, M. V., Hwang, T. S., Lim, M. C., Peterson, J. L., Lum, F., & Lee, A. Y. (2019). Medicare Incentive Payments to United States Ophthalmologists for the use of Electronic Health Records: 2011-2016. Ophthalmology, 126(7), 928–934. https://doi.org/10.1016/j.ophtha.2019.01.030

Boyte-White, C. (2019). How to Calculate Return on Assets (ROA) With Examples. Retrieved from https://www.investopedia.com/ask/answers/031215/what-formula- calculating- return- assets-roa.asp

CareCloud. (2020). Pricing. Retrieved from https://www.carecloud.com/pricing/

Howley, M. J., Chou, E. Y., Hansen, N., & Dalrymple, P. W. (2014). The long-term financial impact of electronic health record implementation. Journal of the American Medical Informatics Association, 22(2), 443–452. doi: 10.1136/amiajnl-2014-002686

Jung, H.-Y., Unruh, M. A., Kaushal, R., & Vest, J. R. (2015). Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011– 12. Health Affairs, 34(6), 1035–1043. doi: 10.1377/hlthaff.2014.1189

Kruse, C. S., Mileski, M., Vijaykumar, A. G., Viswanathan, S. V., Suskandla, U., & Chidambaram, Y. (2017). Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review. JMIR medical informatics, 5(3), e35. https://doi.org/10.2196/medinform.7958

Neves, A. L., Carter, A. W., Freise, L., Laranjo, L., Darzi, A., & Mayer, E. K. (2018). Impact of sharing electronic health records with patients on the quality and safety of care: a systematic review and narrative synthesis protocol. BMJ open, 8(8), e020387. https://doi.org/10.1136/bmjopen-2017-020387

Venice Family Clinic 2018 Annual Report [Annual Report]. (2018). Retrieved from Venice Family Clinic website:

http://venicefamilyclinic.org/pdf/vfc2012_annualreport.pdf

Venice Family Clinic. (2018). Consolidated Statement of Financial Position: With Comparative Totals at June 30, 2018 [2018/2017 Financial Position]. Retrieved from https://venicefamilyclinic.org/pdf/VFC%202013%20Audited %20Financials.pdf

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Goal:

To assess the need for a capital budget item in a hospital scenario

To investigate the information needed to prepare a budget proposal.

Content Requirements:

Identify the capital budget item in the hospital

Identify the need and consequences if it is not purchased.

Identify the cost of the piece of equipment and if there are any alternative funding sources.

Presents a compelling argument for the purchase of the capital item.