Crafting a strategy to bring affiliated, but independent, community physicians up on an EMR is a challenge all large health systems are dealing with. The problem for CIOs is that almost all are doing it in a slightly different way. From which applications to offer, to varying subsidization models, to the thorny problem of ongoing support and maintenance, CIOs are finding themselves huddled with CFOs and lawyers more than ever before. When Mike Hibbard — CIO at Mercy Health Partners of Southwest Ohio, Central Division (A Member of Catholic Partners) — peered down that road, he longed for a little feedback from his colleagues. So Hibbard availed himself of a CHIME benefit which allows CIOs to pose short surveys to the entire membership. Below, you will find the results of that survey, along with a Podcast in which he discusses Mercy’s interpretation of the data, and plans for moving forward.
- Working with the health system CEO and CFO
- Standardization and staying clear of anti-referral laws
- Running the numbers on subsidies
- Epic is it. “CHP is not hosting another option”
- The key to support is scalability
- Pilot first, then fly
- “There is a lot of hunger to get started”
“Affiliated Physician EHR Support,” Conducted by: Mike Hibbard, RN, MHSA, PMP, CIO at Mercy Health
Start date: August 9, 2010; End date: September 6, 2010
Total number of responses = 39
1. Do you offer an EHR to affiliated physicians (non-employed by your health system)?
- 23 – Yes
- 16 – No
2. If YES, which software vendor is used?
- 10 – Other
- 4 – Epic
- 3 – McKesson
- 2 – AllScripts
- 2 – eClinicalWorks
- 1 – Cerner
- MEDITECH and NextGen
- GE Centricity
- Meditech/LSS or for a different EHR vendor we host their server in our data center and have developed lab/radiology feeds to their system
- NextGen, epic and ecw
- LSS MPM
- NO Strategy related to this
3. Do you offer support after implementation? If yes, what model do you use?
- 18 – Yes, internally provided
- 4 – Other – if applicable
- 3 – Yes, provided by an external source
- Hospital arranges 3rd Party support for the practices. We do provide a program manager to help oversee and assist with support and vendor relations.
- Through Cerner
- not providing service
4. If you answered YES to providing support in the previous question, how do you determine the proper amount of staffing? Is there a ratio of X staff per physician, or other metric?
- 1 IT staffer for every 20 MDs. This is incremental to our base.
- So far we are utilizing two practice management and two EMR per application. We are gathering stats so we are more data driven in our staffing.
- As this is new to use it is 1 FTE based on a SWAG
- 1.0 fte to 15 Providers although it can fluctuate, depending on the type of provider.
- 1 FTE per 20 providers
- We are still trying to determine our scaling factors for supporting practices that are live.
- About 1 FTE for every 20 docs
- They are all located on campus and we only have 25 so we staff one FTE for that role.
- Not currently using any metric. We only supply one practice at this time.
- I did a short survey of community hospitals with the same business model and they averaged about 9.5 FTEs. So I budgeted for 7 to start, and will increase staff to 9 in year two.
- we use 3 FTE’s per physician practice during implementation; then 1 FTE per 25 physicians for ongoing tweeks
- Yes, immediately post go live it is a ratio. After several weeks we switch to help desk (phone) support.
- The support requests come into our regular help desk which is staffed 7×24. They get X hours of report request time per month and know if they go over the time allotment there will be a charge, etc.
- N/A Cerner handles.
- Staffing is determined by support satisfaction level. The more staff the more dollars that get allocated.
- It is a minor number of providers compared to the # of employed privders on our EMR so existing staff just handle as parto f their job. We do track hours and bill for support hours used.
- No, we are understaffed and having a difficult adding staff to support additional practices.
- We offer two McKesson products: 1. Practice Partner – this is handled via a regional reseller (implementation and support) 2. Horizon Ambulatory Care – the hospital IS team will handle all application support; the technical field
- support is determined office by office. We are to early into this support model to provide staffing ratios, but I would very much like to stay connected on this topic.
- external vendor manages this