"This is a big deal. It is going to lead to better patient care and improvements in how we get paid for that care." That was Fulton County Hospital Administrator Tony Thompson's excited reaction, after the Hospital Board of Governors approved a proposal to hire a company to install and maintain an electronic medical record system in the facility.
Because of the high cost to go "paperless" by using high tech electronics, the hospital has delayed hiring a contactor, even though Medicare and Medicaid will soon require that bills from hospitals be submitted electronically. Hospitals who do not comply with phase--in deadlines will face a reduction in reimbursements, and a delay in having their reimbursement filings processed.
A Wednesday, Oct. 3 special board meeting was called to discuss approving a contract with Healthland, a Minnesota company. It was one of four companies who made presentations to the hospital.
"I am one of the most computer illiterate people I know, and I think I can do this (Healthland) system," Dr. Jim Bozeman told fellow board members during the discussion.
According to Thompson, physicians, nurses, billing specialists and other staff members were involved in evaluating electronic medical record systems during company presentations.
"Our staff reviewers used a scoring system as they scrutinized the options, and Healthland got the highest score of approval," Thompson said.
Initially, companies who provide electronic record systems wanted to be paid up front, a requirement that would force the hospital to borrow more than $1 million.
|This summer, the hospital found some companies had developed systems specifically designed for smaller hospitals. Instead of requiring immediate payment, they were willing to accept reimbursement funds that Medicaid and Medicare will provide to help hospitals with costs. The money is paid after a hospital completes a phase of installation, and demonstrates "meaningful use," proof the system is working.|
Under the contract FCH negotiated with Healthland, the company will charge $141,892 for hardware, $275,082 for software license fees and $657,027 to install and implement the services. That total, $1,074,000, is the amount FCH expects to receive in stimulus reimbursement from Medicare when the installation of the system reaches its "Go-Live Date," and is up and running.
The hospital expects to receive $330,000 over a four year period in Medicaid stimulus assistance.
The hospital will begin paying $8,202 a month ($98,420 a year) to Healthland to maintain the system when it is functioning.
The maintenance fee had been a sticking point in the negotiations, because it is almost double what the hospital currently pays to maintain its computer systems. Thompson said, however, the higher fee is to be excepted. "When this system is in, we will be so much more computerized than we are now, the higher fees are not unreasonable."
Board members were told that, once the electronic system is in place, there will be a decrease in the number of days money owed to the hospital sits in the medial records department, waiting for medical charts to receive diagnosis and billing codes. An electronic record system will streamline the process. Quicker billing should allow the hospital to receive money it is due faster. The billing should be more accurate, resulting in fewer instances where re-billing is necessary, another issue that causes payment delays.
|The fact that the hospital did not have to borrow money and pay years of interest to implement the system was also seen as a big benefit.|
In a unanimous vote, the four board members present, Jerry Blevins, Dr. Bozeman, Steve Hall and board president John Ed Welch, authorized Thompson to work with Healthland to sign necessary documents and work out a plan to get the system's first phase in place by June 2013.
Besides easier billing, the electronic medical record system is designed with safeguards to improve patient care.
"When a patient comes in, they will receive a barcoded wristband," Thompson said. "Medical charts and medications will have the same barcode, and they must match before any treatment is given. It will result in a great reduction in medication errors."
"The Healthland system seems more suited to a hospital our size," Dr. Bozeman said. Bozeman said he will be able to dictate patient information into a machine with voice recognition. Providing information on a patient's condition, diagnosis and orders for treatment will record the treatment information and billing codes.
Phase one of the system will concentrate on physician order entry, a part of the system nurses and other staff will also be trained use.
"I plan to meet with Healthland in about three weeks, so we can get started," Thompson said. "The first phase needs to be completed by June of 2013, so we can begin a 90 day attestation to show that the system is in and working properly."