Making the Difference in Referral & Communication Systems

1. Emerald Health Exchange Making the Difference in Referral & Communication Systems September 2012

2. STATE OF CURRENT COMMUNICATIONS PEDRO FALLA, M.D. www.emeraldhealthllc.com 88 Faunce Corner Mall Road, Suite 230 | North Dartmouth, MA 02747 | 855.650.9906

3. Typical PCP Office

4. Hospital • Specialist Current Referral System Ancillary Services outside of the network Referral outside of the network • Consult is faxed • Consult is mailed • No Consult at all • No confirmation of appointment • No Show • Discharged patient: • No notification • No comments • D/C summary sent • by mail or fax • Fax • Phone • Forms • Reason for consult • Results: • faxed • mailed • phoned • Ancillary Services • Faxes not received Patients sent to other MDs outside of the network • No Shows • Medical Group/Network

5. Employees • EHE Communication • EMR Impact of EHE on PCP Office • Medical Office PCP

6. Hospital • Specialist Impact of EHE on Referral System Patient is sent back with discharge info and comments through EHE • Confirmation is received • Consults are received • No show info is sent Confirmation sent to hospital Results sent by EHE Referral sent by EHE • Ancillary Services • Confirmation is received • Decrease no shows • Medical Group/Network

7. Hospital • Medical Group/Network • ER Current Network Communications

8. Hospital • Medical Group/Network • ER Impact of EHE on Communication Within the Network

9. Summary of Benefits for Referring Physicians • Cut costs/expenses. • Improve work flow efficiency. • Better documentation in EMR after consultant reports are received. • Decrease liability. • Improve access to consultants. • Reduce or eliminate overwhelming paperwork load.

10. Summary of Benefits for Consultant Physicians • Increase referral base. • Enhanced communication with referring physicians. • Excellent platform to project growth. • Less administrative/labor work by receiving referrals via EHE.

11. Summary of Benefits for Medical Groups/Networks • Create a cohesive and strong relationship with all physicians by improving communication among them. • Track referral pattern inside/outside network. • Control of network leakage. • Improvement of communication with other health care providers (VNA services, home services, hospice care, nursing homes, physical therapy..Etc). • Integration of all physicians within the network despite use of different EMRs.

12. Summary of Benefits from EHE • Cut cost/expenses • Increase referral base • Enhanced communication within the network • Tracking referral within the system

13. Cost Savings Potential The cost savings illustrated are typical of what a FT physician can expect based on workflow improvements • 60-70% of referrals go unscheduled • 25% of scheduled appointments are missed • 68% of specialists receive no information from PCPs prior to referral visits • 25% of PCPs do not receive timely information from specialists post referral Paperwork costs a national average of over $23,000/year per physician

14. EMERALD REFERRAL & COMMUNICATION SYSTEM ARUN B. RAJAN, M.D

15. EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES • Hosted System-SaaS Model • HIPPA Compliant • Comprehensive Referral System • Document Management • Communication Tool For Physicians & Users

16. EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES • Designed For Quick Implementation • Minimal Learning Curve • Customizable Features • Any Size Network • No Paper • No Faxing Documents/Phone Calls

17. REFERRAL MODULE • Send referrals • Receive referrals • Request reports- automated and manual requests • Track the life history of referrals • Capture key data points • Generate report based on predefined data points

18. COMMUNICATIONS MODULE • Communicate securely within the portal • Send secure emails to recipients out of portal • Receive emails (may not be secure) • SMS to recipients

19. DOCUMENT MANAGEMENT • Customization of documents in HTML or XML to track data • Send documents attached to referrals • Receive reports within portal • Manage documents that require receiver responses more efficiently • Capture electronic signature or image signature • Analyze, create reports of customized documents • Store documents

20. SECURITY • Access Control. Technical policies and procedures that allow only authorized persons to access electronic protected health information (e-PHI). • Audit Controls.Software and procedural mechanisms to record and examine access and other activity in information systems that contain or use e-PHI. • Integrity Controls.Electronic measures in place to confirm that e-PHI has not been improperly altered or destroyed. • Transmission Security.Technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network.

21. SECURITY (cont’d) • Facility Access and Control.Limit physical access to facilities while ensuring that authorized access is allowed. • Workstation and Device Security.Implement policies and procedures to specify proper use of and access to workstations and electronic media. * Above security measures to be defined by applications and end users