Mark A. Masters, PhD Chief Executive Officer Kristi Payne Chief Operations Officer

1. Minimizing the Pain from Paper to EHR: Creating Efficiency in Clinical Chart Abstraction Mark A. Masters, PhD Chief Executive Officer Kristi Payne Chief Operations Officer

2. Physicians Caring for Patients during Go-Live Critical Issues • Control – Basic issue related to care and risk • Decisions - Loosing Data in the process • Distractions – Impact on care/missing something • Productivity – Bottom Line for Compensation

3. What is Clinical Abstraction?

5. CRITICAL PROBLEMS PROBLEM ~Increased personnel cost. ~ Increased personnel cost. ~ Data entered is in random format and order. ~ Decreased staff, physician morale and loss of Physician productivity. ~ Increased equipment, IT and space cost. ~ Loss of potential downstream services and loss of potential revenue associated with unstructured data.

6. ABSTRACTION PROCESS Using practice defined rules, abstraction team enters all data into EMR chart templates. QA process begins.

7. Key Components of an Abstraction Program • Selecting Staff for Abstraction • Developing Physician Rules for all abstractions • Developing a Training Program for Clinical Abstraction • Developing a Quality Checking Process • How to utilize Workflow Components in NextGen

8. Key Issues to Consider forSelecting your Staff • Must have enough clinical background to provide “context” for work being completed • Able to navigate EMR templates • Don’t interpret – simply moving information or developing synopsis of procedure results – must follow! • Able to handle detailed work • Must work quickly and effectively • Have ability to sit for long periods of time – two monitors • Must know when to ask questions and do so frequently • We Recommend Nurses or very skilled LPN/MAs

9. Key Issues for Developing Practice Rules for Abstraction • Develop an EMR Committee that is open to as many partners as possible • Committee is charged with developing rules for implementation • Committee develops consensus regarding abstractions rules • Draft presented to Board for approval • Implemented practice wide • Changes must be approved by Board

11. TRAINING & QA PROGRAM 100% accuracy

13. WORKFLOW PROCESS QA process applied to completed abstraction.

14. Abstraction and the Critical Issues • CONTROL • Ensuring historical and ongoing clinical data is available in a standard, usable format allows the Physician to practice medicine. • DECISIONS • Physician is able to have a basic level of confidence that they have what they need to make critical care decisions and reduce their risk for mistakes. • DISTRACTIONS • Physician is less distracted with the learning process of utilizing the EMR due to data issues. • PRODUCTIVITY • Physician is able to achieve higher levels of original productivity in the new EMR because they have the data they need and are less distracted operationally.

15. BENEFITS & RESULTS • Certified Clinical Abstractors completing all abstractions utilizing formal training program coupled with their specific medical background. • Physicians are focused on patient care and utilizing EMR effectively. • Standard approach to chart prep process for initial implementation. • Complete quality audit process implemented on day one. • Ability to properly maintain patient chart using ongoing clinical abstraction process. • Quality clinical data entered into the EMR • Data mineable for reporting and recall purposes • Potential for research program use/sell • Practice is better prepared for meaningful use requirements.

16. Contact Information Mark A. Masters, PhD Chief Executive Officer (904) 334-7397 mmasters@mdabstract.com Kristi Payne Chief Operations Officer (904) 226-2384 kpayne@mdabstract.com Corporate Office 1905 Corporate Square Blvd, Jax, FL 32216 www.mdabstract.com