3. Develop a system selection plan for this practice. What do you envision will be the practice's great challenge in selecting and implementing a new system? Explain your rationale.

Health information system 1203 MRT Case study one: SELECTING AN EHR SYSTEM FOR A DERMATOLOGY PRACTICE Greenfield Dermatology Associates is an eight-physician dermatology practice located in central North Carolina. After several years of contemplation and serious deliberations, the physicians have most recently made the strategic decision to replace their current practice management system (patient scheduling and billing) and to invest in the selection and implementation of an EHR system. Their current practice management system that is antiquated, rather clunky, and not well supported by the current vendor. Ideally, they'd like to select and implement a new integrated practice management system that has a user- friendly EHR component customizable for dermatology care. The practice does not have full-time in-house IT support, so they are open to exploring cloud-based options. BACKGROUND AND OVERVIEW Greenfield Dermatology Associates originally planned to participate in the CMS EHR incentive program years ago, but opted against it, primarily because they had no system champion eager to lead the effort at the time. Dr. Dan Brown, the senior managing partner at Greenfield Dermatology, has little knowledge of information systems technology. He was reluctant to move toward an EHR system for many years, primarily because he had heard stories from colleagues in other specialty areas who had implemented EHRs in their practices and found the systems to be highly cumbersome and disruptive to the patient care process. Dr. Brown also has a close friend who is a cardiologist who complains she spends an extra two hours a night in the office because of the additional time demands of the EHR. She said the system never lived up to expectations. Dr. Brown and his colleagues now feel that the time is right to make an investment in health IT. With increased competition and value-based payment growing, a more mature dermatology-specific EHR market, and greater patient demand for access to records and telehealth visits, the physician partners came together as a team in making this strategic decision. The business manager had been nudging them for a few years. The composition of the physician associates has changed slightly in recent years. One of the practice's newest partners, Dr. Pam Martin, just finished her residency program where EHRs and Al were an integral part of her training. She is a vocal champion of the effort and willing to help lead in any way she can. Another partner. Dr. John Harris, recently visited another colleague who uses Nextech EHRs and is convinced it's the way the practice ought to go. His colleague's practice has been successful in following up on suspicious lesions, tracking referrals, improving outcomes, and achieving high satisfaction scores among patients. As for the other physicians in the practice, two are nearing retirement and nervous about the possible disruption to the office, but they understand the desire to move the practice into the twenty-first century." The other three physicians have some experience with EHRs and are onboard but are concerned about the new system's financial impact on the practice. In fact, one of the partners shared a recent article about a local community hospital that experienced severe financial problems after replacing its EHR system. Another has expressed concern that it will decrease productivity. In addition to the eight physicians, the practice employs twelve nurses, four front office staff, three support staff including an IT technician, two billing staff, and a business manager. The IT technician works on a contract basis (as needed) as he provides onsite technical support to several other physician practices in the area. The practice currently provides service to approximately two hundred patients per day. Fifty percent of patients are covered under Medicare, and half of the Medicare population is part of an ACO. The ACO tracks referrals and Greenfield is incentivized to see high-risk patients who are referred to them within seventy-two hours after the referral. The remaining patients are covered ed by private insurance, self-pay, and Medicaid. CURRENT SYSTEMS Even though the patient records at Greenfield are still predominately paper-based the practice has been using computerized practice management systems for patient scheduling and billing for years. Referrals are also tracked electronically. In anticipation of the migration to an EHR system, six months ago they started to have nurses enter physician-dictated notes into the paper record while in the examination room with the patient. The physician then reviews the notes at the end of the visit or day and signs off on them. This is to decrease the dictation and transcription that the practice had historically done and to get the nurses and physicians ready for EHRS. The expectation is that nurses will do the majority of the data entry in the exam room while the physicians are seeing the patients. However, the physicians will have to review the documentation and sign off on all entries. DISCUSSION QUESTIONS 1. You begin by convening a practice management-EHR selection team. Who would serve on the team? Who should lead the team? Explain your rationale 2. How might you conduct an EHR readiness assessment for this practice? What factors will be important to consider? Why? 3. Develop a system selection plan for this practice. What do you envision will be the practice's great challenge in selecting and implementing a new system? Explain your rationale. 4. Greenfield participates in an ACO that tracks referrals and the practice is incentivized to see high-risk patients who are referred to them within seventy-two hours after the referral. How will the new system enable the practice to track and monitor their performance? 5. Conduct an initial review of the practice management-EHR systems wailable on the market that are tailored to the unique needs of dermatology. What resources would you use to identify vendors/products? Identify at least three to five vendors/EHR systems that Greenfield may wish to send a request for information to gain additional information. (This question is optional and you would get 5 marks if you answer this