Frequently Asked Questions

General

What do I do with a all the paper charts, scan everything, or some things? Store the rest?

Recommended approach is to scan key documents before and after first visit. Physician summarize the chart prior to patient visit via dictation. It is not recommended to scan all charts.


I already have a PM or EMR system. Can I convert?

Yes. You will need to run out the A/R on your existing practice management system. Typically, this takes 4 to 6 months.


I don't want to take it all at once, can I implement in steps? Can I take the PM portion now, then after my staff gets used to that, implement the EMR?

Although the system can be implemented in steps, the approach will be to implement everything together to meet timeline for 'meaningful use' and take full advantage of Stimulus dollars.


After many years of evolution what is the sense of urgency with regard to the Hanover EMR?

Availability of Federal funding as an incentive and the consequences of penalties if not "meaningfully" implemented.


What are the consequences of doing nothing at this time?

Losing federal funding as an incentive and receiving penalties after 2015 if not "meaningfully" implemented.


Why is it essential that we all sign up at the same time?

There is a greater cost savings and best possible training and support.


In order to get the ARRA Stimulus money do we have to scrap our current EMR systems?

Not necessarily if the current EMR system can meet "meaningful use." Exchange of patient data with the community and CCHIT certification will be significant considerations for currently installed systems.


Can chart elements be e-mailed? If so, what formats are available? (PDF, Word, etc.)

Documents will be shared through the Hub and eClinicalWorks internal messaging system to secure data and comply with HIPAA.


Will I need additional staff for implementation?

Depends on changes to work flow defined during implementation, size of practice and approach to scanning.


Do we all have to have the same system features?

No. There will be flexibility with regard to template development and work flow.

Legal

I have HIPAA concerns, how safe is my patient information? If I use a wireless network, can others get to my charts?

No, if specifications for implementing a secure wireless network are followed. These will be provided to each practice and ComputerWorks or other support vendor.


Will we need to sign a contract?

Yes.


Who owns the data?

The physician practices will own the data.


Are podiatrists and PAs/NPs included in the stimulus package? We have a lot of both. If not, can the hospital still subsidize for these providers under STARK?

Podiatrists are covered with the ARRA Stimulus funds. PAs/NPs are not. Yes these can fall under the subsidized program but not receive the stimulus funds.


What would happen if the hospital were to be sold to another institution? How would the providers get their data?

It will be protected in the master agreement with eClinicalWorks and sublicense contracts with each individual practice.


What if a provider leaves the area? Would they be able to take their medical records with them?

Yes.


If I am using an existing PM or EMR system, how can I archive my information and ensure that it's retrievable?

This would need to be discussed and planned with the practices existing vendor.

Costs

On average, how much training time is needed?

Average training of a Physician takes 1-3 weeks.


How much productivity is lost while training, both staff & physicians?

To be determined during implementation planning; reference checks stated that doctors were at full productivity within 1-3 weeks depending on physician.


Is it essential to buy both the PM and the EMR portions of the EHR system?

No however, industry experience has been that the cost of the interfaces between existing PM systems and EMR systems are higher than the conversion to an integrated solution.


What will our cost be later on if some of us sit back and wait and see how the implementation goes?

Incremental costs would be assumed by the practice.


Will there be a charge per page for scanned images?

Yes over a threshold to be established by the Goverance Implementation Team.

Community/Sharing

What's a patient portal and why is it important?

Patient portal allows patients and physician practices to communicate bi-directionally in a secure environment. Patients can make appointment/prescription requests, fill out pre-appointment paperwork, and send questions to your office. This may be required under "meaningful use."


Can patient information be restricted to a need to know basis?

eCW allows the patient to "opt out" of having their clinical information shared with the community. Additionally protected information such as AIDS, social history can be blocked.


Can I opt not to share my patient information at the community level?

To be determined by the Governance structure.


Will hospital progress notes be available (ER notes, inpatient clinical documentation)?

Yes, via interface.


Does the hospital sponsored system offer a one patient/one chart configuration option?

eEHX allows practices to share clinical data across practices. The Goverance Team will determine what information is shared at the community level. However, eClinicalWorks has the ability to" opt out" of sharing individual patient information.


Can I manage diagnostic images from the hospital?

The hospital PACS system will be linked to eClinicals for display purposes.


What is a "master patient identifier" system and who maintains that file?

John Doe at Practice A may have 12345 as an account number and at Practice B as 34567. However, eCW eEHX assigns one eMPI number to John Doe at the community level. The hospital HIM department will manage the community enterprise MPI.


Will ER physicians be able to access my patient's information in an emergency?

Yes. Even if your patient's information is not being shared, eCW offers a "break the glass" feature that will allow access to patient information in emergent situations which is tracked and audited.


The patient portal is going to create more work for me. I am not sure I want to take on the burden of answering e-mails from patients.

During the selection committee site visits, we posed that question. The majority of providers find that responding to patients via e-mail is less time consuming/more efficient than responding to telephone calls. This may be required under "meaningful use."

Diagnostics

Can tests (labs and radiologies) be ordered at the hospital and the results received directly from the office?

Yes, we plan to implement a bidirectional interface between Hanover Hospital's MEDITECH system and the community sponsored EMR for all ancillary testing.

Documentation

If I use transcriptionist services, will I still be able to do so if I opt to go with the hospital sponsored system?

eCW offers functionality that will allow you to continue using transcription services should you desire to do so.


Can templates be customized and created by individual practices and providers?

Yes. eClinicalWorks comes with a robust set of templates that are fully customizable.


What types of documentation methods does the system support?

Free text, touch screen, voice recognition.


How will I be able to move information from MEDITECH or York's system into the new EMR? Will I have to print and scan or can this be done automatically?

Information from MEDITECH can be moved to the EMR automatically. Information from other hospital systems will be discussed through the Governance Team and timelines established. Any document can be scanned.


Does the system having automated faxing capabilities?

Yes.


What if I have mid-level providers? Can the system support this model?

Yes.

E-Prescribing

What if I have an existing E-Prescribing software system and am under contract to use their tool?

No, it will need to be replaced with eClinicalWorks.

Billing

Does the system do automatic insurance and formulary verification?

Yes.


If we go with the hospital sponsored system, can we still apply for payer specific subsidies?

Yes.


Some PM systems have the ability to outsource the billing. Does eCW offer this option?

To be determined during contract negotiations.


Will I have to use the hospital sponsored PM/EMR system's claims clearinghouse?

To be determined during contract negotiations.


Can my financial information be restricted from being viewed by other community practices?

Yes.


Will the new system be able to accept ICD-10 codes?

Yes.


Will we still need encounters/superbills?

No.

Reporting

Can the system do pay for performance?

Yes.


Can the system do payer specific pay for performance?

Yes.


Connectivity

Since eCW is web-based, what if the internet is down?

Each office will have a primary connection and a backup connection. The primary connection is not dependent on the internet.


How secure is the internet connection?

The internet used as a backup is very secure using VPN technologies and encryption.


Is eCW a thin client?

eEHX allows practices to share clinical data across practices. The Goverance Team will determine what information is shared at the community level. However, eClinicalWorks has the ability to" opt out" of sharing individual patient information.

Hardware

What about back up systems, in case my server crashes?

Servers will be housed centrally at the hospital with full backup and redundancy capabilities.


Do I still need to do other backups?

No, not for PM or EMR.

Interfacing

Will there be a published list of available interfaces for the EKG, Sonography, and other instruments I use in my office? What requirements will you have for me when I bring in a new machine that I want to interface?

Yes, eClinicalWorks does have a partial list of those that need to be interfaced by practice and are working on the pricing to have these interface to the eCW system.

Support

What if there is a power failure, unplanned disasters, etc. Who develops the "downtime" routine? Is this something each office must prepare?

The system will be support by backup generators and redundancy. However, each practice should have downtime procedures in place to ensure that the clinic can continue to function in the event of an outage.


Will system updates cause a disruption in my practice?

Updates will be scheduled off hours to not interrupt services.


Will the hospital assist us with the implementation?

Yes.