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President and Chief Executive Officer

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Presentation on theme: "President and Chief Executive Officer"— Presentation transcript:

1 President and Chief Executive Officer
The Taconic Case Study A. John Blair, III, MD President and Chief Executive Officer Taconic IPA, Inc. Fishkill, NY Get Connected Knowledge Forum

2 Taconic IPA Founded 1989 Mid-Hudson Valley region, New York State
8 counties 2,300 physicians / 500 practices 1 to 70+ physician practice size range 4 physicians – average practice size Over 1 million covered lives Get Connected Knowledge Forum

3 Taconic IPA NOT a staff model Physicians NOT employed by Taconic IPA
NO centralized control Not an IDN Not a Clinic Not a University Get Connected Knowledge Forum

4 Taconic IPA Independent practitioners
80% of healthcare delivered nationwide in practices with less than 10 physicians (Forrester Research) Get Connected Knowledge Forum

5 Obstacles Cost Complexity Selection Human Resources Data Silos
Get Connected Knowledge Forum

6 Obstacle: Cost $30,000 - $50,000 Client / Server
$1,000 per physician ASP model Practice productivity loss Lack of financial ROI Bates, 2003 Misaligned incentives CITL findings Get Connected Knowledge Forum

7 Why an EMR? Summary of Benefits
Source: “Cost and Benefit Analysis for Electronic Medical Records in Primary Care.” The American Journal of Medicine 2003; 114: Get Connected Knowledge Forum

8 Misaligned Incentives
Others Providers Substantial savings arise from cost avoidance Formulary compliance/generic substitution Radiology Laboratory ADE Ambulatory Computer-based Provider Order Entry Source: Center for Information Technology Leadership, 2003 Get Connected Knowledge Forum

9 Strategy: Cost Internet and ASP model Leverage IPA size
Aligning incentives Health plans IHA model Technology focus Employers Bridges to Excellence Get Connected Knowledge Forum

10 Uniqueness of the Incentive Strategy
Combines Health Plans and Employers Strict Technology Focus Get Connected Knowledge Forum

11 Rationale for Technology Focus
Health plans currently pay for technology infrastructure within their organization Physician office technology is health plan infrastructure Get Connected Knowledge Forum

12 Obstacle: Complexity Many small physician offices do not want a full EMR Get Connected Knowledge Forum

13 Strategy: Complexity Incremental Approach Electronic Results Delivery
Most popular Electronic signature for transcribed reports Electronic Prescribing Document Imaging Full EMR Get Connected Knowledge Forum

14 Obstacle: Selection Greater than 270 vendors selling EMRs
Lack of health plan involvement Get Connected Knowledge Forum

15 Strategy: Selection Independent EMR Expertise
Leading annual survey In-depth knowledge of vendors Extensive Vendor Evaluation Process End user group Health plan / Employer group Medical Directors CIOs Get Connected Knowledge Forum

16 Uniqueness of the Selection Strategy
Health Plan / Employer Involvement Evidence-based decision support at point-of-care Registries for population-based disease management Get Connected Knowledge Forum

17 Obstacle: Human Resources
Inadequate staff Inadequate expertise Re-engineering workflows Technology Limited pre-implementation planning Limited systems training Limited post-implementation support Get Connected Knowledge Forum

18 Strategy: Human Resources
MedAllies Change Management Expertise Planning, Training, Implementation, Support Hardware / Network Support Get Connected Knowledge Forum

19 Strategy: Human Resources
Industry Average 7.5 hours per physician – Year 1 Phone support – Post-implementation MedAllies 80 hours per physician – Year 1 40 hours per physician – Ongoing 24/7 Help Desk Local support / trainers 1.5 hours maximum onsite response time Get Connected Knowledge Forum

20 Uniqueness of the Human Resources Strategy
Magnitude of support Local Get Connected Knowledge Forum

21 Obstacle: Data Lack of complete hospital, laboratory, and pharmacy data populating EMRs Organization-centric mentality Get Connected Knowledge Forum

22 Strategy: Data Physician Leadership Physician Office Staff
Hospital participation Physician Office Staff Laboratory participation Leverage Competing Hospitals Critical Mass Get Connected Knowledge Forum

23 Uniqueness of the Data Strategy
Overcoming organization-centric mentality Competing hospitals and laboratories on one system Get Connected Knowledge Forum

24 Obstacle: Silos Lack of vendor interoperability Standards
Certification Get Connected Knowledge Forum

25 Strategy: Silos Require vendor interoperability Require standards
Require certification Get Connected Knowledge Forum

26 Uniqueness of the Silos Strategy
Requiring competing vendors to work together towards interoperability Get Connected Knowledge Forum

27 Reference Laboratories
PAYORS INCENTIVE MedAllies Portal EMR 2 E Rx PHYSICIANS E-Results EMR 1 PMS QUALITY METRICS PATIENTS TRANSLATOR MASTER PATIENT INDEX Hospitals Reference Laboratories Pharmacies Physician Practice Get Connected Knowledge Forum

28 Community Health Information Exchange
Get Connected Knowledge Forum

29 Get Connected Knowledge Forum

30 How Did We Get Here? Physician Organization Leadership
Hospital / Laboratory Influence Successful Pilot Physician Usage Additional Hospitals and Laboratories Additional Physicians Payers (Health Plans, Employers) Get Connected Knowledge Forum

31 Available Options/Solutions
Health Plan Driven Advantage: Capital Disadvantage: Physician mistrust Hospital Driven Advantage: Technology expertise Disadvantage: Legal (Stark, Anti-kickback) Get Connected Knowledge Forum

32 Available Options/Solutions
Community Advantage: Employer / Consumer Buy-In Disadvantage: Speed of Implementation Employer Advantage: Capital Disadvantage: Employer / Provider Gap Get Connected Knowledge Forum

33 Recommendations Complete technology solution Strong support Incentives
Get Connected Knowledge Forum

34 Complete Technology Solution
Health Information Exchange Hospitals, Laboratories, Pharmacies Portal Multiple Applications Interoperable Clinical Data Repository Get Connected Knowledge Forum

35 Strong Support Understand physician office operations
Clinical knowledge Experts in portal applications Ability to work with all levels of staff (clerk to physician) Reside in local community Get Connected Knowledge Forum

36 Incentives Multiple payers Uniform metrics Uncomplicated structure
Significant technology focus initially Reasonable evolution to outcomes rewards Get Connected Knowledge Forum

37 Contact Information A. John Blair, III, MD President and CEO Taconic IPA One Summit Court, Suite 200 Fishkill, NY T (845) F (845) Get Connected Knowledge Forum

38 President and Chief Executive Officer
The Taconic Case Study Thanks for your time! A. John Blair, III, MD President and Chief Executive Officer Taconic IPA, Inc. Fishkill, NY Get Connected Knowledge Forum

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