The long awaited road to true healthcare Information Technology (healthcare IT) system interoperability is being implemented at Good Samaritan in Indiana, enabling the 232-bed community healthcare facility to better deliver on its commitment to delivering exceptional patient care. The system will also enable the hospital to substantially increase their practice’s revenue while containing healthcare system integration costs.

“We strive to be the first choice for healthcare in the communities that we serve and to be the regional center of excellence for health and wellness,” stated Rob McLin, President and CEO of Good Samaritan. “We are proud to be the first hospital in the country to implement this great integrated health record system that will allow us to provide a much higher level of continuity of care for our patients, as they are our top priority.”

The integration is being made possible with Zoeticx’s Patient-Clarity interoperability platform which will integrate WellTrackONE’s  Annual Wellness Visit (AWV) patient reports with Indiana’s Health Information Exchange (IHIE) and the hospital’s Allscripts EHR. IHIE is the largest HIE in the US, serving 30,000 physicians in 90 hospitals serving six million patients in 17 states.

Revenue Generator for the Hospital

WellTrackONE and Zoeticx will enable patient’s AWV data to flow from the application to Allscripts EHR and the IHIE system. With Zoeticx’s Patient-Clarity platform and WellTrackONE’s software, the healthcare IT integration passes on increased revenue from the Centers of Medicare & Medicaid Services (CMS) and decreased IT costs for medical facilities.

Medicare pays medical facilities $164.84 for each initial patient visit under the AWV program and $116.16 for each additional yearly visit. With the AWV integration in place, the hospital is now able to meet CMS’s stringent requirements for patient reimbursements.

It is estimated that the Good Samaritan will be able to generate $500.00 to $1,200.00 per AWV patient from follow up appointments for additional testing and referrals for approximately 80 percent of the Medicare patients that are flagged by the AWV for testing, imaging and specialty referrals within the hospital.

This subscriber number is expected to trend upwards into 2050 and will create billions in new healthcare revenue through the US as the population ages. The hospital is not charged any costs for the system until it is reimbursed by CMS.

Overcoming Healthcare System Limitations

The hospital began offering Medicare’s AWV’s a few years ago, but had to develop their own tracking protocols which impacted their budget and staff resources. The system they created also operated poorly, allowing them to only view about 10-15 percent of their patient data.

Good Samaritan medical teams were also constrained by interoperability, having to enter new illness findings and other medical info manually and fax PDFs to other facilities where they would have to again be entered into a different system. They also had all of the data contained in WellTrackONE and Allscripts’ system, but no way to integrate the two, let alone achieve that integration with IHIE. Providers were also spending valuable patient face time trying to find specific patient data buried in the EHR system.

“Our systems were working fine, independently of each other,” said Traci French, Director of Business Development and Revenue Integrity. “But we could not achieve true interoperability between the two systems. The best we could do was basically reshuffling PDF documents. The next challenge was to integrate that data with the exchange. We needed to get data to providers where they needed it, when they needed it. “

Searching for a Solution

The facility turned to Robert Storch, Founder, National Medical Reps, who identified three goals when asked to find an interoperability solution for the hospital’s AWV’s integration.

“We wanted to have the ability to seamlessly integrate with any EMR product, but we also saw another specific need that no one in the market had addressed – the inclusion of integration with Health Information Exchanges. It was the best way we could help keep costs down for our customers and allow them to share that information across the HIE’s multiple providers and facilities to provide a better continuity of care to AWV participants,” said Storch.

“First, I set out to find the best companies we could to integrate the AWV, provide interoperability across all EMRs and include seamless integration into the chronic care management side of the equation,” said Storch. “WellTrackONE was already implemented, but finding Zoeticx was a bit more complicated. Everyone complains about lack of interoperability, but Zoeticx appears to be one of the few companies doing anything about it,” said Storch.

He discovered that not only did Zoeticx solve interoperability, but it had identified the steps needed to connect the dots of the long elusive CMS stringent requirements for its Chronic Care Management patients.

“It appears that Zoeticx is the first medical facility EHR integrator to access this multi-billion dollar aging population market. This technology breakthrough enables providers to electronically invoice Medicare and Medicaid with a new billing code number, creating a new medical facility profit center and substantially impacting care giver revenue for the approximate 15 million patients who have two chronic diseases and qualify for CCM care,” said Storch.

Part-II of this article can be found here.