Centricity Physician Office

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							Centricity Physician Office
 2005 User Summit




EMR General Session
Dave Henriksen
General Manager, CPO




Agenda

GE Healthcare Introduction
                    - David Henriksen, General Manager

Clinical Content Update
                    - Susan Thomas, MD, Medical Director

Government and Industry Initiatives Update
                             - Marianne Braunstein, Marketing
Manager

Centricity Physician Office Roadmap Update
                    - Kathleen Brooks, EMR Product Manager




                                                                  1/
                                                                GE /
             Business Brief




Agenda

• Centricity Physician Office Organization Update

• Clinical Leadership

• EMR 2005 – Early Adopter Program

• Digital Communities




                                                      2/
                                                    GE /
 Physician Office Organization




Functional Summary

• Engineering        134
• Support            75
• Implementation     46 + 33 contracted
• Sales/Marketing    53
• RTS                      14
Total                332




                                            3/
                                          GE /
Significant Investment
   Focus on Development                       Revenue Growth
            Development FTE’s                             $ Million
    120                                        120




                                                      14%
    100                                        100




     80                                         80




     60
                  134          54%              60




     40   87                Increase!           40
                                                                 73
                                                     64
     20                                         20




      0                                          0




          2004   2005                                2004       2005




                              Integrated Financials
                                  User Interface
                        Clinical Content and Workflows
                                Decision Support
                                 Interoperability
                                       eRX




                  Clinical Leadership




                                                                         4/
                                                                       GE /
NCQA Certification:
•FIRST EMR in the
Industry!
•Diabetes Physician
Recognition Program
•Commitment to Quality
•Pay for Performance




Medical Quality Improvement Consortium
     Membership = 50% Growth in ‘05   Database = 60 % Growth in ‘05

     87 Members                       4.4 Million Patients
     3,288 Physicians                 30 Million Office Visits
     35 States                        326,580,576 Observations
     8 Big Birds (100+ MDs)


     QI Reports (June ’05) 66%        Clinical Studies
     Growth
                                      30 sponsored studies/year
     Sessions: 100
                                      9 Academic Studies/year
     Hours: 50
                                      $3.5M commercial grants
                                      in 2005




                                                                        5/
                                                                      GE /
   Introducing the Newly Released
Centricity Physician Office Primary Care
                Kit (PCK)

                    • Six-Sigma project by our
                      ITPS and Engineering
        New           teams
      in 2005 !     • Dozens of forms, letters,
                      handouts, clinical lists
                    • Created over the years with
                      input from Clinicians
                    • Embedded intelligence
                    • Free to new users and IB




       EMR 2005 and EAP
     Early Adopter Program




                                                      6/
                                                    GE /
EMR 2005

                                    Images, Illustrations, & Annotations
                                    Medications
                                    Growth Charts
                                    Problems
                                    •Enhanced Allergies & Adverse
                                    Reactions
                                    •Desktop Document Management
                                    •Clinical Accuracy
                                    •CPO PM/EMR Integration




The Value of EAP (Early Adopter
Program)
Our 2005 EAP Sites:                       • Goal of EAP is to ensure
                                          readiness of new release
• Carilion Health System
                                          • Validation feedback provided
• Central Maine Healthcare                on new and changed features
• Children’s Health System – UAB*         • Usability and performance of
                                          application verified
• Community Health Network
                                          • Accuracy and completeness
• Erickson Retirement*                    of documentation improved
• Evans Medical Group*                    • Upgrade process verified first
                                          on test servers, then in
• Joseph Perkinson*                       production
• Wake Internal Medicine                  • 3 sites now live on EMR 2005
                                          Pilot Version*




                                                                               7/
                                                                             GE /
        Digital Communities




Province of Ontario

                          Ontario Only
                           24,000 Physicians
                         8,000 subsidy eligible
                              13 vendors
                        1 ASP provider – Aliant




         $150 million      $60+$20 million




                                                    8/
                                                  GE /
Thank You!




 Clinical Content




                      9/
                    GE /
Centricity Physician Office
2005 User Summit




Clinical Content Roadmap




 Susan Thomas, MD, FAAFP
           Medical Director
     Centricity Physician Office




                                    10 /
                                   GE /
   Providing Clinical Content
         For the EMR




    Paths to Richer Clinical Content

              Encounter
 Quality       Forms         Decision
Reporting                    Support

Clinical        EMR
Systems
                            Knowledge
 Links
                              Links
            Instrument
             Interfaces




                                         11 /
                                        GE /
 Paths to Richer Clinical Content


                     GE Encounter Forms
                     • Creative and flexible
                       encounter forms, letters,
                       handouts, clinical lists
     Forms!          • Backbone of standard
                       forms
                     • Build on these with
                       disease management
                       and specialty content
                     • Embedded intelligence




 Paths to Richer Clinical Content
 When
was last     Labs
  eye                   Decision Support
              are        Tools
exam?        Due!!
           Decision
           Support •      Enhanced Protocol
                          Kits
                        • Evidence Based
                          Reminders
                        • Intelligent Forms




                                                    12 /
                                                   GE /
Paths to Richer Clinical Content

                           WEB BASED CONTENT
                            LINKS
                           • MedscapeTM from WebMD
                           • iConsultTM from Elsevier
              Knowledge    • PIERTM from ACP
                           • Clinical Evidence TM from BMJ
               Links!      • UpToDateTM Inc
                           • ZynxTM Health Inc
                           • eMedicineTM Clinical
                             Knowledge Base
                           • Joslin Diabetes Center
                           • Bright FuturesTM from AAP




Paths to Richer Clinical Content
 Centricity   Centricity
 Perinatal    Laboratory



                           Clinical Interfaces
                      • Inpatient Perinatal
                      • Cardiac
                ClinicalEchocardiography
                      • PACS Imaging
               Systems!
                      • Laboratory Order
                        Interfaces
                      • OB Ultrasound
                      • Intellidose
                        Chemotherapy
                        Administration



                                                              13 /
                                                             GE /
     Paths to Richer Clinical Content
                                                                                    Post-MI Patients on Beta Blocker


                                                                                   85%




                                                                 Adherence R ate
                                                                                   80%
                                                                                   75%
                                                                                   70%
                                                                                   65%
                                                                                         MQIC Benchmark        Clinic




Encounter   Protocols &
                            Quality
                               Disease             Production   MQIC/Quality
                          Inquiries
 Forms      Guidelines
                          Reporting!  Registries    Reports     Improvement

            Tools to Improve Quality & Outcomes


Individual                    Provider                    Broader
 Patient                       Panel                     Populations




                First step on the
                Clinical Content
                    Roadmap




                                                                                                                         14 /
                                                                                                                        GE /
           Introducing the
 Centricity Physician Office Primary
               Care Kit
                     • Six-Sigma project by GE’s
                       Field Support and
                       Engineering teams
            Free to  • 49 Encounter Forms,
                     • Letters, handouts, clinical
           All users!  lists
                     • Created over the years with
                       the help of Clinicians
                     • Embedded intelligence
                     • Free to all users through the
                       KnoweldgeBank




PCK: Well Child Form Series




                                                        15 /
                                                       GE /
PCK: Adult Comprehensive




PCK: Lab Result Letter Form




                               16 /
                              GE /
PCK: Childhood Immunizations




PCK: Flexible Sigmoidoscopy




                                17 /
                               GE /
PCK: Phone Notes and Refills




      Let’s work together
              *****
   Susan.Thomas.MD@ge.com




                                18 /
                               GE /
              Government and Industry
                    Initiatives




NHIN: The Framework
In July 2004, Dr. Brailer delivers,
“The Decade of Health Information Technology: Framework for Strategic
Action”
Goal 1: Inform Clinical Practice (“get EHRs adopted”)
•  Strategy 1. Incentivize EHR adoption                         Key Actions
•  Strategy 2. Reduce risk of EHR investment                    • Establish a Health Information
•  Strategy 3. Promote EHR diffusion in rural/underserved          Technology Leadership Panel
   areas                                                        • Support private sector certification
Goal 2: Interconnect Clinicians
                                                                   of HIT products
•  Strategy 1. Foster regional collaborations
•  Strategy 2. Develop a national health information            • Fund community health
   network                                                         information exchange
•  Strategy 3. Coordinate federal health information               demonstrations
   systems                                                      • Plan the formation of a private
Goal 3: Personalize Care                                           interoperability consortium
•  Strategy 1. Encourage use of Personal Health Records         • Require standards to facilitate
•  Strategy 2. Enhance informed consumer choice
                                                                   electronic prescribing
•  Strategy 3. Promote use of telehealth systems
Goal 4: Improve Population Health                               • Establish a Medicare beneficiary
•  Strategy 1. Unify public health surveillance architectures      portal
•  Strategy 2. Streamline quality and health status             • Share clinical research data
   monitoring                                                      through a secure infrastructure
•  Strategy 3. Accelerate research and dissemination of         • Make a commitment to standards
   evidence




                                                                                                          19 /
                                                                                                         GE /
 Govt & Ind Initiatives:                                                                                    Most
                                                                                                            Americans

 “The Community”                                                                                            have their
                                                                                                            medical
                                                                                                            informatio
                                                                                                            n in an
 Jun ‘05    Jul ‘05    Aug ‘05   Sept ‘05   Oct ‘05   Nov ‘05   Dec ‘05   Jan ‘06   Feb ‘06   Mar ‘06   2009EHR
                                                                                                              2014




                      AHIC “The Community” Members
 • In response to Brailer’s “Framework for Strategic Action” Framework call-to-
   action “Establish a Health Information Technology Leadership Panel” with the
   objective to help achieve the 2014 goal
 • Total of 17 members including the chair, Sec. Leavitt:
      – 8 federal
      – 8 private
      – 1 position open for an IT vendor     to Intel
 • Breakthroughs identified:
      – Consumer empowerment (e.g., PHRs)
      – Health improvement (e.g., eRx, chronic disease management)
      – Public health protection (e.g., biosurveillance)




 Govt & Ind Initiatives:
 ONC RFPs
 Jun ‘05    Jul ‘05    Aug ‘05   Sept ‘05   Oct ‘05   Nov ‘05   Dec ‘05   Jan ‘06   Feb ‘06   Mar ‘06   2009 2014




3 of the 4 ONC RFP Awards: Stds, Cert, Sec/Priv
           Oct 6, 2005
            Oct 6, 2005
           For a total of $17.5m
            For a total of $17.5m
           •• Standards Harmonization
              Standards Harmonization
                ANSI to form Health Information Technology Standards Panel (HITSP)
                 ANSI to form Health Information Technology Standards Panel (HITSP)
                $3.3m
                 $3.3m
           •• Certification (of EHRs)
              Certification (of EHRs)
                CCHIT
                 CCHIT
                $2.7m
                 $2.7m
                “Production” certification of EHRs in March 2006
                 “Production” certification of EHRs in March 2006
           •• Security & Privacy (federal or state laws precedence)
               Security & Privacy (federal or state laws precedence)
                Research Triangle Institute to form The Health Information Security and Privacy
                 Research Triangle Institute to form The Health Information Security and Privacy
                Collaboration
                 Collaboration
                $11.5m
                 $11.5m




                                                                                                                          20 /
                                                                                                                         GE /
 Govt & Ind Initiatives:
 ONC RFPs
 Jun ‘05   Jul ‘05   Aug ‘05   Sept ‘05   Oct ‘05   Nov ‘05   Dec ‘05   Jan ‘06   Feb ‘06   Mar ‘06   2009 2014




Last of the 4 ONC RFPs: NHIN Real World Demos




 Govt & Ind Initiatives:
 NHIN Demo’s
 Nov 10, 2005
  Nov 10, 2005
 For a total of $18.6m
  For a total of $18.6m
 • • Accenture (Apelon, Cisco, CGI-AMS, Creative Computing Solutions, eTech Security Pro, Intellithought,
      Accenture (Apelon, Cisco, CGI-AMS, Creative Computing Solutions, eTech Security Pro, Intellithought,
     Lucent Glow, Oakland Consulting Group, Oracle, and Quovadx)
      Lucent Glow, Oakland Consulting Group, Oracle, and Quovadx)
        –– Eastern Kentucky Regional Health Community (Kentucky)
            Eastern Kentucky Regional Health Community (Kentucky)
        –– CareSpark (Tennessee)
            CareSpark (Tennessee)
        –– West Virginia eHealth Initiative (West Virginia)
            West Virginia eHealth Initiative (West Virginia)
 • • CSC (Browsersoft, Business Networks International, Center for Information Technology Leadership,
      CSC (Browsersoft, Business Networks International, Center for Information Technology Leadership,
     Connecting for Health, DB Consulting Group, eHealth Initiative, Electronic Health Record Vendors
      Connecting for Health, DB Consulting Group, eHealth Initiative, Electronic Health Record Vendors
     Association, Microsfot, Regenstrief Institute, SiloSmashers, and Sun Microsystems)
      Association, Microsfot, Regenstrief Institute, SiloSmashers, and Sun Microsystems)
        –– Indiana Health Information Exchange (Indiana)
            Indiana Health Information Exchange (Indiana)
        –– MA-SHARE (Massachusetts)
            MA-SHARE (Massachusetts)
        –– Mendocino HRE (California)
            Mendocino HRE (California)
 • • IBM (Argosy, Business Innovation, Cisco, HMS Technologies, IDL Solutions, Ingenium, and VICCS)
      IBM (Argosy, Business Innovation, Cisco, HMS Technologies, IDL Solutions, Ingenium, and VICCS)
        –– Taconic Health Information Network and Community (New York)
            Taconic Health Information Network and Community (New York)
        –– North Carolina Healthcare Information and Communications Alliance (Research Triangle,
            North Carolina Healthcare Information and Communications Alliance (Research Triangle,
           North Carolina)
            North Carolina)
        –– North Carolina Healthcare Information and Communications Alliance (Rockingham County,
            North Carolina Healthcare Information and Communications Alliance (Rockingham County,
           North Carolina)
            North Carolina)
 • • Northrop Grumman (Air Commander, Axolotl, Client/Server Software Solutions, First Consulting Group,
      Northrop Grumman (Air Commander, Axolotl, Client/Server Software Solutions, First Consulting Group,
     SphereCom Enterprises, WebMD)
      SphereCom Enterprises, WebMD)
        –– Santa Cruz RHIO (California)
            Santa Cruz RHIO (California)
        –– HealthBridge (Cincinnati, OH)
            HealthBridge (Cincinnati, OH)
        –– University Hospitals Health System (Cleveland, OH)
            University Hospitals Health System (Cleveland, OH)




                                                                                                                   21 /
                                                                                                                  GE /
                                                                                                AHRQ State Demos in HIT ($25M
   AK                Sample of RHIOs                                                            eHI 2005 HIEs (+$2M)
                                                                                                Hurricane affected Gulf states
                                                                                                NHIN Demos

                WA                                                                                                                                  ME
                                      MT
                                                               ND                                                                            VT
                                                                                MN                  MI
                                                                                                                                                   NH
           OR
                                                                                               WI                                    NY            MA
                                                               SD                                                                                 CT    RI
                         ID                                                                                    MI
                                        WY
                                                                                                                                PA           NJ
                                                                                     IA
                                                                NE                                                  OH                  MD
                  NV                                                                                                                               DE
                                                                                                    IL    IN
                                                                                                                           WV
     CA                         UT              CO                                                                                 VA
                                                                     KS                   MO                   KY
                                                                                                                                     NC
                                                                                                               TN
                                                                          OK                                                  SC
                                                                                          AR
                           AZ                NM
                                                                                                     MS                  GA
                                                                                                           AL
                                                                                          LA
                                                                     TX
          HI

                                                                                                                                   FL




Govt & Ind Initiatives:
DOQ-IT
Jun ‘05        Jul ‘05   Aug ‘05     Sept ‘05        Oct ‘05    Nov ‘05        Dec ‘05         Jan ‘06    Feb ‘06        Mar ‘06          2009 2014




                                     DOQ-IT: CMS 8th SOW

           •• Going national with the 7th Scope of Work, DOQ-IT special studies
               Going national with the 7th Scope of Work, DOQ-IT special studies
              program limited to AR, CA, MA, UT
               program limited to AR, CA, MA, UT
           •• 5911 practices (5% of “primary care”) in each state
               5911 practices (5% of “primary care”) in each state
           •• Final goal is to support quality
               Final goal is to support quality
           •• Export of key measures on chronic diseases to a data warehouse
               Export of key measures on chronic diseases to a data warehouse
           •• Marketing to and working with QIOs (DOQ-IT University)
               Marketing to and working with QIOs (DOQ-IT University)




                                                                                                                                                              22 /
                                                                                                                                                             GE /
   Govt & Ind Initiatives:                                                                                      Most
                                                                                                                Americans

   Stark / AKS                                                                                                  have their
                                                                                                                medical
                                                                                                                information
                                                                                                                in an EHR
  Jun ‘05     Jul ‘05   Aug ‘05   Sept ‘05   Oct ‘05   Nov ‘05   Dec ‘05   Jan ‘06     Feb ‘06   Mar ‘06   2009 2014




2003: MMA                                                                  Rx Drug                         eRx uniform
                           eRx: Stark & AKS Relaxtion                      Program
                                                                           effective
                                                                                                           stds
                                                                                                           compliance




   Govt & Ind Initiatives:
   eRx Proposed Stark / AKS
    Available to:
   Relaxation staffs
    • hospitals for their medical
      • group practices to physician members
      • PDP sponsors and MA organizations

      1) eRx exception / safe harbor
          • MMA of 2003 mandate for HHS
      2) EHR exception / safe harbor “pre-interoperability”
          • Authority given to HHS in Stark and AKS for additional exceptions / safe
            harbor
      3) EHR exception / safe harbor “post-interoperability”
          • May include billing and scheduling software as long as core functionality
            includes EHR

      •     All must comply with the eRx standards
      •     Necessary and used solely
      •     Cannot donate IT technology already exists (donatee must certify)
      •     Donatee cannot divest existing technology
      •     Value caps
      •     Without regard for volume and value



                                                                                                                               23 /
                                                                                                                              GE /
   Govt & Ind Initiatives:                                                                                        Most
                                                                                                                  Americans

   eRx                                                                                                            have their
                                                                                                                  medical
                                                                                                                  information
                                                                                                                  in an EHR
  Jun ‘05     Jul ‘05   Aug ‘05   Sept ‘05     Oct ‘05   Nov ‘05   Dec ‘05   Jan ‘06     Feb ‘06   Mar ‘06   2009 2014




2003: MMA                                                                    Rx Drug                         eRx uniform
                                              Stark &
                                              AKS NPRM
                                                           eRx               Program
                                                                             effective
                                                                                                             stds
                                                                                                             compliance




   Foundation standards:
   •NCPDP SCRIPT Version 5.0 for transactions between prescribers and dispensers for new
   prescriptions, refill requests and response, prescription change request and response,
   prescription cancellation request and response, and related messaging and administrative
   transactions.
   •ASC X12N 270/271, Version 4010 and addenda, for eligibility and benefits queries and
   responses between prescribers and Part D sponsors.
   •NCPDP Telecommunication Standard, Version 5.1, and supporting NCPDP Batch
   Standard, Version 1.1, for eligibility queries between dispensers and Part D sponsors
   Initial standards:
   •Formulary and benefits, patient instructions, prior authorization messages and clinical drug
   terminology (RxNorm), medication history, NPI




   GE’s Involvement
            John Schaeffler                  GEHC’s representative to U.S. Congress and govt
                                             agencies
            Jackie Studer                    GEHC’s counsel for legislative activities (e.g., Stark)

            Francois de Brantes              Bridges to Excellence, The Leapfrog Group, eHealth Initiative

            Charles Parisot                  HITSP, IHE, HL7, ASTM

            John Moehrke                     CCHIT, IHE, HL7, ASTM

            Hugh Zettel                      EHRVA, HIMSS, ONC CSC NHIN Demo RFP,
                                              CCHIT, Katrina Relief, Legislation
            Tom Ricciardi                Outcomes research, P4P, RHIOs

            Susan Thomas,                    HIMSS, CCR Acceleration Group, CCHIT, AAFP
            MD
            Marianne Braunstein              eHI, HIMSS, CCHIT, RHIOs, DOQ-IT, Legistlation, Katrina efforts




                                                                                                                                 24 /
                                                                                                                                GE /
   Road Map




Market Drivers &
   Priorities




                    25 /
                   GE /
Dynamic & Complex Environment…
EMR Product Roadmap Drivers…
                        Customer Enhancement
                              Requests
        Interfaces
                                                 Certification

 Interoperability                                         DOQ-IT


  Clinical                 Centricity                      Pay for
  Content                                                Performance
                            EMR
 Decision Support                                      NHIN Support


    ePrescribing                                   Integrated Financials


             Outcomes                                System
                                                   Architecture
                        User Interface Refresh




Centricity Physician Office Priorities


Interoperability


                        Clinical Leadership


                                             Integrated Financials




                                                                            26 /
                                                                           GE /
CPO-EMR Initiatives for 2006/2007

Customer Requests – Better reporting, Alerts, FH/SH tab on Chart
Summary, Medical necessity checking w/ABN, Clinical Update “icon”
Interoperability – Support RHIO initiatives, Inpatient connectivity,
Interfaces, CCR/CDA Support
ePrescribing – New Rx, Refills, Formulary and eligibility support, RX
Hub, Sure Scripts
Clinical Content and Decision Support – moving beyond the paper
chart to providing decision support
Federal Initiatives – RHIO(NHIN), CCHIT Certification, AHRQ, QIO,
DOQ-IT, P4P
User Interface and System Architecture – update screens and
tools, on going product development goals




 Current Programs – 2005 & 2006




                                                                         27 /
                                                                        GE /
2005/2006 – New Product Introductions

         Mobile                        EMR 2005                      CPO-2006

 Handheld Charge Capture        EMR Release                      Integrate PM and EMR
   Fully Integrated               Images Illustrations &            Unified SQL Database for
   Centricity Schedule on         annotations                       both PM and EMR
   PDA                            Medications Enhancements          Platform rationalizations
   Patient Demographics on        Growth Charts                     Unified Scheduling and
   PDA                            Problems                          Administration
   Mobile Charge Capture          Enhanced Allergies & adverse      Collection enhancements
   CPT and ICD-9 Codes            reactions                         for PM
   available n drop down list     Desktop Document                  Updated User Interface
   Sync with Centricity           Management
   Import External Charges        Clinical Accuracy
   Confirmation of Imported       Preparation for PM-EMR
   Charges                        integration
                                  Support of multiple DB
                                  instances on a single server



     November 2005                 December 2005                     3rd Quarter 2006




 Save time, automate the billing
 process, and recapture lost revenue
 • Centricity Mobile is Fully Integrated with the
   Centricity Physician Office Practice Management
   System
 • Provides Access to Patient Lists,
   Demographics & Schedules on the PDA
 • Increase Revenue
 • Eliminating Lost and/or Never Recorded
   Charges
 • Reduce Lag Time
 • Real-time Code Edits



                                                                                                 28 /
                                                                                                GE /
Fully Integrated




Patient Lists, Demographics, & Schedules on the
PDA




EMR 2005 Features / Functionality
Images, Illustrations, & Annotations       Enhanced Allergies & Adverse
   Workflow designed for capturing         Reactions
   digital images
   Images saved into database              Desktop Document Management
   Ability to add illustration templates      Views
   Simple annotation on images or             Teams
   illustrations                              Out-of-office support
                                              Multi-document routing
Medications
   Medication monographs                   Clinical Accuracy
   Drug dosing calculator                     Required fields on encounter forms
   Drug interaction checking earlier          Redesigned panic high/low
   Brand medically necessary (by              indicators
   state)                                     Custom flowsheet observation
   Monthly medication updates                 labels
                                              Pediatric age improvements
Growth Charts                                 Units support JCAHO’s “Do Not
                                              Use List”
Problems
   Problem list views with dimming    CPO PM/EMR Integration
   Problem reactivation                 MIK error handling
   Duplicate problem notice             Insurance & contact management
   End date improvements (i.e., minor   Appt matching
   diagnoses)




                                                                                    29 /
                                                                                   GE /
CPO 2006
 Description                         Target Market
EMR Port to MS SQL 2005         Combined EMR/PM Customers
                                  Small – Medium Size Doctor
Integration of                       office
                                SQL Database – lower cost
    User Model/SSO
                                Appeals to office with minimal IT
    Installation                support
    Patient Information
    Administration & Set-up
    Scheduling & Appointments
    Application Look & Feel
    Billing and orders

 Collections Enhancements




                 CPO Roadmap
                  The future…




                                                                     30 /
                                                                    GE /
Clinical Content
                             Next Step                     Building the Future
Foundation
                                                           Enhanced Decision Support
                             Evidence Based Guidelines     Embedded Knowledge
Charting Excellence          Knowledge Base Links
Primary Care Kit                                           Collect and Implement Best
                             Instrument Interfaces         Practices
Patient Education




 GE Six Sigma Content           GE Clinical Content        Quality & Efficiency
  Primary Care Kit              “Backbone” content –         Commitment to further
  New Encounter Form Sets       elements of a SOAP note      development & excellence
  Flex Sig Form, EKG Form,      Chronic Disease Mgmt         Continue to Enhance
  more                          Web Enabled Knowledge        Decision Support tools
  Vaccine management             Building Blocks for the     3rd party clinical interfaces
  New Letters and Handouts      future
 Completed November 2005                 2006                        2007




Interoperability… the key to the
future                   Today
                        The future…
                                                            • Multiple versions of
                                                             HL7 v2.3
                                                           •HL7 and ASTM,
                                                           Interfaces
                                                            NCDPD, DICOM, X12
                                                           •• 130 different
                                                              Faster Interface
                                 Link                       development
                                                           interfaces have
                                 Logi
                               New Interface
                                  Engine
                                                           been written
                                                            • ASP Support
                                                           •• Has been a great
                                                              More flexibility
                                 c                         tool
                                                            • Ability to support

       EMR                       Tool                      •RHIO
                                                             Limited for future
                                                           growth
                                                            • In-patient/Out-patient
                                                           •interoperability HL7
                                                             Limited to one
                                                           format Integration
                                                            • Device
                                                              IHE Profiles
                                                           •• Ready for a
                                                            • DOQ-IT support
                                                           change tomeasures
                                                           new Standards



                                                                                              31 /
                                                                                             GE /
 CCHIT Certification for EMR
What is it?
CCHIT (The Certification Commission for Health Information Technology) is a industry
group formed to develop certification standards for the many EMR vendors. The
mission of CCHIT is to accelerate the adoption of robust, interoperable HIT throughout
the US healthcare system, by creating an efficient, credible, sustainable mechanism for
the certification of HIT products.

                                                  As a leader in EMR…
                            GE Commitment         • Commit to unmet requirements:
                                                  We will support…
                                                          Documentation of Medication Administration
                                                          Track Chronicity Levels
                                                         Orders Updates – view by like types (all
                                                       Radiology, all labs, etc)
                                                          Record Advanced Directive Reviews

   Centricity EMR                                         Support Structured documentation of Medication,
                                                       dose, time,route, site, lot #, Manufacture and User
                                                       ID
                                                         Electronic Transmission of prescriptions and
                                                       renewals
                                                          Track state license, DEA, UPIN & NPI numbers




 ePrescribing                                    Transmissions via Sure Scripts for
                                                 Retail Pharmacies
                                                 • Kryptiq will offer in 1st quarter 2006
                                                 • Ability to electronically transmit to
                                                 participating pharmacies in EMR Meds
                                                 window for new and renewal Rx
                                                 • Error management provided
                                                 • Implementation only

                                                 Transmissions via RX HUB for Mail
                                                 Order Pharmacies

Centricity EMR                                   • GE will develop interface to RX HUB
                                                 for 2007 availability
                                                 • Ability to electronically transmit to
                     Meeting customer            participating pharmacies in EMR Meds
                           needs                 window
                   Support MMA & CCHIT
                       requirements              • Will support Formularies and
                                                 Eligibility
                                                 • New Renewals workflow and tab
                                                   Will        id M d hi t


                                                                                                              32 /
                                                                                                             GE /
You asked…
   All future EMR releases will contain
   enhancement requests provided by
   the Users!
                                                                                                 2007

                                                           Customer Enhancement Requests from
                                                           “Speaking with a Single Voice” session at
                                                           2004 Summit
                                                           • Add new patient chart tab for Family History/Social History
                                                           • Medication Export
                                                           • Care Alerts/Reminders
                                                           • Enhance Refill Form – part of ePrescribing




Updating Tools… staying current
Refreshing the User Interface
• Work flow improvements
                            Updating the
• Seamless Clinical Content
                            Architecture
                                                                                                  Financial
                                                                                                                       • Service oriented Architecture
                                                                                                  Financial                Desktop
                                                                                              Transaction Mgmt              Desktop                     Chart
                                                                                                                                                         Chart
                                                                                              Transaction Mgmt            Documents                 Chart Review
                                                                                                 Billing, A/R,
                                                             Licensing & Security Framework




                                                                                                 Billing, A/R,
                                                             Licensing & Security Framework




                                                                                                                           Messaging                  & Update
                                                                                                 Collections
                                                                                                 Collections
                                                                                                                       Hosted Scheduling           Documentation
                                                                                              Balance Forward
                                                                                              Balance Forward                                      (Text & Forms)
                                                                                                                                                  Decision Support
                                                                                                                              Patient
                                                                                                                               Patient
                                                                                               Payment Entry
                                                                                               Payment Entry                                         (Protocols,
                                                                                                                           Information
                                                                                                                            Information             Int Checking,
                                                                                              EDI Management
                                                                                              EDI Management               Scheduling
                                                                                                                           Scheduling               E&M Advisor)
                       Application & Server Installers
                      Application & Server Installers
                       (Single Common installer for all)
                      (Single Common installer for all)




                                                                                                                                                        Orders
                                                                                                EDI Plug-Ins
                                                                                                EDI Plug-Ins                   Reports
                                                                                                                               Reports                (Charges)

                                                                                                                         Administration
                                                                                                                         Administration
                                                                                                                         Common UI Shell



                                                                                              Service Wrappers          Service Wrappers          Service Wrappers    HL7 (Integration)
                                                                                                                                                                      HL7 (Integration)
                                                                                              Service Wrappers          Service Wrappers          Service Wrappers         Engine
                                                                                                                                                                            Engine
                                                                                              Business Logic
                                                                                              Business Logic             Business Logic
                                                                                                                         Business Logic            Business Logic
                                                                                                                                                   Business Logic

                                                                                                                   ADO.NET Data Access Layer
                                                                                                                   ADO.NET Data Access Layer                              Insite II
                                                                                                                                                                           Insite II
                                                                                                                    Internet Information Server
                                                             Terminology




                                                                                                                                                                       (Monitoring &
                                                             Terminology




                                                                                                                                                                        (Monitoring &
                                                                                                                      (Web/Application Server)                         Supportability)
         Legend                                                                                                                                                        Supportability)
       PM Specific
       PM Specific
                                                                                                                                                                        Clinical Tools
         Shared
         Shared                                                                                                CPO Database                           CPO Users       (Formulary Editor,
       EMR Specific
       EMR Specific
                                                                                                 PM Data         Shared Data       EMR Data          (CPO SSO)           Form Editor)
                                                                                                                                                   Active Directory
                                                                                                    (Single Shared Database Server)                (User Database)




                                                                                                                                                                                            33 /
                                                                                                                                                                                           GE /
Mobile Roadmap Vision
TODAY                             FUTURE
• Integration with                • Integration with
Centricity PM                     Centricity EMR
• Patient List                    • Clinical Summary
                                  and Clinical Results on
• Demographics
                                  PDA
• Schedule
                                  • ePrescribing
• Charge Capture
                                  • Dictation




EMR Roadmap
    2005                 2006                                     2007



                                                             Interoperability
                                                            New Interface Engine
                       CPO                                       Standards
                       2006                   Clinical Content
    EMR                                        Decision Support     EMR         ePrescribing
                                              Form Development                     Electronic
    2005                                                                            RX-Hub
                                                             Enhancements
                                                               User requests
                     GE Clinical Content                       User Interface
                                                             Architecture update




  Primary Care
  Kit
                                               CPO 2007/EMR 2007
                  SureScripts
                  ePrescribing



     Mobile
 Charge Capture            Mobile – EMR for Clinical Summary and results &
                           ePrescribing




                                                                                                 34 /
                                                                                                GE /
Thank You!




              35 /
             GE /

						
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