# Presentation: 683117

## Massachusetts DOQ-IT

- Where are we today

## DOQ-IT

- DOQ-IT: Doctor’s Office Quality – Information Technology
- Established in April 2004 – funded through January 2009
- CMS recognized barriers to successful adoption
- Concerns about selecting the wrong product and paying too much
- The effect of the EHR on practice workflow
- Physicians feel they can’t afford the right advice, technology, or time to achieve greater success
- DOQ-IT’s mission is to reduce these risks
- Assist small (<3 MDs) and medium (3-9 MDs) sized practices in the adoption of technology
- Focused on primary care and Medicare beneficiaries
- Assist the community

## DOQ-IT

- Over 1,400 physicians currently enrolled, representing over 300 practices across the state
- 43 practices that have already adopted technology
- Working with 33 IPA/PHO organizations
- No fees for services

## DOQ-IT Services

- Education
- CMEs – Risk Management
- Consultation
- EHR selection process
- Workflow analysis and redesign
- Implementation planning
- Pay For Quality Programs
- CMS programs
- Bridges To Excellence

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...

## DOQ-IT Services - Consultation

- Implementation

- Organizational Redesign

- Culture Change

- Vendor Selection

- Plan

- Assess

- Evaluate/Improve

- Care Management

- Workflows
-  Clinical
-  Operational
-  Financial

-  RFP
-  Contracting

-  Focus on Staff

-  Chronic Care
-  Preventive
-  P-4-Quality

-  Practice redesign
-  Patient Access
-  Measurement

- DOQ-IT Roadmap

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...

## DOQ-IT Services - Education

**Notes:**
So where do you start?  I’ve given you a lot of information today...but there are a few key ingredients to getting started:

DOQ-IT is here to help – and we can offer the most help to primary care practices per our directive from CMS, but we can provide guidance to any practice.  We have a combined 37 years of experience in this industry and we are available to you at no cost.  We can educate you and step you through the process.
You need to start thinking about a high level plan.  Developing a project charter is a MUST – you cannot achieve your goals if you do not define them. You also need to establish a budget (both in terms of costs and projected savings), and identify key resources within your practice who will participate as part of the project team.  Having a physician champion is a critical success factor for this type of project. And finally, establish a timeline from selection through implementation and communicate this to everyone involved.  

Then you are ready to talk to vendors...

## DOQ-IT Services – Pay for Quality 	

- Pay For Quality Programs
- Bridges to Excellence
- Alternate qualification for rewards
- Pilot for the rest of the country
- MCMP – Medicare Care Management Performance
- New program starting in July 2006
- Administered by DOQ-IT

**Notes:**
Pay For Quality Programs are also a growing trend in the market.  The key to participating and earning $$ for your practice is to be able to measure quality.  How will you be able to measure quality??  You need an EHR to measure quality – because you need the data – structured and reportable data.  

The two most widely known programs are:  P4P (Pay For Performance) and BTE (Bridges To Excellence).  DOQ-IT can assist you in getting enrolled in these programs if you qualify, and in fact for BTE, DOQ-IT is the only organization that can enroll you at no cost.  

Another program that is brand new is called MCMP or the Medicare Care Management Performance Project. CMS has contracted with DOQ-IT to administer this program where physicians will be selected to receive incentive payments for meeting clinical performance measures. Physicians can earn up to $12,500 per year if they are selected.  The highest dollars will be paid to those submitting their data from their EHR.

So now you are probably thinking...I need to have an EHR – so lets talk about EHRs.

## From the Field

- Physician offices
- Cost still a factor – need some way to organize purchase
- Staffing an issue – need to pay overtime and choose the right adoption pathway
- Negative reports on EHR adoption slow or stop adoption (Geisinger experience)
- Lack of technical knowledge permits bad selection practice

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...

## From the Field

- Physician offices
- Vendors can create issues – volatile Return on Investment modeling
- ‘Stuck’ or ‘Failed’ implementations can be addressed
- How do I participate? (IPA, Hospital, RHIO, stand-alone)
- Workflow redesign is key to improvement
- Culture change is key to adoption

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...

## From the Field

- Legal issues
- RHIO/LHIO permits additional data that may have legal implications on decision-making
- Community record creates issues around who updates the record
- Support of controlled access still an issue with EHR and RHIO
- Too much info creates data blindness
- Varying models don’t provide data quick enough – how long do you wait?

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...

## From the Field

- LHIO/ RHIO stratification
- Local HIE (LHIO) requires much more data transfer amongst Community of Practice
- RHIO requires limited data set
- Create stratification of practices between the ‘Haves’ and the ‘Have Nots’
- Patient Portals vs. Personal Health Records
- Need for other data streams – P4Q, Bio surveillance, community, etc

**Notes:**
How can DOQ-IT help you? In general, when you sign up with DOQ-IT, we provide education and consulting services to assist you from start to finish in your EHR selection process.  Along the way, you can earn CMEs and once your EHR is implemented, you may qualify for P4P programs- with real dollars that can be earned to offset the cost of your EHR system.

We can also provide insight into what other practices in the state are doing related to EHRs.  Let’s talk about what is going on in Massachusetts...