EMR Interoperability Makes an Attractive Partner for ACOs

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EMR has helped MJHS’s home care agencies be more efficient with aggregated data to improve internal operations while the ability to provide custom­ized data about outcomes to partners and payers a key success factor in a future environment that will most certainly include payment bundling, capitation, health homes and Accountable Care Organizations (ACO).

This is the 12th in a series of case studies from the Preparing for the Future report.

You can check out the full MJHS case study or continue reading the summary below.
The Organization 
MJHS is a charitable, not-for-profit organization with more than a century of experience providing health care services to the community. Founded in 1907 by 4 courageous Brooklyn Ladies who believed in the values of compassion, dignity and respect for every culture, MJHS has grown into 1 of the most expansive health systems in the New York metropolitan area. 

The participating programs and agencies of MJHS provide home care, pioneering hospice and palliative care, state-of-the-art rehabilitation and nursing care, adult day health care, senior housing and affordable health plans to more than 40,000 individuals and their families in the region.

The Approach 
After conducting a strategic review of its operations about 10 years ago, MJHS decided to convert all of its paper medical records into an integrated electronic medical record (EMR) system. EMR adoption began with MJHS Home Care in 2006 and was fully implemented in 2008. EMR adoption in the skilled nursing setting started up in 2008 and was completed in 2010.

Through a partnership with the State University of New York (SUNY) Downstate Medical Center in Brooklyn, MJHS offers intensive follow-up services to kidney transplant patients after their discharge from the hospital. At the core of the MJHS service package is an electronic pill box that provides medication reminders and a variety of alerts when doses are missed. 

The device helps transplant patients remain compliant with medications, which is a critical factor in ensuring their long-term health.

MJHS has deployed a variety of technology-enabled services and models, including EMR and Telehealth. It also has made a number of investments in technology ventures.

Keys to Success 
The MJHS philosophy is that in order to win, an organization cannot be risk averse and should be strategic with investments. This philosophy allows staff to make mistakes in the creation of new businesses or the exploration of new technologies for the sake of testing a new service that could add value to the organization. 

It also allows the organization to take calculated risks, including its move into the field of Medicare and Medicaid managed care, which now accounts for 52 percent of MJHS revenues.

A dedicated project management department manages each technology deployment at MJHS and works proactively to address challenges that inevitably accompany implementation. This department gets staff teams involved in the early stages of implementation, creates enthusiasm about the launch, and educates staff about the technology before and after it is implemented. 

It also conducts root-cause analysis when employees push back against technology to ensure that the push-back isn’t related to a problem with the technology.

Business Case 
MJHS made a capital investment to finance its EMR program but received grant funds to connect itself with the Brooklyn Health Information Exchange. The organization views its spending on technology as a worthwhile investment aimed at reducing the cost of labor and improving the outcomes of individuals.

MJHS also has a long tradition of investing in the development of new aging services technologies. In the late 1990s, the organization helped to establish the Israel Center for Assistive Technology and Aging (GeronTech), a joint venture with the Association for the Planning & Development of Services for the Aged in Israel. MJHS is currently in the process of launching 2 distinct programs that are focused on technology development: the MJHS Research and Development Endowment, and the MJHS Venture Fund. 

These 2 programs will invest in start-up technology companies focusing on medical and assistive technologies that help aging service providers deliver better care to the elderly and chronically ill.

You can also view all 18 case studies from the Preparing for the Future report.