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Memorial Health Care System
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EMR Hosting Service Information
Overview

CooperativeCare, Fremont Physicians Association, and Memorial Hospital have partnered to create a collaborative model to implement and operate a common, shared Physician Office Management and Electronic Medical Record (EMR) system. This service will be offered as an Administrative Service through CooperativeCare and be called the CooperativeCare EMR Hosting Service (CEHS).

Memorial Hospital has negotiated a contract with Practice Partner, a leading provider of Physician Office systems, to provide the software and support services for CEHS. The contract leverages the existing relationship between Memorial Hospital and McKesson providing discounts and additional services not typically offered to other Practice Partner customers. CEHS is offered to physicians via CooperativeCare, and CooperativeCare will oversee the operating budget and changes to the operating model. Memorial Hospital will provide tactical operation of CEHS and will report to CooperativeCare in all aspects of the operation and support of the CEHS model.

CEHS Service Description and Financial Model

Under the Stark Law, with certain limitations, Memorial Hospital may fund up to 85% of software costs for a physician office EMR system. Memorial Hospital is not permitted under Stark to provide any hardware, manpower, or associated technology infrastructure for such a system. For the CEHS system, Memorial will purchase the hardware and system infrastructure, leveraging their existing infrastructure whenever possible, to centrally run the EMR system and provide the service in this shared operating model with costs being allocated among participating physicians. Additionally, Memorial Hospital will collaborate with Practice Partner and McKesson to develop interfaces and appropriate integration from the CEHS system to Memorial Hospital’s systems, and will also work on strategic integration of the systems for creation of a patient continuous care record across providers. The interfaces to Memorial Hospital systems and the agreed to integration will be funded by Memorial Hospital. The CEHS approach dramatically reduces the costs of an EMR system and provides for a manageable and predictable ongoing cost structure.

The budget for operation of the CooperativeCare Hosted EMR System has been developed jointly by CooperativeCare and Memorial Hospital. CooperativeCare provides the overall financial oversight of the CooperativeCare Hosted EMR System and will approve, communicate and monitor the financial expenses, with the support of Memorial Hospital. Each participating provider will pay a monthly cost to support the CooperativeCare Shared System Model as long as they continue to use such services.

All ownership and rights to the data and data privacy is with the physicians. Memorial Hospital or any other entity is prohibited access to the information unless agreed to by the physicians. CooperativeCare may work with the physicians and payers, at the direction of the physicians, to provide information to the payers to allow for increased reimbursement. CooperativeCare may conduct quality of care studies upon the direction of the board of the Fremont Physician Association, which serves as a Medical Advisory Committee to CooperativeCare.

A more detailed description of the funding and responsibilities is described below:

  1. PHYSICIAN OFFICE EMR SOFTWARE
    1. Memorial Hospital will purchase all Practice Partner Software licenses, leveraging their existing relationship with McKesson, and will retain ownership of the software licenses. Physicians participating in the CEHS model will reimburse Memorial Hospital for 15% of the software costs as required by Stark.
    2. Memorial Hospital will retain the licenses for the software and may reassign them in the event that a physician terminates its relationship with CEHS. Physicians will own no termination rights to the Practice Partner software license, but may use it for the duration of their relationship with CEHS.
    3. Memorial Hospital may purchase licenses for, and support other non-CooperativeCare physicians. Should this occur, it will be communicated to CooperativeCare in writing.
    4. Practice Partner offers optional software add-ons for the physician. All add-on software modules are the responsibility of the physician and each physician will pay Practice Partner directly for each module based on Practice Partner’s pricing schedule.
    5. Annual software maintenance will be paid to Practice Partner by CooperativeCare, with the first maintenance payment due one year after go-live for each physician. Each participating physician will be charged 1/12th of the annual maintenance costs each month, beginning at go-live to escrow the cost of the maintenance.
  2. CENTRAL AND PHYSICIAN OFFICE HARDWARE
    1. Memorial will leverage their existing infrastructure and hardware wherever possible to host and support the Practice Partner EMR system.
    2. All costs of hardware and infrastructure software used directly for the Practice Partner EMR system will be charged directly to the CooperativeCare Hosting budget.
    3. All costs of existing hardware and infrastructure software that is partially used to support the Practice Partner EMR system will be apportioned, whenever practical, to the CooperativeCare Hosting budget
    4. Ongoing operating costs for personnel to support and maintain the central system will be charged directly to the CooperativeCare Hosting Budget. The initial assumption is that .25 FTE is required to support the system and infrastructure for 10 providers.
    5. Each physician practice is required to purchase all hardware and infrastructure at their office. Implementation and hardware support of this equipment is the responsibility of the physician, however CooperativeCare will offer initial hardware installation and on-going office support for a nominal charge. Practice Partner and Memorial Hospital will provide physicians with hardware specifications for their office equipment that are supported in the CEHS model. Each physician is required to abide by the hardware specifications to assure optimum performance and reliability of the system.
    6. CooperativeCare may engage a dedicated Memorial Hospital IT technician to provide physicians with hardware, software and network technical support. If CooperativeCare provides such a service, the technical support will be provided solely for the recommended hardware and software; or,In the event CooperativeCare successfully enters into a GPO arrangement with local computer networking service(s), CooperativeCare will provide participating physicians with access to such discounted services.
  3. NETWORK
    1. Memorial Hospital will provide high-speed Internet access to allow remote access to the Practice Partner EMR system through the physician portal.
    2. Each physician office is responsible for:
      1. high-speed Internet connectivity to access the system from the physician office. Each office should also consider having an alternate Internet provider for redundancy. High speed cable access is recommended for optimal access performance.
      2. costs of network wiring and wireless network access at their office, as well as installation, operation, and support of the office network infrastructure.
  4. FINANCIAL AND PATIENT DATA
    1. All physician patient and financial data will be maintained in a secure manner with access limited and restricted as per the physician direction.
    2. No Memorial Hospital employee or supplemental staffing contractor will have access to the data except that Memorial Hospital will make secure backup copies of the data with said backups being stored on-site in a secure vault, and off-site at a secure tape vault location.
    3. Upon the direction of the Medical Advisory Committee, CooperativeCare may engage in quality of care studies.
  5. SUPPORT AND RESPONSIBILITIES
    1. Practice Partner will provide initial training in the setup of the system with each physician practice and individual physician. Such training will be a combination of online guided training and assistance, as well as on-site training.
    2. As part of the annual software maintenance, day-to-day operational support will be provided by Practice Partner. Practice Partner will provide each physician practice with a support line for ALL questions and system support issues and will be the first call from the physician or office for first level problem determination and resolution. Practice Partner is capable of handling most questions or issues, and will escalate problems to Memorial Hospital if necessary. The negotiated contract with Practice Partner provides 24x7 support to each physician practice and Memorial Hospital at no additional cost. A separate after hours support line will be provided to each physician practice. The physician practice can call the Memorial Hospital Service Desk with known connectivity questions or issues. The number for the Service Desk is 419.334.6629.
    3. The annual software maintenance also includes updates, fixes, and enhancements to the software. Practice Partner and Memorial Hospital will install software updates and new releases into a test system for the physician and practice to perform acceptance testing before it is rolled into the live environment.
    4. Practice Partner will provide Memorial Hospital with logs of problems called in by CEHS participants. Memorial Hospital will monitor problem logs and analyze any trends or situations that require attention. Memorial Hospital will work with Practice Partner to coordinate best practice initiatives between and among CEHS participants. On request, Memorial Hospital will provide CooperativeCare with such logs and analysis.
    5. Memorial Hospital will provide backups of the system, disaster recovery planning, system redundancy where possible, high-speed internet access to the system via the Physician portal, and provide assistance to the Practice Office to identify and resolve network connectivity and performance issues.
    6. CooperativeCare may engage a dedicated Memorial Hospital IT technician to provide physicians with hardware, software and network technical support. If CooperativeCare provides such a service, the technical support will be provide solely for the recommended hardware and software.
Agreements Between Practice Partner and Physicians

Each Physician, Physician Assistant, and Nurse Practitioner is required to be a licensed user of the Practice Partner system. Additionally, each provider, and/or Physician Practice is required to enter into a contractual relationship with Practice Partner for certain items as identified on a quote provided by Practice Partner. Each Physician and/or Physician Practice is required to:

  1. Purchase services from Practice Partner for system implementation and training. CooperativeCare may engage a dedicated Memorial Hospital IT technician to provide physicians with hardware, software and network technical support. If CooperativeCare provides such a service, the technical support will be provide solely for the recommended hardware and software.
  2. Purchase services from Practice Partner for demographic data conversion from their existing billing system, if such a conversion is desired. The current billing vendor may charge the physician for providing data extracted from the current system to be loaded into Practice Partner.
  3. Sign the Clearinghouse Agreement and subscribe to the Practice Partner approved clearinghouse services.
  4. Purchase, or pay yearly subscription costs to Practice Partner for any and all optional features and services offered by Practice Partner. Such optional components may include Eligibility checking, Formulary Tracking, Instant Medical History, Web Interface, Patient Education, SureScripts, Patient/Physician Web Access, Clinical Tools, or other such optional services that may become available over time.
Negotiated Master Agreement

A common Master Agreement has been negotiated between Memorial Hospital, the Physicians, and Practice Partner to leverage the CEHS collaborative effort and pass along savings and additional services to each CEHS participant. It consists of interwoven and related discounts and services based on Memorial Hospital’s relationship with McKesson and include discounts from Practice Partner as well unique services and allowances to participating CEHS physicians.

The Memorial Hospital has signed this Master Agreement. Each physician is required to sign a similar agreement in form and content as the Master Agreement with Practice partner in order to participate in the discount programs and additional services offered.

The highlights of the agreement include:

  • The physicians will purchase the Practice Partner Essential Implementation & Training Package for each Provider/Practice.
  • If Memorial Hospital or physicians request additional services from Practice Partner beyond the scope of the original implementation, such services are discounted at a twenty (20%) discount off the then current list price.
  • Physicians may purchase the optional Practice Partner demographic data conversion services from an existing system.
  • Practice Partner will provide 24 x 7 support for each Provider based on the maintenance and support agreement. CooperativeCare will pay for the annual maintenance and a monthly charge will occur for each provider using the system.

If you are interested in a personalized demo of Practice Partner and how it can be used for your office, please call the Service Desk at 419.334.6629 or internally x6629.

You can also download a demo to your PC by clicking HERE.

FOR ASSISTANCE, CALL THE MEMORIAL HOSPITAL SERVICE DESK AT 419.334.6629 or use x6629 internally.