What to Do Today to Maximize Your ARRA Funding
Ian Janer and William N. Bernstein, LEED®AP, AIA
June 25th, 2009
Overview of ARRA: Opportunities and Challenges
The American Recovery & Reinvestment Act of 2009 (ARRA) has been instituted under President Obama to encourage economic stimulus. For healthcare providers, the bill seeks to encourage advancement and development by providing incentives for converting from paper records to EMRs (electronic medical records) and for better patient care through improvements in data infrastructure. In order for hospitals and other healthcare providers to maximize their ARRA funding and ultimately cut costs, it is essential that they begin the process of upgrading their systems now to reach the first deadline at the end of 2010.
Another important motivator in adapting these technologies is the nature of the diminishing incentive rates. Every year the incentives will decrease for those facilities still attempting to get up to par with their peers, and any facility that has not adapted EMR by 2015 will begin to see penalties taken out of their Medicare refunds. With the deadline approaching so soon, healthcare providers that haven’t already adopted EMR must act now to see the necessary improvements.
The Realities of Meaningful Use
The government has allotted $77B dollars for medical incentives, and the largest payments will be made to hospitals and practices that are up to the standards of “meaningful use” by the end of 2010. While the term “meaningful use” generally means clear improvements in workflow and patient care thanks to the adoption of EMR, the official definition is still being determined by the CCHIT (Certification Commission for HIT). However, there are a few digital technologies that are expected to be necessary to prove “meaningful use.” Among other systems, hospitals should have PACS (picture archiving and communication systems), CDSS (clinical decision support systems), and, most importantly, CPOE (computerized physician order entry) systems installed throughout their facilities. These electronic methods are essential to the type of patient care improvements that are expected to come out of the ARRA.
Gap Assessment
To be able to make the switch over to digital, medical professionals should go through their workflow and search for gaps: do nurses have to go back and forth between the patients’ rooms and nurses’ stations to enter data? One of the purposes of EMR is to minimize physical workflow constraints, so this would be one area to improve. Another area to investigate is whether the information technologies are available throughout the facility or just in one department: it’s essential that the entire facility be up to standards to receive ARRA funding. What if the IT system goes down? All healthcare providers should have system redundancies (backup computers, servers, workstations, etc.) in case something happens to part of the system – a hospital should never be in a situation where all of radiology is on a single server that could crash without having a backup. The last area to investigate before preparing for the transition is staff readiness: it is important that the doctors, nurses, administrators, and other staff members are behind the transition and prepared to proceed smoothly. The best way to ensure this is through offering monetary incentives and paid training.
Qualified EMR Systems
In order to reach the standards set by CCHIT, which will be announced in about 6 months, facilities should try to start work now, even before the final requirements have been laid out. The main goal should be to reach what is considered by Dr. Richard Howe, vice president of Healthcare Informatics Associates, to be the minimum required to see a large difference in patient care: fully-operational CPOE. Because this is what enables doctors to interact with patients’ files and records digitally, this is one of the most important aspects of a good EMR system. Without CPOE, it’s impossible for any hospital to advance to full digitization and difficult for any hospital to see any significant improvements in patient care.
Evaluating the IT Infrastructure
It’s important that hospitals looking to update to enable CPOE first evaluate their current systems to see if they will be able to support CPOE and other basic digital technologies. In some cases, facilities may need to go through the expensive, time-consuming, but ultimately rewarding process of replacing their old computer systems with modernized ones and starting from scratch. Another option, for hospitals that have EMR systems that are relatively up-to-date but not quite up to par, is to simply refurbish what they already have. This may not be possible or even preferable in many cases, however, because new technologies can mean large changes in workflow and user-interface that could be more easily negotiated with an entirely modern system.
Measuring the Investment
Healthcare providers should make sure not to see this transition as an obligatory inconvenience, but as a way to both improve patient care and cut costs. EMR significantly increases accountability and reduces error, which can save lives and eliminate mistakes that cost money. The investment in a good EMR network is well worth it. To put together a more specific cost-benefit analysis, there are calculators online that hospitals and practices can use to approximate their ARRA stimulus packages, which can be found at the CMS (Centers for Medicare and Medicaid Services) or HIMSS (Healthcare Information and Management Systems Society) websites. Healthcare providers must then estimate how far they are from their goal and how large the investment to reach that goal will be, and they must not forget to include the significant operational cost of training in that estimate.
Action Steps to Take Today
Although the task of switching to digital records may be daunting, there is no time like the present to get started. The first thing that providers seeking to get ARRA checks by the end of 2010 should do is set their “meaningful use” goals: see what systems (PACS, CPOE, CDSS, etc.) can be installed now, and what can follow immediately after. Next, facilities should check on their existing IT infrastructures to see if they can carry the transition and whether they have redundancies or, on the negative side, disparate systems/networks. Hospitals and practices should also immediately eliminate any non-standard procedures, including shortcuts taken by staff to save time. Any procedures that aren’t industry best practices can lead to inconsistencies, which will interfere with the switch to digital. Basically, facilities should be filling in the gaps now to prepare for the transition.
For Healthcare Design News see, http://bernarch.com/healthcare-design-news/
For further information on ARRA, contact healthcare and hospital architecture firm:
William N. Bernstein, LEED®AP, AIA
Principal
Bernstein & Assoc. Architects - PLLC
59 West 19th Street - 6A, New York, NY 10011
T: 212.463.8200
C: 917.747.2924
F: 212.463.9898
E: wb@bernarch.com
W: www.bernarch.com
NEW YORK - HARTFORD - PRINCETON
Monday, June 29, 2009
Friday, June 26, 2009
Architect Initiates New Hospital-Oriented Twitter Account
For Immediate Release (06/26/09)
Bernstein & Associates, Architects is pleased that the firm principal, well-known healthcare and hospital architect --- William N. Bernstein, LEED®AP, AIA --- has initiated a new Twitter account with news about hospital and healthcare subjects.
This hospital Twitter account can be found at: www.twitter.com/hospitals
The Twitter account will focus on the many aspects of specialized design and construction required by hospitals and healthcare facilities, as they improve their aging hospital infrastructure and/or add new programs and technologies to stay up to date with the fast moving world of the healthcare marketplace.
Mr. Bernstein is well equipped to author this Twitter account. He was educated at the Yale University School of Architecture, where he received a Master of Architecture. He is a member of the American Institute of Architects, American College of Healthcare Architects, Construction Specification Institute and Project Management Institute. He is one of the few architects in the United States to receive the American Hospital Association Construction Management Certificate. He has written many articles on hospital and healthcare design and construction, and his healthcare and lab projects have won numerous awards and been published widely.
In addition, Mr. Bernstein is a principal of a healthcare and laboratory architecture firm --- Bernstein & Associates, Architects (www.bernarch.com).
About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm specializing in healthcare and laboratories.
For Hospital Design see, http://bernarch.com/healthcare-design-hospitals/
For more information about hospital and lab design and construction, please contact:
William N. Bernstein, AIA
Principal
Bernstein & Associates, Architects
59 West 19th Street - 6A New York, NY 10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
W: www.bernarch.com
Bernstein & Associates, Architects is pleased that the firm principal, well-known healthcare and hospital architect --- William N. Bernstein, LEED®AP, AIA --- has initiated a new Twitter account with news about hospital and healthcare subjects.
This hospital Twitter account can be found at: www.twitter.com/hospitals
The Twitter account will focus on the many aspects of specialized design and construction required by hospitals and healthcare facilities, as they improve their aging hospital infrastructure and/or add new programs and technologies to stay up to date with the fast moving world of the healthcare marketplace.
Mr. Bernstein is well equipped to author this Twitter account. He was educated at the Yale University School of Architecture, where he received a Master of Architecture. He is a member of the American Institute of Architects, American College of Healthcare Architects, Construction Specification Institute and Project Management Institute. He is one of the few architects in the United States to receive the American Hospital Association Construction Management Certificate. He has written many articles on hospital and healthcare design and construction, and his healthcare and lab projects have won numerous awards and been published widely.
In addition, Mr. Bernstein is a principal of a healthcare and laboratory architecture firm --- Bernstein & Associates, Architects (www.bernarch.com).
About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm specializing in healthcare and laboratories.
For Hospital Design see, http://bernarch.com/healthcare-design-hospitals/
For more information about hospital and lab design and construction, please contact:
William N. Bernstein, AIA
Principal
Bernstein & Associates, Architects
59 West 19th Street - 6A New York, NY 10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
W: www.bernarch.com
Thursday, June 11, 2009
New Article To Be Published on Trends in Radiology Design and Operations
For Immediate Release (06/10/09)
New Article to Be Published on Trends in Radiology Design and Operations
Bernstein & Associates, Architects is pleased to announce the upcoming publication of an article on recent trends in radiology design and radiology planning.
The article will be published in the July 2009 edition of Hospital Newspaper.
The article discusses the latest trends in radiology design and radiology planning, including the following issues:
- The fields of radiology and design for radiology have undergone numerous changes due to groundbreaking advances in technology,
- Development of digital imaging and PACS (picture archiving and communication systems)
- Rethinking the radiology environment from the point of view of patients, radiologist and staff, with the general goals of radiology facilities which increase patient and staff comfort, patient privacy, staff safety, and greater efficiency, speed, and through-put in the radiology workflow..
- Significant increases in worker productivity and improvements in the radiology workflow
- Eliminating film developing facilities, and also eliminating --- or at least drastically reducing --- the need for physical storage of hard copy films.
- Increases in legibility and reliability of scans
- Quicker responsiveness to patients.
- Reading room design.
- Ergonometrics for the new digital reading room
- Contemporary reading room must allow for future adaptability.
- Making the radiologists’ reading stations more comfortable, easier to use, and allowing for more control over the environment. Some more specific reading room design initiatives are listed below:
- Limiting Distractions
- Climate Control
- Seating and Positioning Adjustability
- Lighting specifications
- Unification of Systems
- Advances in scanning technologies. Among the most significant: 3.0T MRI’s are the upcoming standard in MRI design, multi-slice CT’s are the same for cat scan design, and digital mammography in the latest in mammography design.
- Mobile scanning equipment, such as portable CT
- Improvements in patient’s experience
- Philips “Ambient Experience”
- Relative growth of private practice radiology over academic, hospital-based radiology
- Opportunities for further development and improvement in the design of radiology facilities
- Patient comfort within the scanning machines s
- Advantages to separating healthy outpatients from very sick inpatients
- Separating women into a women’s center vs. co-mingling male and female throughout
- How the equipment will be changed out in future vs. concern exclusively with initial equipment access to space
- Green design --- eco-friendly design that is good for the environment as well as the patient --- is working its way through the healthcare environment, including the radiology department.
- Increased use of interventional radiology and surgical codes
The above article was written by the Ian Janer and William N. Bernstein, LEED®AP, AIA, of the well-known healthcare and hospital design firm of Bernstein & Associates, Architects. The firm’s principle, Mr. Bernstein, is a well-known architect and radiology consultant in radiology department planning and design. Mr. Bernstein is a graduate of the Yale University School of Architecture, who has specialized in healthcare design and construction for over 30 years.
About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm and specializing in the design and planning of radiology departments. The firm takes pride in providing the highest level of healthcare and hospital design work, with additional expertise in sustainable healthcare facilities, energy saving measures for hospitals, cost reduction strategies for hospitals, hospital safety and patient safety.
For Radiology Design see, http://bernarch.com/healthcare-design-radiology/
For more information about radiology department planning, design and construction, please contact:
William N. Bernstein, LEED®AP, AIA
Principal - Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A New York, NY 10011
Office: 212.463.8200 - Fax: 212.463.9898
Email: info@bernarch.com
www.bernarch.com
New Article to Be Published on Trends in Radiology Design and Operations
Bernstein & Associates, Architects is pleased to announce the upcoming publication of an article on recent trends in radiology design and radiology planning.
The article will be published in the July 2009 edition of Hospital Newspaper.
The article discusses the latest trends in radiology design and radiology planning, including the following issues:
- The fields of radiology and design for radiology have undergone numerous changes due to groundbreaking advances in technology,
- Development of digital imaging and PACS (picture archiving and communication systems)
- Rethinking the radiology environment from the point of view of patients, radiologist and staff, with the general goals of radiology facilities which increase patient and staff comfort, patient privacy, staff safety, and greater efficiency, speed, and through-put in the radiology workflow..
- Significant increases in worker productivity and improvements in the radiology workflow
- Eliminating film developing facilities, and also eliminating --- or at least drastically reducing --- the need for physical storage of hard copy films.
- Increases in legibility and reliability of scans
- Quicker responsiveness to patients.
- Reading room design.
- Ergonometrics for the new digital reading room
- Contemporary reading room must allow for future adaptability.
- Making the radiologists’ reading stations more comfortable, easier to use, and allowing for more control over the environment. Some more specific reading room design initiatives are listed below:
- Limiting Distractions
- Climate Control
- Seating and Positioning Adjustability
- Lighting specifications
- Unification of Systems
- Advances in scanning technologies. Among the most significant: 3.0T MRI’s are the upcoming standard in MRI design, multi-slice CT’s are the same for cat scan design, and digital mammography in the latest in mammography design.
- Mobile scanning equipment, such as portable CT
- Improvements in patient’s experience
- Philips “Ambient Experience”
- Relative growth of private practice radiology over academic, hospital-based radiology
- Opportunities for further development and improvement in the design of radiology facilities
- Patient comfort within the scanning machines s
- Advantages to separating healthy outpatients from very sick inpatients
- Separating women into a women’s center vs. co-mingling male and female throughout
- How the equipment will be changed out in future vs. concern exclusively with initial equipment access to space
- Green design --- eco-friendly design that is good for the environment as well as the patient --- is working its way through the healthcare environment, including the radiology department.
- Increased use of interventional radiology and surgical codes
The above article was written by the Ian Janer and William N. Bernstein, LEED®AP, AIA, of the well-known healthcare and hospital design firm of Bernstein & Associates, Architects. The firm’s principle, Mr. Bernstein, is a well-known architect and radiology consultant in radiology department planning and design. Mr. Bernstein is a graduate of the Yale University School of Architecture, who has specialized in healthcare design and construction for over 30 years.
About Bernstein & Associates, Architects: Founded in 1990, this company is an award-winning architectural firm and specializing in the design and planning of radiology departments. The firm takes pride in providing the highest level of healthcare and hospital design work, with additional expertise in sustainable healthcare facilities, energy saving measures for hospitals, cost reduction strategies for hospitals, hospital safety and patient safety.
For Radiology Design see, http://bernarch.com/healthcare-design-radiology/
For more information about radiology department planning, design and construction, please contact:
William N. Bernstein, LEED®AP, AIA
Principal - Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A New York, NY 10011
Office: 212.463.8200 - Fax: 212.463.9898
Email: info@bernarch.com
www.bernarch.com
Pharmacy Design Trends Article Published
For Immediate Release (06/10/09)
Bernstein & Associates, Architects is pleased to announce the publication of an article on recent trends in pharmacy design and pharmacy planning.
The article was published in the June 2009 edition of Pharmacy Design, the pharmacy design and pharmacy planning website, located at http://www.pharmacydesign.org/.
The article discusses the latest trends in pharmacy design in the following areas:
- Pharmacy design has been undergoing dramatic changes in recent years
- A main trend has been the need to modernize and automate the production, packaging, distribution, and provision of drugs, particularly of prescription drugs, which have to be monitored and secured at all times.
- Clients looking to design a pharmacy will want to be cognizant of these trends.
- The movement towards pharmacy automation has been spurred by a number of factors
- The new electronic systems mean fewer medication errors and tighter security, not to mention more reliably safe drugs.
- Successful pharmacy plans from now on
- Clean rooms in pharmacies
- USP 797 for pharmacies
- automated drug management
- Pharmacy automation equipment within the pharmacy
- Swisslog PillPick
- McKesson ROBOT-Rx
- Pharmacy automation equipment connecting the pharmacy to other hospital departments
- Pyxis Medstation
- Bedside pharmacy dispensers
- Pneumatic tube systems in the pharmacy
- Future of the retail pharmacy
- Latest trends in retail pharmacy interior design
The above article was written by the Ian Janer and William N. Bernstein, LEED®AP, AIA, of the well-known healthcare and hospital design firm of Bernstein & Associates, Architects. The firm’s principle, Mr. Bernstein, is a well-known architect and pharmacy consultant in pharmacy planning and design. Mr. Bernstein is a graduate of the Yale University School of Architecture, who has specialized in healthcare design and construction for over 30 years.
About Bernstein & Associates, Architects:
Bernstein & Associates, Architects has specialized in healthcare and lab design and construction since the firm's founding in 1990. This architecture firm is well-known for pharmacy planning, pharmacy design and pharmacy architecture, including a sub-specialty in usp 797 compliant pharmacy design and construction. The firm has designed over twenty new pharmacies, pharmacy renovations, and pharmacy relocations in the past five years. The firm is featured on the pharmacy design website, http://www.pharmacydesign.org/, and the usp 797 website, http://www.usp797.org/. The firm's principal --- William N. Bernstein, LEED®AP, AIA --- is a well known pharmacy architect. He has written extensively on pharmacy design and pharmacy construction including usp 797 compliant pharmacies. Mr. Bernstein's pharmacy design articles can be found on http://www.pharmacydesign.org/, and his usp 797 articles can be found on the usp 797 website http://www.usp797.org/.
For Pharmacy Design see, http://bernarch.com/healthcare-design-pharmacy/
For more information about healthcare and hospital design and construction, including pharmacy design and construction, contact Bernstein & Associates, Architects at:
Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A, NY, NY 10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
www.bernarch.com
NEW YORK - HARFTFORD - PRINCETON
Bernstein & Associates, Architects is pleased to announce the publication of an article on recent trends in pharmacy design and pharmacy planning.
The article was published in the June 2009 edition of Pharmacy Design, the pharmacy design and pharmacy planning website, located at http://www.pharmacydesign.org/.
The article discusses the latest trends in pharmacy design in the following areas:
- Pharmacy design has been undergoing dramatic changes in recent years
- A main trend has been the need to modernize and automate the production, packaging, distribution, and provision of drugs, particularly of prescription drugs, which have to be monitored and secured at all times.
- Clients looking to design a pharmacy will want to be cognizant of these trends.
- The movement towards pharmacy automation has been spurred by a number of factors
- The new electronic systems mean fewer medication errors and tighter security, not to mention more reliably safe drugs.
- Successful pharmacy plans from now on
- Clean rooms in pharmacies
- USP 797 for pharmacies
- automated drug management
- Pharmacy automation equipment within the pharmacy
- Swisslog PillPick
- McKesson ROBOT-Rx
- Pharmacy automation equipment connecting the pharmacy to other hospital departments
- Pyxis Medstation
- Bedside pharmacy dispensers
- Pneumatic tube systems in the pharmacy
- Future of the retail pharmacy
- Latest trends in retail pharmacy interior design
The above article was written by the Ian Janer and William N. Bernstein, LEED®AP, AIA, of the well-known healthcare and hospital design firm of Bernstein & Associates, Architects. The firm’s principle, Mr. Bernstein, is a well-known architect and pharmacy consultant in pharmacy planning and design. Mr. Bernstein is a graduate of the Yale University School of Architecture, who has specialized in healthcare design and construction for over 30 years.
About Bernstein & Associates, Architects:
Bernstein & Associates, Architects has specialized in healthcare and lab design and construction since the firm's founding in 1990. This architecture firm is well-known for pharmacy planning, pharmacy design and pharmacy architecture, including a sub-specialty in usp 797 compliant pharmacy design and construction. The firm has designed over twenty new pharmacies, pharmacy renovations, and pharmacy relocations in the past five years. The firm is featured on the pharmacy design website, http://www.pharmacydesign.org/, and the usp 797 website, http://www.usp797.org/. The firm's principal --- William N. Bernstein, LEED®AP, AIA --- is a well known pharmacy architect. He has written extensively on pharmacy design and pharmacy construction including usp 797 compliant pharmacies. Mr. Bernstein's pharmacy design articles can be found on http://www.pharmacydesign.org/, and his usp 797 articles can be found on the usp 797 website http://www.usp797.org/.
For Pharmacy Design see, http://bernarch.com/healthcare-design-pharmacy/
For more information about healthcare and hospital design and construction, including pharmacy design and construction, contact Bernstein & Associates, Architects at:
Bernstein & Associates, Architects - PLLC
59 West 19th Street - 6A, NY, NY 10011
T: 212.463.8200
F: 212.463.9898
E: info@bernarch.com
www.bernarch.com
NEW YORK - HARFTFORD - PRINCETON
Subscribe to:
Posts (Atom)