Clinical integration is about leveraging the abilities of an Electronic Medical Record (EMR) to archive increased integration of practice workflow, referral management, and physician – patient – hospital coordination in the near term, and position for more effective use of clinical data in the longer term. The reasons to move forward with an EMR are compelling and include: Medicare requires it by 2014; the evidence that it improves clinical delivery is mounting; it provides the data that will be required for "value based reimbursement" (Pay-For-Performance and Risk Adjusted Reimbursement); it increases "Groupness" for contract negotiation; and physicians who have adopted EMRs are universal in stating that they would never "go back".

The JHD Group provides the clinical, technical, and implementation skills to install a common EMR in a private group (multi-specialty and single specialty), an IPA, or in a hospital affiliated physician organization. We assist the client to best determine how an EMR fits into its strategy, selecting the right vendor, and implementing the EMR so that it is effectively "operationalized" into the clinical practice. Our clinical integration services include:

	Clinical Enterprise Market Strategy: An EMR will, or should, change an ambulatory organization's strategy because of the impact it will have on how physicians interact in the market and how patients view the organization. Our approach assesses the current market strategy, the new opportunities an EMR would bring, and provides an "EMR business case" which reconciles investment, market position, threats, and opportunities into a pragmatic go-forward strategy.
	EMR Planning and Selection: We help the client identify and select a software system for Electronic Medical Record (EMR) and Electronic Practice Management (EPM) to achieve clinical integration across the practice, regardless of size, specialty, or location. Our approach is based on developing the business plan, selecting the necessary vendors, and developing an implementation/roll-out plan in 120 days, and with significant physician involvement.
	Readiness/Implementation Progress Assessments: Frequently organizations are unsure as to how ready their physicians (either employed, IPA physicians, or hospital community physicians) are to move forward with an EMR, or an EMR project may have been started and is now bogged down. The JHD Group can quickly make an assessment of what it will take to make an EMR project successful given the specific circumstances facing a physician or ambulatory service organization. Our assessments have the detail to be actionable and are rigorous on the cost – benefit considerations.
	Hospital – Community Physician Programs (Stark Safe Harbor): The October 2006 "Stark Safe Harbor" announcement opened the door for hospitals to in effect "fund" the acquisition of an EMR by community physicians. This announcement presents a "window in time" where hospitals, particularly in highly competitive markets, can increase the "bond" with their community physicians and dramatically improve the continuity of care and patient experience offered. The JHD Group understands the Stark Safe Harbor regulations and can help design and accelerate a program to support community physicians with an EMR. Our experience includes determining how to build a "subsidy program", how to organize and roll-out the project, and how to overcome the challenges of "inter-operability" associated with hospital – physician systems.
	Implementation Management: We provide the project management, clinical, technical and implementation skills necessary to install a common Electronic Medical Record (EMR) using a blended team of client and JHD Group professionals. We are experienced with the major vendors, most specialties, and all physician organization models. Our methodology includes a structured process for enterprise and practice "set-up"; practice readiness evaluations; written agreements with physicians as to responsibilities; "layered" training programs; practice workflow redesign; and implementation "Queue Management" disciplines. Subject to the specific situation and number of physicians, our cycle time for EMR/EPM implementation is 6 – 8 months and our contractual arrangements include going at risk for results.
	"Total Turnkey Implementation": In many physician EMR implementation projects, the client does not have the robustness needed in its Information Technology Department to support the necessity for 24/7 support, or the expertise in ambulatory operations support. For these clients the JHD Group has the ability to provide the servers, software support, desktop management, network management, help desk, implementation and training support, workflow redesign, and template development on a turnkey – outsourced basis.