System Implementation & Support LIS 4776 Advanced Health Informatics Week 9 Instructor: Dr. Sanghee Oh College of Communication & Information, Florida State University

Today’s Topic IT Alignment & Strategic Planning (Weeks 2,3 ) Records management IT governance; IT standards System Standards(Week 4,5,6,7) PHRs EHRs Health websites System Acquisition (Week 8) Vender Evaluation System Implementation & Support (Week 9, 10) No classes (Week 11): 3/22, 3/24 Medical Site Visit Presentations (Week 12): 3/29, 3/31 System Security (Week 13, 14)

Class Presentations Michael Trebbi

EMR Implementation

Things to think about when implementing an EMR Presentation Information Things to think about when implementing an EMR ______________ will drop __________ is necessary (for staff and MDs) Start Small …. Have an IMPLEMENTATION schedule … _________ (a myth!) CONFIDENTIAL

How to Implement EHRs (from HealthIT.gov) Step 1: __________________________ Why Implement EHRs? Assess Your Current Practice Envision the Future Set Goals (SMART) National Learning Consortium Resources https://www.healthit.gov/providers-professionals/ehr-implementation-steps/step-1-assess-your-practice-readiness#resource_table

How to Implement EHRs (from HealthIT.gov) Step 2: __________________________ ________ and _________ Steps in the Planning Phase Analyze and map out the _________________ and processes Map out ________________desired workflows and processes to improve inefficiency or duplicative processes (the future state). Create a ___________ plan or __________ plan. Create a project plan for transitioning from paper to EHRs, and appoint someone to manage the project plan. Understand what data elements may be migrated from your old system to your new one Identify concerns and obstacles regarding _________ and _________

Workflow Process Mapping

Class Activity Create a flowchart of a clinical workflow. Reception: From scheduling an appointment with a new patient to creating a chart of the patient. Medication refill: From receiving a request of medication refill from a patient to providing the refill to the patient.

How to Implement EHRs (from HealthIT.gov) Step 3: ________________________________ Understand if and how a vendor's product will accomplish the key goals of the practice. Clarify _________before selecting an EHR system Define implementation support Clarify _________, _________, and _________ for data migration strategy if desired. Ability to integrate with other products (e.g., _________, _________, and _________) Privacy and security capabilities and back-up planning Vendor's _________ and/or _________in region

How to Implement EHRs (from HealthIT.gov) Step 4: _________________________________ Chart abstraction plan and other data migration plans in conjunction with your EHR vendor Execution of an EHR implementation _________that includes practice specific goals and needs, as well as compliance with Meaningful Use objectives Privacy and security risk management mitigation plan Chart Migration and Scanning Checklist https://www.healthit.gov/providers-professionals/implementation-resources/chart-migration-and-scanning-checklist

How to Implement EHRs (from HealthIT.gov) Step 5: __________________ Improve _________, _________, _________ Engage Patients & Families Improve Care Coordination Improve Public and Population Health Ensure Privacy and Security for Personal Health Information

How to Implement EHRs (from HealthIT.gov) Step 6: ____________________________ Were the _________ and needs met? Do _________need to be re-evaluated? Is additional training required? Are you capturing the required data elements needed for internal clinical priorities, as well as for reportable quality measures? Do staff _________need adjustments? Is the technology in the _________ locations, _________, and “_________”? Is additional hardware needed?

Pre-Implementation: Step 0 Presentation Information Pre-Implementation: Step 0 BEFORE YOU IMPLEMENT Step 0 GOALS PEOPLE PLANS Strategic Planning CONFIDENTIAL

Pre-Implementation: Step 1 Presentation Information Pre-Implementation: Step 1 Make a list of EMR vendors Check with other practices of similar size/specialty Visit other offices for the day Review published articles on vendors Review ranking of vendor satisfaction – AAFP Create a list of appropriate criteria Ability to include legacy software Ability to pull in paper records Ability to expand in the future Ability to integrate new technology Ability to meet revenue needs Vendor Evaluation CONFIDENTIAL

Pre-Implementation: Step 2 Presentation Information Pre-Implementation: Step 2 Create implementation team Identify budget Identify Equipment needs Create Gantt Chart Narrow choices of Vendors Plan a testing schedule for EMR vendors to come and demonstrate IT Needs Assessment CONFIDENTIAL

Presentation Information Implementation: Step 1 Identify training needs of office staff Choose vendor Negotiate final contract Start data conversion of demographic data Vendor Selection CONFIDENTIAL

Presentation Information Implementation: Step 2 Continue training Preload systems with new patients and the last 3 months of patient data Enact Record Management strategy for old paper records (REPORT 2) Test system interactions, functionality, etc. Build in training time and “learning time” for office staff and MDs Communicate changes to patients Training and Tests CONFIDENTIAL

Report 7: Vendor Evaluation Part 1 Read the article, McDowell, S.W., Wahl, R., and Michelson, J. (2003). Herding cats: The Challenges of EMR vendor selection. Journal of Healthcare Information Management, 17(3), 63-71.  For the article, Herding cats, read and review the Appendix: Criteria for Evaluation of Electronic Medical Record System Vendors. What would you add to the list? (add at least 2)  RANK the seven (+ your additions) categories listed in the order of importance you would give them.  Why/How did you choose #1? (a paragraph)  Part 2 Create Vendor Evaluation Flowchart. Include at least 10 measures that you think important. (1 page)

Criteria for Evaluation of Electronic Medical Record System Vendors Ability to execute (due diligence) Functionality Current technology architecture Service and support Relationship Company vision for future technology architecture Pricing and products See the Herding_Cats article in Canvas> Modules > Week 8 or Canvas > Assignment > Reports > Report 8.

Flowcharting Symbols How to create stunning flowcharts withi MS Word: http://www.makeuseof.com/tag/create-stunning-flowcharts-microsoft-word/