2. Patricia Alafaireet

3.  Lecture 2 – Implementation and go-live strategies Data conversion Communication Planning Downtime

4.  Upon completion of this lecture, students will be able to: Identify implementation strategies and understand the need for data conversion planning Develop effective communication messages Identify and assess potential downtime issues and apply a tool to develop at least one approach to one downtime issue

6.  Chart review  Charting for core data (problem lists, medications lists, allergies, preventive health dates, tobacco and alcohol use) [11]

7.  Retain up-to-date chart summary  Identify what information will need to be scanned for placement in chart [11]

8.  Finalize contract  Prepare detailed implementation plan  Begin lab interface [11]

9.  Order hardware  Decide on workstation and service configuration  Complete Internet connection planning  Complete interfacing (practice management, PACs, etc.) [11]

10.  Set security policy  Install and test software  Begin staff training  Determine coding systems to be used  Review vendor generated templates and begin customization  Review forms used in practice and decide if they can be digitalized [11]

11.  Finalize implementation plans  Adjust patient schedules for implementation period  Set up and test printers  Test interfaces [11]

12.  Begin application specific training  Re-check system configuration and specifications  Create an implementation “problem” team  Review last minute details with all staff [11]

13. Use a Tool to Help with Decisions in Implementation and Go-Live Phase including:  Data mapping and conversion of data  Hardware and software considerations  Data loading  Configuration of systems  Conversion timeframe and strategy  Testing and Training

14. Implementing a new practice management system as part of an EMR implementation:  May make financial sense  May well prove overwhelming

15.  Creating practice-wide workflow practice management implementation  Implement 60 days prior to EMR  Prepare to rebuild patient scheduling  Prepare to rebuild billing

16.  The Rollout and Turnover Strategies Checklist developed by the national Health Information Technology Research Center (HITRC) found at: http://hitrc-ollaborative.org/confluence/ dosearchsite.action queryString=of+Rollout+and+Turnover+Strategies+http://hitrc-ollaborative.org/confluence/ dosearchsite.action queryString=of+Rollout+and+Turnover+Strategies+ Includes suggested timeframes Used to record the documentation

17.  The “Develop Workflow for Migrating Practice Management System Data” guidelines which are also available through HITRC can be found here: http://hitrc- collaborative.org/confluence/display/CoPimpPM/Workflo w+for+Practice+Management+System+Data+Migrationhttp://hitrc- collaborative.org/confluence/display/CoPimpPM/Workflo w+for+Practice+Management+System+Data+Migration

19.  Vender customer relationship necessary to successfully implement information technology  Successful implementation of information technology is based on effective communication [14]

20.  Face to face interaction  Training, tracking, and testing,  Status reports  User tips, user support services and new feature information  Subject matter experts and information sharing on new federal legislation  Periodic follow up visits, surveys and courtesy calls

21.  Changes brought by the implementation of new technology have far reaching ramifications  Communication across all stakeholders presents a challenge.  Many healthcare organizations lack internal support to draft and disperse effective communications [14]

22.  Stratis Health, has developed a matrix of 30 messages that should be created for any IT implementation. Let’s look at their tool, found here:  http://www.stratishealth.org/search/results.html?cx=0174 10084581823431738%3A2kz_uqgs8_g&cof=FORID%3 A11&ie=UTF-8&q=communication&Searc http://www.stratishealth.org/search/results.html?cx=0174 10084581823431738%3A2kz_uqgs8_g&cof=FORID%3 A11&ie=UTF-8&q=communication&Searc

24.  Period of time during which the IT is non-functional  Time needed to recover from the effect of non- functioning information technology  Is unavoidable [15]

25.  Help staff determine if downtime procedure should be followed  Specify how documentation should be handled  Help prepare for the transfer of information  Be a regular part of employee training [15]

26.  Unplanned  Planned  Both should have policies and procedures in place and staff should be trained.[15]

27.  Registration  Scheduling  Patient calls  Laboratory and radiology results  Orders and prescriptions  Dictation and transcription  Documentation needed for special projects or studies  Charge capture [15]

28.  Should be part of downtime planning  Should be ordered logically from registration to billing  Should include data flow to and from interfaces  Should include plans for back filling of data  Should include manual data entry plans [15]

29.  Regular use to help staff gain experience  Walk though by disaster planning staff  Assessment of staff knowledge of downtime polices and procedures  Identification of any gaps [15]

30.  The American Health Information Management Association’s tool to help healthcare organizations successfully create downtime policies and procedures “PLAN B - A Practical Approach to Downtime Planning in Medical Practices” can be found here:  http://library.ahima.org/xpedio/groups/public/documents/ ahima/bok1_045486.hcsp?dDocName=bok1_045486 http://library.ahima.org/xpedio/groups/public/documents/ ahima/bok1_045486.hcsp?dDocName=bok1_045486

31.  Implementation strategies and data conversion planning are both needed to ensure a successful IT implementation.  Effective strategies and effective communication messages are essential to the IT implementation process.  For every IT implementation there are potential downtime issues and using a tool to develop approaches to downtime is an effective solution.

32.  References for material used in this lecture can be found at the end of the slides for lecture 3 in this module.