1. 7/20/2012 University of New Mexico * Department of Pediatrics * Envision New Mexico 1

2. Kevin Werling, Systems Analyst Technical Software Support/Implementation Support Specialist November 28 & 29, 2012 7/20/2012 2 University of New Mexico * Department of Pediatrics * Envision New Mexico

3.  NEW To connect audio, please telephone 1-866-260-9581 (no access code needed)  Please mute/un-mute your telephone line by pressing *#. You may also press your mute button on your headset or speakerphone during the webinar when you are not speaking.  Do not place your phone on hold.  If you wish to receive CME/CEU/ or an attendance certificate, you must announce your name when we ask who is participating both at the start and at the end of the session. Your certificate will be emailed to you after the end of this calendar quarter.  If you are called on and do not wish to answer, feel free to say “pass”. 11/7/2012 3 University of New Mexico * Department of Pediatrics * Envision New Mexico

4. Disclosure:Accreditation:  UNM CME policy, in compliance with the ACCME Standards of Commercial Support, requires that anyone who is in a position to control the content of an activity disclose all relevant financial relationships they have had within the last 12 months with a commercial interest related to the content of this activity.  The presenter discloses that he/she/they have no relevant financial relationships with any commercial interest.  The University of New Mexico School of Medicine, Office of Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The Office of Continuing Medical Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  Envision NM is a division of the UNM Department of Pediatrics and receives funding from the NM Department of Health and the NM Human Services Department. 11/7/2012 University of New Mexico * Department of Pediatrics * Envision New Mexico 4

5. 7/20/2012 5 University of New Mexico * Department of Pediatrics * Envision New Mexico  Outline steps involved in preparing an organization for implementing an electronic health record system  Outline the steps involved in implementing an electronic health record system

6.  Goal: Interoperability of EHRs, practice management systems, patient portals, billing systems, ePrescription systems, and state/federal registries  Standards (defined by Office of National Coordinator):  Requirement of interoperability; removes barriers to interoperability  EHR/HIT History Timeline (handout)  Expectations: real-time interoperability, telehealth, mobile devices, implantable microchips 7/20/2012 6 University of New Mexico * Department of Pediatrics * Envision New Mexico

7.  Server or Internet (Cloud)-based EHR system?  # of users  # of in-house support staff  Hardware/software currently in place  IT Support currently in place  Server-based system typically for large organizations  Internet-based system typically for smaller organizations (less costly up front) 7/20/2012 7 University of New Mexico * Department of Pediatrics * Envision New Mexico

8.  Request for Proposal (RFP)  Invitation to vendors  RFP Benefits  Forces organization to describe needs before involving a vendor  Helps organization compare vendors and understand potential project risks 7/20/2012 University of New Mexico * Department of Pediatrics * Envision New Mexico 8

9.  RFP Elements  Overview of business issue  Description of product/services required  Detailed business requirements  Proposal format  Due date  Selection criteria  Time line  How to respond  Point of contact 7/20/2012 9 University of New Mexico * Department of Pediatrics * Envision New Mexico

10.  Resources  Broader Description of RFP Elements http://www.epiqtech.com/request-for-proposal- rfp.htm http://www.epiqtech.com/request-for-proposal- rfp.htm  HIMSS RFP Sample Documents http://www.himss.org/ Must be a member to access documents. 7/20/2012 10 University of New Mexico * Department of Pediatrics * Envision New Mexico

11.  Stakeholders  Physicians (champion)  Nurses  Patients  Clerical staff  Lab staff  Management  Suppliers  Community 7/20/2012 11 University of New Mexico * Department of Pediatrics * Envision New Mexico

12.  Stakeholders (cont.)  Involve in all aspects of planning  Communication planning  Design benefits plan and tracking  Process gap analysis  Policy procedure changes  Learning plan (training depends on role)  Roll of Project Manager  Keeps all stakeholders in mind  Leads the project and timeline 7/20/2012 12 University of New Mexico * Department of Pediatrics * Envision New Mexico

13.  Project Cost  Capital  Licenses  Maintenance  Staffing  Financial strength of vendor  Ratings (KLAS)  Integration with current software systems 7/20/2012 13 University of New Mexico * Department of Pediatrics * Envision New Mexico

14.  Roll out testing  Full roll out in tandem with current system (paper charts)  Intended as a temporary deployment for a limited time  Pilot Testing  Roll out for a pilot group (adequate cross-section) of users  Helps test in real world with limited amount of users/entries  Pilot test group members should include some super users who can spot bugs quickly. All issues should be reported to the Project Team. 7/20/2012 14 University of New Mexico * Department of Pediatrics * Envision New Mexico

15.  Training and support considerations are paramount for either type of roll out  Train prior to implementation  Train immediately before implementation  Have extra support staff available for implementation period 7/20/2012 15 University of New Mexico * Department of Pediatrics * Envision New Mexico

16.  Big Bang Roll Out = All users + all modules + all equipment  Pros  Short term disruption  No need for linking old system with new  Only one system to support  Cons  Much higher risk to organization  Requires comprehensive planning  Mass training required 7/20/2012 16 University of New Mexico * Department of Pediatrics * Envision New Mexico

17.  Phased Roll Out = groups at a time of users + modules + equipment  Pros  Progressively adjust implementation strategy  Focused planning  Disruptions are isolated  Smaller groups of users affected  Cons  Need to maintain two systems (old and new)  Risk of stagnation  Need to correlate information from both systems 7/20/2012 17 University of New Mexico * Department of Pediatrics * Envision New Mexico

18.  Command Center  For big bang rollout  Serves as project help desk and meeting place  System Change Management  PDSA – Plan, Do, Study, Act method  6-step method  Record/classify  Assess  Plan  Build/Test  Implement  Close/Gain Acceptance 7/20/2012 18 University of New Mexico * Department of Pediatrics * Envision New Mexico

19.  HIMSS – Healthcare Information and Management Systems Society (founded 1961) http://www.himss.org/ http://www.himss.org/  KLAS http://www.klasresearch.comhttp://www.klasresearch.com  Epiq Advanced Supply Management (RFP information) http://www.epiqtech.com/request-for-proposal- rfp.htm http://www.epiqtech.com/request-for-proposal- rfp.htm  New Mexico Health Information Technology Extension Center http://nmhitrec.orghttp://nmhitrec.org 7/20/2012 19 University of New Mexico * Department of Pediatrics * Envision New Mexico

20.  Plan, Do, Study, Act Form (Envision NM’s Tools & Resources page) http://envisionnm.org/xpdf/PDSA_Fillable_Form_9- 6-2012.docx http://envisionnm.org/xpdf/PDSA_Fillable_Form_9- 6-2012.docx  Six-step system change management http://en.wikipedia.org/wiki/change_control http://en.wikipedia.org/wiki/change_control 7/20/2012 20 University of New Mexico * Department of Pediatrics * Envision New Mexico

21.  If you wish to receive CME/CEU/ or an attendance certificate, please tell us your name.  Please un-mute your telephone line by pressing *#. 9/21/2012 21 University of New Mexico * Department of Pediatrics * Envision New Mexico

22. Envision New Mexico Staff Directory Telephone 505-925-7600www.EnvisionNM.org Jane McGrath, MD, FAAP Program Director jmcgrath@salud.unm.edu Kris Carrillo, LISW Program Operations Director kcarrillo@salud.unm.edu Dan Rifkin, MD Child and Adolescent Psychiatrist drifkin@salud.unm.edu 9/21/2012 22 University of New Mexico * Department of Pediatrics * Envision New Mexico Kirsten Bennett, MS, RD, LD QI Training, Consultation and Outreach kdbennett@salud.unm.edu Terri Chauvet Administrative Assistant III tchauvet@salud.unm.edu Carole Conley, LMSW QI Training, Consultation and Outreach cconley@salud.unm.edu Paula LeSueur, CFNP CHIPRA Manager plesueur@salud.unm.edu Kristine Lucero Accountant II krisgonzales@salud.unm.edu John Martinez QI Training, Consultation and Outreach johnLMartinez@salud.unm.edu Janette Schluter Program Data Specialist jschluter@salud.unm.edu McKane Sharff CHIPRA Program QI Specialist msharff@salud.unm.edu Jeanene Sisk Administrative Assistant II jsisk@salud.unm.edu Clancey Tarbox Program Coordinator ctarbox@salud.unm.edu Kevin Werling Systems Analyst ll kwerling@salud.unm.edu Michelle Widener Data Analyst miwidener@salud.unm.edu Nancy Vandenberg CHIPRA Program Youth Specialist nvandenberg@salud.unm.edu

23. Thank you 23