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

2. 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)

3. Class Presentations
Michael Trebbi

4. EMR Implementation

5. 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

6. 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

7. 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 _________

8. Workflow Process Mapping

9. 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.

12. 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

13. 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

14. 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

15. 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?

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

17. 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

18. 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

19. 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

20. 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

21. 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),  
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)

22. 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.

23. Flowcharting Symbols
How to create stunning flowcharts withi MS Word: