1. EHR IMPLEMENTATION: FACTORS FOR SUCCESS Tess Settergren, MHA, MA, RN-BC Director, Clinical Informatics July 19, 2005

2. What is EHR? A real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision-making. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting. (Brailer, 2005)

3. EHR Components Patient Data (PHI) –Discrete, structured, sometimes coded –Textual/other non-structured –Digitized images, biomedical, other Clinical Decision Support –Information Displays –Rules-based Order Entry (CPOE) –Best Practice Reminders, Alerts, Tools

4. EHR Components Clinical Messaging –Results & Other Clinical Management –Operational Efficiency Personal Health Record –View Results & Reports; Add Data –Patient Education Resources –Clinical Advice & Messaging Support of Secondary Data Use

5. EHR Building Blocks FUNCTIONAL BLOCKS Decision Support Multi- disciplinary Guidelines QM/UM Scheduling Results Reporting & Imaging Documen- tation Order Entry Registration Coding & Grouping Confidentiality and Security Unique Patient and Provider Identifiers Scanning Automated Data Capture Data Exploration and Display Tool TECHNICAL UNDERPINNINGS Scanning Automated Data Capture

6. EHR Target: Provider Level Patient RIGHT INFORMATION AT THE RIGHT PLACE TO THE RIGHT PERSON AT THE RIGHT TIME AT REASONABLE COST Staggers & Leaderman, 2000

7. EHR Target: Community Level Population Interconnected Clinicians & Informed Practice Personalized Care Care Quality-- Outcomes Resource Efficiencies Economic Growth Enabling Technologies

8. EHR Opportunities Technology & Standards Maturity Health Information Technology Financing Organizational (Cultural) Readiness Individual Adoption of Innovation Data Security & Availability

9. Transforming Healthcare Delivery Installation is hard, and mainly technical Implementation is really hard, and mainly organizational Transition (lasting change) is incredibly hard and purely human Transformation is a state of profound new personal and enterprise behavior [which accompanies the strategic acceptance of information technology] Cerner Corp

10. Diffusion of Innovation ( Rogers, 1995 )

11. EHR Evolution

12. CSFs for Successful Implementation Commitment to Redesigning Processes…a Vision Operations-Led IT Strategy Alignment with Strategy: Clinical/Operational, Financial, Customer Service, & Employee Learning/Growth Foundational to Organizational Metrics Integration of CLINICAL, FINANCIAL, & QUALITY Measures

13. CSFs for Clinician Adoption Engaged & Credible Leaders Managers Accountable for Success Data Availability & Flexible Displays Efficiency & Revenue Hooks Easiest Path to Doing It The Right Way Leverage Nursing Support of Providers Report Card Transparency Training, Training, Training; then Optimization