Introduction toGebaroff, Vasquez & Williams Consulting

Beginning with the End in Mind◦ Understanding your objectives is key

Build vs. Buy◦ Maximize benefit of software that already exists

An Iterative Process◦ A lot will be learned during this project: Put those

discoveries to work for you Formal Success Metrics

◦ It is important to agree on what “success is” and to measure it.

Common EHR-Related Goals◦ Qualifying for Incentives – e.g. Achieving Meaningful Use◦ Migration Towards an Accountable Care Organization

Model◦ ICD-9 to ICD-10 Transition◦ Increased Efficiency and/or Lower Error Rates

Collecting Metrics◦ For each objective, it is important to agree on a means by

which it can be measured.

Begin with Where You Are◦ Use surveys to measure how the hospital is perceived by

staff, patients and vendors. Paint a Compelling Picture of the Future Vision

◦ Bear in mind the survey results – Don’t create a vision no one will believe or want

Describe the Adventure◦ Be able to sketch out how you will realize the vision.

Identify:◦Project Steps◦Dependences◦Resources◦Timelines

Provide or Supplement Project Management Staff

The Importance of Sponsorship◦Be clear on who actually makes key decisions

The Role of Resistors◦Get them engaged in the project◦Otherwise they may engage in sabotage

The Role of Champions◦Not necessary technical experts◦Influential and enthusiastic

Internal Communication◦Making sure the hospital staff is kept informed◦Keeping rumor in check◦Maximizing motivation/contribution

External Communication◦Avoiding surprises◦Managing relationships / contracts◦Managing the hospital’s “brand”

Collection of Baseline Measurements◦ Examples:

Admissions / day Procedures / day Revenue / day

Document Workflows◦ Understand how people work today

Internal/External Interfaces◦ Understand which systems communicate with which

Review Infrastructure◦ What computers/networks/buildings might need to be upgraded?

Assess Skills◦ Who will need to be taught what?

Interfaces are critical due to:◦Cost◦Complexity◦Impact on multiple parties

Documenting Your Current Interfaces◦Identifying Internal and External Partners

Focus on simplification◦HL7 framework◦“Integration engine” vs. decentralized

Integration Engine

Devices

Labs

EMR

Imaging

Clinics

Admin

Protocols

HL7

HTTPS

LOINC

DICOM

X12N

Payers

Govt./HIE

Govt./HIE

Devices

Labs

EMR

Imaging

ClinicsAdmin

HL7

HTTPS /HL7

LOINC

DICOM

X12N

Payers

LOINC HL7

HL7

Identification of Modules and 3rd Party Add-Ons◦ What capabilities aren’t built into candidate solutions?

Issuing RFI’s◦ Getting the information you need

Issuing RFP’s◦ Formalizing how vendors will compete for your business

Software Hardware Property Rental or Acquisition Construction Arrange for Temporary Staffing

Iteration Planning◦ Which departments go first?

Implementation Prototyping◦ Let staff use new workflows, devices in a realistic setting

Data Migration◦ How will old data get into the new system

Finalize Integration Planning Phase◦ Develop a detailed timetable

Integration, Build and Test◦ Confirm that systems work when fully-assembled

Deploy the EHR Solution

Assessment and Feedback Report to Executive Sponsor and Board