EHR Planning Your EHR Implementation

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    Planning Your EHRPlanning Your EHR

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    Webinar

    Schedule

    October

    27

    and

    30

    SelectingyourEHR January26and29

    February23and26

    p m z ngyour or ua yImprovement March23and26

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    Looking

    for

    More

    Information?

    Live,comprehensive,

    6part

    series

    on

    each

    Limitingseries

    to

    40

    participants

    SeriesstartsDecember11inRaleigh,NC

    ContactEHRservices@thecarolinascenter.or

    formore

    info

    and

    to

    register

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    Why

    Promote

    EHR/

    HIE?Why

    Promote

    EHR/

    HIE?EffectiveEHR/HIEImplementationwill:

    Improvepatient

    quality

    of

    care

    Preventmedicalerrors

    Reducehealthcarecosts

    Decreasepaperwork

    Expandaccess

    to

    affordable

    care

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    Prework

    Assessment

    EHR

    system

    selection EHRsystemimplementation

    EHRpostimplementationevaluation

    Clinicalsystemimprovement

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    Review:

    Pre

    work

    Steps1. Performfinancial/ROIassessment

    2. Confirmsenior

    level

    commitment

    3. Assi na h siciancham ion

    4. SelectEHRimplementationteam

    .

    6. LearnEHRhardwareandsoftwareterms

    7. Reviewrecommended

    EHR

    functionalities

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    Review: AssessmentSteps

    Performreadinessassessment

    Assess

    practice

    cu ture

    Evaluatetheenvironmentforchange

    Assesscomputerskillsofallemployees

    Evaluatehardwareandnetworkingneeds

    Per ormwor ow

    ana ys s

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    EHRA option

    Step

    3

    EHRA option

    Step

    3ann ng ourann ng our

    mp emen a onmp emen a on

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    Planning

    StepPlanning

    Step IncludesIncludes Createplans: Turnassessmentfindingsinto

    ac ona e n orma on.

    Planforbackloadingandscanningpapercharts

    DetermineImplementationApproach

    implementation

    measurements

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    ep

    CreatePlans

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    TurningAssessmentintoAction

    Create documentedplansfor:

    resourceassi nmentmatrix

    Trainingneeds

    (computer

    skills,

    other)

    communications Interfaceandconversionneeds

    Functionalit wishlist/vendorselectionmatrix

    processimprovementplanspre/postEHR

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    TrainingPlan

    Plancomponents

    as ccompu ers san yp ng ra n ngnee e

    Staffneedingtraining

    Communityorotherresourcesavailable

    Costsassociated

    Schedulesforstafftraining

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    HardwareandSoftwarePlanPlancomponents:

    , ,

    workstations,etc

    new

    network

    drops

    (if

    necessary) newelectricaloutlets(ifnecessary)

    wirelessnetworkneedsincludingsuggested

    placementof

    access

    points

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    CommunicationsPlan

    Plancomponents

    Stakeholdercommunications

    Implementationteammeetingschedule

    a commun ca ons

    Requirementsforwrittenv.verbal

    communication

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    InterfaceandConversionPlan

    Detailedaccount

    of

    the

    interfaces

    needed

    Plan

    for

    current

    PM

    system

    (keep

    or

    replace) Detailedaccountofneededdataconversions

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    FunctionalityWishList

    Plancomponents

    ,

    functionalityis

    important

    to

    your

    practice?

    epor ngrequ remen s

    Planfor

    assuring

    CCHIT

    and

    meaningful

    use

    criteriaareincludedintheEHR

    Creationofavendorselectionmatrix,oralist

    ofquestions

    that

    will

    be

    asked

    of

    every

    vendorandamethodforcomparingresults

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    ProcessImprovementPlan

    Detailedaccount

    of

    the

    issues,

    bottlenecks,

    ,

    Based

    on

    your

    workflow

    analysis,

    what

    issues

    nee to ea resse preEHR

    WhichissuescanberesolvedwiththeEHR?

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    BudgetandFundingPlan

    Estimateddirect

    cost

    of

    implementation

    Estimate in irectcosto imp ementation

    Estimatedrevenue

    increases

    Estimatedrevenuesavings

    Fundingplans

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    DetermineImplementation

    Approach

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    Approach1BigBang

    systemfunctions

    are

    turned

    on

    at

    go

    live

    and

    , ,

    supportstaffusetheEHRastheirsolemeans

    otherpatientrelatedtasks.

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    Approach1BigBang

    Pros

    Cons

    time Shortenspainfulparallel

    Significantlyhigher

    productivityhitatgolivepaper/EHRoperational

    periodandsometimeafterward

    Staff

    or

    physicians

    unable

    to

    investmentmuchquicker

    Lesslikelytogetstuckpart

    ea w c angemayre e

    Doesntallowfor

    tweakin the rocess

    wayto

    the

    goal

    Takesadvantageofstaffbased

    on

    lessons

    learned

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    Approach2Phased

    toease

    into

    the

    EHR.

    The

    office

    goes

    live

    with

    asmessagingandprescriptionrefills)and

    visits.

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    Approach2PhasedPros Reducesimplementation

    Cons

    Totalimplementationand

    pa nstoonegroup unct on

    atatime

    tra n ngcostsmay e g er

    ROIis

    not

    achieved

    as

    hardwareandsoftware

    over

    a

    longer

    period

    of

    time

    Riskgettingstuckpartway

    tothe

    goal

    Lessriskof failure

    CANhelpbuildsupportina

    Canbeexhausting imparts

    thefeelingthatthingsare

    Minimizeproductivityloss

    Allowstimetotweakthe

    Hybridpaper/EHRsystemcanbeconfusing

    process

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    PhasedApproachSuggestions

    , ,

    allergies,problems

    lists,

    vitals,

    messaging,

    lab

    ,

    Phase2:prompts/reminders,orders,referrals,

    Phase3: advancedclinicaldecisionsupport,

    pat ent

    ea t

    ma ntenancemo u es,

    c ron c

    illnessflowsheets/tracking

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    ep

    Backloadin

    andScannin

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    BackloadingandScanning

    electronicallyscanning

    your

    paper

    medical

    .

    Backloadingreferstotheprocessofmanually

    EHR.

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    BackloadingandScanningKey

    Considerations

    Whichpaper

    charts

    will

    be

    scanned?

    All

    charts? Activecharts?

    Whatorderwillthechartsbescanned?

    Willindexingbeused?

    Whichparts

    will

    be

    manually

    backloaded

    ?

    Whowillscan? Backload? AndWhen?

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    Moreconsiderations

    Processfornew,incomingdocuments?

    Enoughspace

    for

    ahigh

    volume

    scanner?

    Willscanneddocumentsbe

    searchable/reportable? Postscanpaperdocumentstorage?

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    BackloadingandScanningTip

    ,

    todevelop

    apaper

    to

    electronic

    transition

    apatientschart.Forexample,shouldthey

    patientschart?

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    Step

    4Step

    4

    ImplementationImplementation

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    Hopeisnotaplan

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    WhyCreateaWorkplan?

    Helpscommunicatetheimplementation

    toplan

    the

    timing

    of

    specific

    implementation

    tasks

    canbe

    used

    to

    plan

    resource

    allocation

    for

    eachimplementationtask

    Anaidinvendorcontractne otiations.

    Tomonitor

    and

    control

    the

    implementation

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    I

    you

    aveac ear

    v s on

    o

    WHEN

    occur,you

    can

    add

    specific

    languagetoyourEHRvendor

    livewhenYOUneedittobe.

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    SampleBaseWorkplan

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    CreatingtheWorkplan

    StartwithabaseEHRimplementationplan

    .

    Plugin

    your

    desired

    live

    date

    and

    then

    work

    ac war s o n eres o e a es.

    Fill

    in

    who

    will

    be

    responsible

    for

    each

    task.

    Theworkplanwillneverbesetinstoneso

    anticipatechangestoyourworkplan.

    TheEHR

    vendor

    you

    choose

    may

    also

    have

    ste sthatneedtobeaddedtothework lan.

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    Step

    5

    and

    Measurements

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    WhySetGoals?

    Helpsdefinesuccessfortheimplementation

    an overa qua ty mprovement

    Whenyoudefineyourgoals,youcandefine

    yourneedsandactions

    When

    oudefine

    our

    needs,

    ou

    can

    select

    anEHRsystemthatwillmeetyourneeds

    communication

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    GoalSettingBasics

    GoalDefinition: Setclear,measurablegoalsconditions.

    ActionPlan: Foreachgoal,defineaplanofactionforachievingthegoal.Whatspecific

    steps oyounee tota etoreac yourgoa

    MeasuringSuccess: Determinehowyouwillmeasure

    the

    success

    of

    your

    action

    plan.

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    SampleGoal

    Goal: Decreasethenumberofpharmacy

    ActionPlan:

    Use

    the

    eprescribing

    feature

    in

    theEHRtoeliminatepaperandhandwritten

    prescriptions.Utilizethedruginteraction

    c ec ing eatureo t eEHRtoguar against

    druginteractions

    Measureof

    Success:

    In

    two

    months,

    have

    an

    85%reductioninpharmacyphonecalls

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    SampleGoal

    and

    reduce

    transcription

    cost.

    EHRtoeliminatetheneedfortranscription

    .

    MeasureofSuccess: Withintwomonthsofve,

    re uce

    t e

    cost

    o

    transcr pt on

    y80%.

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    GoalSettingGuidingPrinciples

    ,

    samplesize

    and

    complicating

    factors

    ,

    Involveeveryoneinoffice brainstorm

    Defineaplanofactionforachievingthegoal

    Determinehow ouwillmeasurethesuccess

    ofyour

    action

    plan

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    Contact CCME

    TheCarolinasCenterforMedicalExcellence9193809860asktospeakwithEHRServices

    YoumayvisitCCME

    www.thecarolinascenter.org/EHRYoumayalsoemail

    EHRServices@thecarolinascenter.org

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