HIT Update and Evaluation ToolsJune 18, 2013

Self Assessment

• Needs Assessment• System Diagram• Evaluation Tool Preparation• Evaluation Tool

Needs Assessment

Needs Assessment

• Gather the needed information. – Problems and opportunities– Distinguish real needs from exaggerated needs

• Review and Prioritize the needs.– How do they relate to technology– How do they relate to organizational structure– How do they relate to process/workflow

Needs Assessment

• Predict the future.– Service level mix– Community needs– Funding

• Document the results.• Peer review, solicit comments.• Publish.

System Diagram

• For current systems– Identify each system currently in use.– Identify relationships between systems.– Identify interfaces between system.

• Based on needs defined in the assessment– Diagram the future systems and relationships– Security– Sustainability

Sedgwick County Initial Diagram

KIPHS

PsychConsult

WHIEKHIN

Records Access

EmdeonWebIZ EpiTraxTrisano

BioSenseX-SintinelReport

Management/ BI / Warehouse

KHINWHIE

Secure Messaging

I Boss Well/ We Plan Well

ClearHealth

ChallengerSoft FIMR Bassinet

KWIC Evaluation Web

SAS Analytics Pro

Dispensing Database (Access)

ePHAB

QA

Imaging/ScanningInsurance Cards

Lab Results

Lab Equipment Interfaces

Sustainability

Public Client Portal

Kiosk Outbound Dialing/Reminders

ePrescribe

Sedgwick County Health DepartmentComputing Systems Architecture as of September 12, 2012

Current Applications Potential Applications

Missing Functionality

Weak Values

Sedgwick County Preferred FutureSedgwick County Health DepartmentPossible Computing Systems ArchitectureAs Of September 12, 2012

EMRReport

Management/ BI / Warehouse

KWICWebIZEpiTraxTrisano

ePrescribe

Lab Results

WHIEKHIN

Records Access

Kiosk Evaluation Web

Stand-Alone Applications

ePHAB I Boss Well/ We Plan Well SAS Analytics Pro BioSense X-Sintinel

FIMR Bassinet

Evaluation Tool Preparation   For Each of these service types, provide the average number of Encounters per MonthQ.1 Adult Immunizations Q.2 Correctional Health Q.3 Diabetes Support Group Q.4 Family Planning Clinic Q.5 Food Safety Education Q.6 Foot Care Q.7 Health Maintenance Services Q.8 Healthy Start Visitor Program Q.9 HIV/AIDS Screening Q.10 HIV/AIDS Treatment Q.11 Home Health Q.12 Hospice Q.13 KanBe Healthy/School Entry Physicals Q.14 Laboratory Services – Comprehensive Q.15 Laboratory Services – Minimal Q.16 MCH Home Visits Q.17 Oral Health Q.18 Prenatal Care Q.19 School Health Q.20 School-Based Clinics Q.21 STD Screening Q.22 TB Treatment Q.23 Tobacco Prevention Q.24 Weight Management Q.25 Other Chronic Disease Support Groups

Evaluation Tool Preparation  For the Entire OrganizationQ.26 Number of Locations Determine the number of office locations where the records will be accessed.

Q.27 Number of Staff – MD Determine the number of MD level staff that will use the system.Q.28 Number of Staff – PA/APRN Determine the number of PA/APRN level staff that will use the system.Q.29 Number of Staff – RN Determine the number of RN level staff that will use the systemQ.30 Number of Staff – Other Licensed Medical Determine the number of other licenses medical staff that will use the system.

  Mission Alignment/Goal Congruence Q.31 Does Your Organization’s Mission Include Patient Care? The mission statement may or may not include statements about patient care.

This will indicate the organization’s high level direction for services to the public.

Q.32 Does our organization have goals for improved efficiency and effectiveness

The mission statement goals may or may not contain statements about improving efficiency and effectiveness of service levels. These should be related to clinical services to be included.

  Staff Acceptance – Change ManagementQ.33 Evaluate the ability of staff to accept electronic records Rate your staff on their ability to accept and use electronic medical records.

Q.34 Strength of Change Culture Rate your organization culture for the ability to embrace change.Q.35 Implementation Commitment Rate your organization on the level of commitment to complete the

implementation.  Data Analysis Requirements/Capacity – Evaluate the need for the organization to monitor or analyze the following dataQ.36 Program Level Data Rate the need to analyze data at the program level.Q.37 Utilization Data Rate the need to analyze data on service utilization.Q.38 Diagnosis Data Rate the need to analyze services by diagnosis.Q.39 Performance Metrics Analysis Rate the need to analyze performance metrics data.Q.40 Cost of Service Delivery Rate the need to have cost metrics by serviceQ.41 Evaluate the Analysis Capacity of Staff Evaluate the ability of staff to analyze data  Cost of Purchase/Implementation Q.42 Financial/Budget Capacity to Purchase and Implement

the System at $100/EmployeeEvaluate the capacity to purchase and implement the system at a cost of $100 per employee.

Q.43 Financial/Budget Capacity to Purchase and Implement the System at $250/Employee

Evaluate the capacity to purchase and implement the system at a cost of $250 per employee

Evaluation Tool PreparationQ.44 Meaningful Use Incentive Eligibility Is your organization eligible for Meaningful Use incentive funding?Q.45 Have You Performed and ROI Analysis Is there an analysis for Return on Investment  System SustainabilityQ.46 Annual Maintenance at 20% of Purchase Price Evaluate the financial capacity to spend 20% of the purchase price on

annual maintenance.Q.47 IT Expertise to Support On-Going Operations Evaluate the level of IT expertise to maintain and upgrade the

infrastructure needed to support on-going operations.Q.48 Financial/Budget Capacity to Maintain and Upgrade

InfrastructureEvaluate the financial capacity to maintain and upgrade IT infrastructure needed to support on-going operations.

  Insurance ClaimsQ.49 Claim Volumes for Electronic Interface 835/837

Insurance Claims/MonthEstimate the claim volumes that would be or are in an 835/837 Electronic Interface each month.

Q.50 Have Payers Eliminated Paper Claims Have any of your insurance payers stopped accepting paper claims.Q.51 Budget Available for Clearing House Expense Evaluate the financial capacity to pay for clearing house services for

claims and insurance verification.  Electronic PrescribingQ.52 Script Volumes to Pharmacy/Month Estimate the volume of scripts sent to the pharmacy each month.Q.53 Pharmacy/Dispensing Data to HIE Evaluate the need to report pharmacy and/or dispensing data to the HIE.  Drug DispensingQ.54 Dispensing Volume/Month Estimate the volume of drug dispensing each month.Q.55 Number of Different Medication Types Estimate the number of different medication types dispensed.  External LabQ.56 Volume of Lab Orders/Month Estimate the number of lab orders each month to an external lab.Q.57 Critical or Abnormal Results/Month Estimate the number of abnormal results each month from the external

lab.  Lab Equipment InterfacesQ.58 Internal Lab Equipment Capability to Interface to the

EMRDetermine the ability of internal lab equipment to directly interface with an EMR.

Q.59 Volume of Tests/Month Estimate the volume of test per month on the internal lab equipment.  Paper ChartsQ.60 Average Number of Missing Charts/Month Estimate the average number of missing or lost charts, per month. The

charts were not available at the time of service.  Referrals

Evaluation Tool PreparationQ.61 Need to Track Referrals Rate the need to track referrals, internal and external.  Order TrackingQ.62 Volume of Medication Administration Orders/Month Estimate the volume of MARs per month.

Q.63 Lab Order Tracking Volume/Month Estimate the volume of lab orders issued per month.  HIE Data ExchangeQ.64 Requirement/Need to Send Patient Data to HIE Evaluate the need to send patient data to the HIE after each

service/encounter.Q.65 Requirement/Need to Receive Data from HIE Evaluate the need to receive patient data from the HIE prior to each

service/encounter.  SecurityQ.66 Staff Adherence to Policies and Procedures Rate how well your staff complies with security policies and procedures.Q.67 IT Expertise to Protect Data at Rest and in Transit Rate the level of IT expertise to protect ePHI Q.68 HIPAA Compliance Capacity Rate the ability to fully comply with HIPAA Q.69 Physical Security Rate the ability to provide physical security to the data storage and

processing systems.Q.70 Risk Assessment and Gap Analysis Capacity Rate the ability to develop and execute a risk assessment and gap

analysisQ.71 Risk Tolerance of Organization and Management Rate the how comfortable the organization is in accepting risk.  Patient Interaction (Optional) – Indicate if there is a need to accomplish each of the followingQ.72 Kiosk Check-In Use of a kiosk system to allow for self-check-inQ.73 Kiosk Automated Vital Checking Use of a kiosk system to check vitalsQ.74 Kiosk Quality and Exit Survey Use of a kiosk for exit surveysQ.75 Web Portal Appointment Scheduling Use of a web portal system for appointment schedulingQ.76 Web Portal Bill Payment Use of a web portal system for bill paymentQ.77 Web Portal Demographics Capture Use of a web portal for capturing demographics prior to initial

appointmentQ.78 Web Portal Lab Result Checking Use of a web portal for patients to receive lab resultsQ.79 Web Portal Immunization Records Use of a web portal for patient/parents to retrieve immunization recordsQ.80 Web Portal Secure Messaging Between Patient and

ProviderUse of a web portal for secure messaging/email between the patient and their provider

Q.81 Automated Appointment Reminders – Text, Phone Voicemail

Use of an automated system for appointment reminders

Q.82 Automated Appointment Reminders – Automated Reschedule

Use of an automated system for appointment reminders and allow for rescheduling

Evaluation Tool Preparation

Q.83 Automated Medication Reminders – Text, Email, Phone, Voicemail

Use of an automated system for medication reminders

Q.84 Automated Medication Reminders – No Contact Alerts Use of an automated system for medication reminders that notifies staff if no contact is made.

Evaluation Tool