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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