guide to implementing eivf™
TRANSCRIPT
Guide to Implementing
eIVF™
By PracticeHwy.com, Inc.
Notice
Information in this document is subject to change without notice and does not represent a commitment on the part of
PracticeHwy.com, Inc. Companies, names and data used in examples herein are fictitious unless otherwise noted. The
software described in this document is furnished under a license or nondisclosure agreement. The software may be used
or copied only in accordance with the terms of the agreement. It is against the law to copy this software on any medium
except as is specifically allowed in the license or nondisclosure agreement. No part of this manual may be reproduced or
transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or information
storage and retrieval systems, for any purpose, without the express written permission of PracticeHwy.com, Inc.
ClickNBuild® and DataPlates® and respective graphics are trademarks or registered trademarks of Clinical NetwoRx, Inc.
PracticeHwy.com, eIVF, eIVF Connect, from thought to conception... and respective graphics are trademarks or
registered trademarks of PracticeHwy.com, Inc.
Microsoft Windows® and Microsoft Word® are trademarks of Microsoft Corporation.
All other names, products, services and logos referenced herein maybe trademarks or registered trademarks of their
respective owners
© 2003 PracticeHwy Inc. All rights reserved. Printed in the United States of America
Support for eIVF
Support is available during business hours, Monday through Friday excluding holidays.
In the United States: Customer Support: (972) 247-3483
(972) 247-3535 – Fax
www.practicehwy.com
Or write to: PracticeHwy.com, Inc.
9400 N. Mac Arthur Blvd.,
Suite 444
Irving, Texas 75063-4790
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Contents • i
Contents
Notice ............................................. ...................................................................................................................... ii Support for eIVF ................................... ............................................................................................................... ii Contents........................................... ..................................................................................................................... i Implementation Basics .............................. .........................................................................................................1
Implementation Guide Overview .......................................................................................................................1 The Implementation Consultant.........................................................................................................................1 Site Visit.............................................................................................................................................................1
The Implementation Team............................ ......................................................................................................3 Assembling the Implementation Team ..............................................................................................................3 Team Members .................................................................................................................................................3
The System Administrator..............................................................................................................................3 Physicians......................................................................................................................................................4 Clinical Support Staff .....................................................................................................................................4 Receptionists and Office Support Staff ..........................................................................................................4 Medical Records and Transcription Staff .......................................................................................................4
Working with the Team......................................................................................................................................4 The Implementation Plan............................ ........................................................................................................6
Implementation Plan Overview..........................................................................................................................6 The Implementation Process ......................... ....................................................................................................8
Practice Information Form .................................................................................................................................8 Current Workflow...............................................................................................................................................8 Information Flow In And Out Of the Office.........................................................................................................9 Gather Forms, Letters, and Templates..............................................................................................................9 Baseline Configuration / Enterprise Solution ...................................................................................................10
Design of the enterprise solution .................................................................................................................10 Design of the Baseline Configuration...........................................................................................................10
Multi-Site Implementation ................................................................................................................................11 Hardware, Software and Networks .................... ..............................................................................................12
Minimum Hardware and Software Requirements............................................................................................12 Client Workstations ......................................................................................................................................12 Server ..........................................................................................................................................................12 Network........................................................................................................................................................12 Other Software and Hardware .....................................................................................................................12
System Integrator / Hardware Vendor .............................................................................................................12 Software Installation ........................................................................................................................................13 Interfacing with Analyzers................................................................................................................................13 Electronic Connectivity with Ultrasound ..........................................................................................................14 Portals Implementation....................................................................................................................................14
System Configuration............................... ........................................................................................................16 System Configuration Overview ......................................................................................................................16 System Configuration Outline..........................................................................................................................16
Configuration Outline List.............................................................................................................................16 Training ........................................... ...................................................................................................................18
Training Overview............................................................................................................................................18 Training Room Requirements..........................................................................................................................19 System Administrator Training ........................................................................................................................19 End User Training............................................................................................................................................19 Training Information Forms .............................................................................................................................20
Going Live......................................... .................................................................................................................21
ii • Contents © PracticeHwy.com, Inc. Guide to Implementing eIVF™
Preparation for Going LIVE .............................................................................................................................21 Be Prepared to Deal with the Psychological Impact........................................................................................21 Going LIVE ......................................................................................................................................................22
Follow Up Plan ..................................... .............................................................................................................23 Customer Support................................... ..........................................................................................................24
Customer Support Overview ...........................................................................................................................24 Phone Calls..................................................................................................................................................24 Online Customer Support ............................................................................................................................24
Response to Ongoing Support Issues.............................................................................................................24 Program Errors or "Bugs".............................................................................................................................25 Customization ..............................................................................................................................................25 Enhancements .............................................................................................................................................25 New Releases..............................................................................................................................................25 Questions About Application Functions .......................................................................................................25 Hardware or Operating System Issues ........................................................................................................25
Exhibits ........................................... ...................................................................................................................26 Practice Information Form ...............................................................................................................................26 System Administrator Roles and Responsibilities Form..................................................................................26 Implementation Milestones Form ....................................................................................................................26 Workflow Information Form .............................................................................................................................26 System Configuration Form.............................................................................................................................26 Training Information Form ...............................................................................................................................26 Skills Analysis Form ........................................................................................................................................26 Training Room Requirements Form ................................................................................................................26 Go Live Check List Form .................................................................................................................................26 Network Verification Check List.......................................................................................................................26
eIVF Standard Tables/Templates..................... ................................................................................................26 Chief Complaints .............................................................................................................................................26 Clinical Value Sets...........................................................................................................................................26 Diagnosis Codes .............................................................................................................................................26 Procedure Codes.............................................................................................................................................27 Labs (Blood) ....................................................................................................................................................27 Labs (Follicular Ultrasound).............................................................................................................................27 Labs (Obstretical Ultrasound)..........................................................................................................................27 Labs (Andrology) .............................................................................................................................................27 Labs (Panels) ..................................................................................................................................................27 Infertility Drugs.................................................................................................................................................27 Clinical Data ....................................................................................................................................................27 General (Administrative Data) .........................................................................................................................27 Protocol Instructions ........................................................................................................................................27 Scheduling (Visit Types)..................................................................................................................................27 Scheduling (Provider Book).............................................................................................................................27 Scheduling (Provider Non Schedule Days) .....................................................................................................27 Scheduling (Facility Book) ...............................................................................................................................27 Scheduling (Facility Non Schedule Days) .......................................................................................................27
Quick Note Templates ............................... .......................................................................................................27 Cycle Management Note .................................................................................................................................28 Established Patient Consult.............................................................................................................................28 Hysterosonogram ............................................................................................................................................28 Intrauterine insemination from frozen specimen..............................................................................................28 New Patient visit ..............................................................................................................................................28 Semen Analysis Review ..................................................................................................................................28 Embryo transfer ...............................................................................................................................................28 Hysterosalpingogram.......................................................................................................................................28
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Contents • iii
Intrauterine insemination ALS ........................................................................................................................28 IUI ....................................................................................................................................................................28 Oocyte Retrieval ..............................................................................................................................................28
Infertility History (Female Questionairre) ......... ..............................................................................................28
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Implementation Basics • 1
Implementation Basics
Implementation Guide Overview Throughout this guide you will be asked to complete several Forms. These forms or worksheets ask you to write down specific information related to the section of the implementation plan that you are working on. A copy of each Form is provided in this Guide to Implementing eIVF Packet . Completion of these Forms will enable you to clearly think through the issues and record them. It is most helpful if the forms are sent to your Implementation Consultant as you complete and update them. This will keep the Implementation Consultant informed on the process and enable the consultant to make sure you are on track in terms of your timeline and your decisions This guide is divided into the following sections:
• The Implementation Team • The Implementation Plan • The Implementation Process • Hardware, Software and Networks • System Configuration • Training • Going LIVE • Follow Up Plan • Customer Support
Each section will walk you through a step-by-step process that will enable you to customize the implementation of eIVF to suit the needs of your particular practice. Our goal is to work with you to create an implementation plan that, when followed, will allow you to introduce eIVF and "Go Live" in the shortest possible time with the least possible disruption to your practice.
The Implementation Consultant It is the role of the Implementation Consultant to work with you throughout the implementation process. Your consultant will take you through each step of the process to a successful installation of eIVF. As you proceed with your implementation process, your Implementation Consultant is available to answer questions, discuss issues, provide guidance and suggestions, and to help you manage the process. In addition, you can always contact our Customer Support department at (972) 953-1600. There will be someone available to take your call anytime between the hours of 9:00 a.m. and 5:00 p.m. CST. If you need assistance at any other time, our Customer Support Specialists can be paged, and will call you back immediately.
Site Visit Your Implementation Consultant will set up a phone conference for an initial “kick off” meeting with you and key individuals involved in the project. Some of the topics that will be discussed are the following:
2 • Implementation Basics © PracticeHwy.com, Inc. Gui de to Implementing eIVF™
• Goals and Objectives • Review Implementation Process • Discuss Timeline • Discuss System Integration (hardware/network) • Tour of Facility(s) • Meet Key Individuals • Schedule System Administrator Training
By the end of the phone call, which generally takes one hour, the site should feel comfortable with the overall implementation process and be knowledgeable on what is required to install eIVF. In addition, the Implementation Consultant should have a good understanding of the site, its mission, its major goals and objectives, and the specifics of the plan to communicate back to the PracticeHwy staff. At the meeting you and your PracticeHwy Consultant will be discussing the milestones and defining dates in the implementation process. Please make sure to complete Implementation Milestones Form found on the back of this guide.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. The Implementation Team • 3
The Implementation Team
Assembling the Implementation Team The successful implementation of eIVF relies on getting the right mix of individuals together to manage the project. It is of utmost importance to bring together people in your practice with varying roles and experience. These key people will provide you with valuable input from their areas of expertise. Depending on the size of your practice, you should try to include practitioners, administrators, clinical support staff, and medical records personnel. By involving staff members from the beginning you are more likely to gain acceptance of the system when you are ready to GO LIVE and beyond that into the future.
Team Members The following describes some of the key team members, their roles and input in the implementation process. Your practice may include more or different roles, these should all be included and their input welcomed into the process. Overall, think about the various staff that work in your office and get them involved in the project. Installing a computerized medical record system will have a significant positive impact on your office. You will want as many voices as possible giving you input and assisting you in the initial set up of the system.
The System Administrator At least one person from the group will take on the role of System Administrator. This person will be responsible for the following:
Implementation tasks: • Managing the implementation process • Organizing the project team, their meetings and organizing the information they
produce • Analyzing current workflows, evaluating current processes • Coordinating the installation of hardware and networking systems • Coordinate interface activity • Coordinate installation of software and system testing • Acting as liaison for PracticeHwy, Administration and Staff • Scheduling user training • Delegating implementation responsibilities, setting deadlines and ensuring that
work is completed in a timely fashion • Tracking the progress of both project and team • Ongoing tasks: • Ensuring daily and weekly backups are performed • Acting as liaison for PracticeHwy, Administration, Staff • Modifying the system as requested by users • Monitoring system security • Performing updates to the system • Attending user group meetings • Training new staff
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• Triaging problems and reporting to PracticeHwy • Conducting internal meetings to assess the system and improve operations
Please remember to review and complete the System Administrator Roles and Responsibilities Form, provided in the back of this guide, and give it to your PracticeHwy consultant.
Physicians You will certainly want input from the physicians in your practice. They will be major system users and have valuable input regarding workflow, data collection, improving quality of care, financial implications, and many other facets of using the eIVF system.
In addition, the physicians will have a key role in the set-up of eIVF. They will set up the clinical maintenance files such as diagnoses, drugs, labs, procedures, and medications. They will need to provide feedback on where they would like to install workstations and printers. These decisions will greatly affect their everyday workflow which needs to be as efficient as possible.
Clinical Support Staff Your nurses, clinical assistants, and technicians will probably be entering clinical information into eIVF. For example, nurses can take vital signs, and enter that data directly into the system. If a lab technician performs a blood draw, data can be entered directly into the system. If a clinical assistant makes a follow up phone call to a patient, it can be entered directly into the system.
It is important that you discuss your workflow with the various office staff and include them on the decision making process for setting up eIVF. They can provide much needed information regarding the physicians’ hectic workflow and including them in the process at the outset can save time and boost morale.
Receptionists and Office Support Staff Your receptionists and other office staff will be answering telephones, printing schedules, confirming appointments, and performing other related tasks. Most of these tasks can be managed through the eIVF system. If you involve representatives from these work areas, they can help you improve your office operation.
Medical Records and Transcription Staff You may want to include a representative from medical records and/or transcription. Although the number of charts you pull each day will significantly decrease or disappear altogether, you may change your workflow such that medical records personnel or your transcription can improve efficiencies elsewhere.
Working with the Team Your project team should meet regularly from the beginning of the implementation process, throughout the duration of the project, and beyond scheduled LIVE dates. You should assign tasks to individuals on the team and set deadlines for completion of the tasks. The System Administrator should monitor the progress of the team and ensure the project stays on track.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. The Implementation Team • 5
During the implementation, parts of the project will be happening simultaneously. For example, while you are entering medications into the Drug Maintenance File, you can also be defining Security Levels for your users. It is important to keep things moving, however, if you stumble across a road block, your PracticeHwy Consultant is available to assist you whenever necessary.
Finally, the team should continue to meet after the system has gone LIVE in your practice. Ongoing evaluation and improvements can be made to the system. You will want to listen to feedback from your entire staff and incorporate their ideas into any modifications you may make.
One person from the team should be selected as the “point person” (usually the System Administrator as designated earlier). This person should be considered the resident expert on eIVF and should troubleshoot problems from the staff. This person should be well-versed in the tools eIVF uses to set up the system, Microsoft Word, and the eIVF application itself. The System Administrator should also be able to troubleshoot basic computer problems. With a resident expert on hand, the staff can turn to this person with any initial problems, concerns, questions, or issues. He/she can then contact the PracticeHwy Customer Support department for additional assistance.
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The Implementation Plan
Implementation Plan Overview eIVF® is implemented using a proven installation and training program. The PracticeHwy staff works closely with the customer to ensure that the implementation meets the goals and expectations of the clinic.
The PracticeHwy team usually consists of an Implementation Consultant and a Trainer. The Implementation Consultant works with the client throughout the implementation to plan each phase of the process. The Trainer is responsible for providing module-based system administration and user training to clinic personnel. The Implementation Consultant works with the client to configure the software for the individual needs of the practice.
Each site needs to designate one person to act as the System Administrator for the site. This person will act as the contact person for the implementation as well as performing the configuration of eIVF® to meet the needs of the clinic.
A typical Implementation Plan would include the following:
Personnel Phase Areas of Consideration Project team State goals and objectives Assess current situation Hardware/software network Information flow in and out of
the clinic Current staffing - numbers
and responsibilities Workflow Volume of practice(s) Number of facilities Current problem
areas/bottlenecks Baseline Configuration /
Enterprise Solution What tasks will be automated
What tasks will not be automated
What interfaces need to be developed
What conversions need to take place
Dial in capabilities E-mail Develop timeline When will system go LIVE
with scheduling List tasks, responsible
person, and deadline for completing task
When will end user training occur
Write up detailed project plan
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. The Implementation Plan • 7
Personnel Phase Areas of Consideration Write up detailed follow up
plan Select system integrator Trainer, System Administrator System Administrator
Training Training on configuration tools in eIVF®
System Administrator, System Integrator, Implementation Consultant
Hardware and Software Installation
Meet with client to determine hardware and networking needs - review minimum requirements
Select hardware vendor Networking and hardware
installation and testing System Administrator, Implementation Consultant
System Security Identify all users
Assign levels of security Review other security issues System Setup Scheduling setup Practice setup Clinical Setup Preference Setup Provider Center Setup Patient Explorer Coding Systems Billing Interface Mail User Home Reminders Trainer, Users User Training User role-appropriate Training All Personnel Go Live Implementation Consultant System Administrator
Follow up plan Continue customization
Select point person Contacting customer support Additional needs/ongoing
process
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The Implementation Process
Practice Information Form Your PracticeHwy Consultant will be available to support you throughout the implementation process and beyond. In order for that person to best assist you, it is important that he/she understand your practice and how you operation. In order to do so, please complete the Practice Information Form and give it to your Consultant as the first step in the implementation process.
Current Workflow Before you begin planning for automation, it is necessary to assess your current workflow. By analyzing your workflow, you will discover:
• Areas of your operation that you want to improve • Areas of your operation that work well and you simply want to automate • Bottlenecks and problems in your workflow that automation can resolve • How efficient you will be with a computerized patient record
To start, look at the example workflow chart below which outlines some of the tasks that would take place in a typical physician’s office. The chart lists the task, the person responsible for completing the task, and the time of day or week the task is normally completed (morning, as needed, Friday afternoon, etc.).
Workflow Analysis
Task Staff Time Schedule appointments Receptionist As needed Confirm appointments Receptionist One time/day Send confirmations Receptionist One time/day Collect demographics Receptionist As needed Collect insurance info Receptionist Pt. check in Check in Receptionist As needed Create encounter Receptionist Pt. check in Add ons Receptionist As needed Room patient Nurse As needed Vital signs Nurse As needed Prep patient for exam Nurse As needed Handout pt. literature Nurse As needed Review normal labs Nurse One time/day Review chart Physician As needed Examine patient Physician As needed Order labs Physician As needed Order consults Physician As needed Give prescriptions Physician As needed Order x-rays/test Physician As needed Complete checkout form Physician As needed Dictate Physician As needed Review abnl/panic labs Physician As needed
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. The Implementation Process • 9
Task Staff Time Print schedules Medical Records Day before Pull charts Medical Records Day before Enter progress note Medical Records Day before Schedule updates Medical Records Day before Filing Medical Records Ongoing Transcription Transcriptionist Daily Run reports Administration Daily/Weekly Backups Administration Daily/Weekly
Following this example, complete the blank Workflow Information Form found on the back of this guide. Talk to your staff about the tasks they do on a regular basis. Gather as much information as you can about your workflow and write it down on the chart. This will help you when you begin to plan for automating your office workflow.
Information Flow In And Out Of the Office As you know, a lot of information comes into your office from outside sources, such as labs, consultations, radiology centers, and medical records. In addition, your office sends information to outside sources such as pharmacies, labs, referrals, and patient letters. The next step in the process is to understand this information flow. Using the Workflow Information Form, provided in the back of this guide, you can begin to document this flow. Again, talk to the various staff in your office to fill in the blanks.
Gather Forms, Letters, and Templates Many of the forms you currently use will be automated. The first step in the process of an eIVF implementation is to provide PracticeHwy.com with all electronic documents currently being used in the clinic that will need to be in eIVF.
These documents will include the following and any others necessary.
• Consent Forms/Letters • Written Procedures • All Protocols with written instructions • Exact medication list for each protocol • Checklist for each protocol • Reports (HSG, Procedures, surgery, etc.) • Patient Instructions • Etc.- Anything you currently document on paper that will need to be incorporated in eIVF. • Main Pharmacies Used: Name, address, telephone number, fax number • Andrology Forms • Embryology gamete sheet, reports and forms
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Baseline Configuration / Enterprise Solution One of eIVF’s® most powerful features is the ability to be customized to meet the specific needs of the physicians and clinicians it supports. However, this customization requires analysis into how the clinic operates and how information is exchanged between physicians, clinicians, and administrative staff (both within the clinic and across the network).
System implementation typically occurs in the following phases:
• Design of the enterprise solution. • Design of the Baseline Configuration for eIVF.
Design of the enterprise solution The enterprise wide implementation of eIVF® must facilitate seamless exchange of information between the planned business systems (i.e. billing, managed care, occupational medicine, and practice management.) It must facilitate the flow of patients and patient records between clinics.
PracticeHwy works closely with the user physicians, clinicians, and administrators to develop requirements for the planned business systems and information flow. Requirements definition will include setting performance and functional expectations for the final system with respect to cost and technology trade-offs. The results of the requirements will be analyzed in order to recommend configurations. The configurations typically include Intranet requirements. Wide area and metropolitan area network bandwidth requirements for optimal performance, workstation and local area requirements for each clinic as well as the baseline specification for the interfaces between eIVF® and the business systems.
Design of the Baseline Configuration This baseline will be used as the basic configuration of eIVF at each of the clinics. eIVF is provided with a general (generic) system configuration at set-up time. This configuration includes definitions for Practice Setup and Clinical Setup which control functions such as:
• How the appointment is set-up (time periods, search capability, etc.). • The reports which are created using DataPlates (templates) and the Click & Build
feature, and the content and layout for each type of report. • Classifications of visit types, diagnosis categories, laboratory tests and test
element set-up, procedures, descriptions, and correspondence formats. • Automated workflow between physicians, clinicians, and administrators within the
same office and between offices.
This general configuration will be modified to meet the functional needs of the majority of practices. In addition, common information will be identified and added to the baseline configuration. Common information includes such information as referral specialists and lab facilities that are associated with the hospital and medical group. Consensus on the baseline configuration will be reached by a process of system review and discussion, modeling the discussed configuration on a laboratory configuration of eIVF (called prototyping) followed by additional review and discussion.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. The Implementation Process • 11
Multi-Site Implementation The baseline configuration created in the previous phase will be implemented at each clinic. It will then be customized as necessary to meet individual, clinic specific needs. General consensus on the baseline configuration should minimize the number of clinic specific customizations required as well as the scope of any such customizations.
The baseline configuration and clinic specific customization process will be fine-tuned during the first implementations. At this stage typically, the users own internal staff should be able to complete the remaining implementations. PracticeHwy will be available to continue the implementation directly or to assist and support user hospital and medical group if necessary or as required.
The eIVF® implementation at each clinic will begin with the verification of the following:
• Local Area Network (LAN) and workstation installation • Installation of associated hardware • Review of what will be installed with the clinic staff • Identification and specification of clinic specific customizations • Implementation of customizations • Function and load testing of the clinic system • Creation of as-installed documentation • User training.
Selection and integration of the business systems with the enterprise wide eIVF implementation. PracticeHwy will work as a partner with the user hospital and medical group to identify the best business systems to meet the requirements and integration strategy.
The user hospital and medical group may define participation in the selection and integration of the business systems. PracticeHwy will work in whatever capacity the hospital and medical group deems appropriate. Following implementation, there will be a transition to a site maintenance review process whereby each site will be monitored and the users involved in discussions about ongoing utilization and workflow issues.
12 • Hardware, Software and Networks © PracticeHwy.com , Inc. Guide to Implementing eIVF™
Hardware, Software and Networks
Minimum Hardware and Software Requirements
Client Workstations • 500 MHz • Pentium-compatible • 128 MB (for eIVF and MS Word) • 2 GB with minimum of 200 MB free space • 10 Mbps NIC • Resolution: 1024x768 256 colors • Windows NT/2000/XP • Internet Explorer 6.0 or later • PC Anywhere (for remote support)
Server • 1GHZ • Pentium II-compatible • 500 MB • 8 GB • 10/100 Mbps NIC • 56Kbps V90. • Resolution: 1024x768 256 colors • Windows NT4 SP6/ Windows 2000 Sever with IIS • SQL Server 2000 or higher • PC Anywhere (for remote support) • Windows NT4 SP6/ Windows 2000 Sever with IIS
Network • 10 Mbps Ethernet • TCP/IP • 10 Base-T Hub • 10 Mbps Ethernet
Other Software and Hardware • Electronic Signature Pad or Tablets along with respective software to capture
and embed signatures into Microsoft Word documents • Internet IP Address, Registered Domain Name and SSL (for secure
communications)
System Integrator / Hardware Vendor If you do not already have a hardware vendor, your Consultant may be able to suggest vendors for you to contact depending on your location. It will be your responsibility to select a reliable vendor and purchase the necessary equipment, based on the above list.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Hardware, Software and Net works • 13
Once you have selected a hardware vendor, you will provide the vendor with the list of minimum requirements needed to run eIVF. In addition, you will give the vendor Network Verification Check List Form, found on the back of this guide, which details the set-up and testing that must be done prior to software installation. This list is not all inclusive; rather, it lists the minimum required to run the application.
If you or your network administrator needs additional information on how to design a network that will meet your eIVF needs, please contact your Implementation Consultant to provide you with a copy of Networking Your Office document.
You will also need to give us the name and contact of your vendor in order for us to help you ensure the proper hardware selections are made. If the you or your vendor have any questions or concerns, your Consultant will contact the hardware vendor directly to set up a meeting or conference call between the parties.
In addition to installing the hardware and network, you will need to install a modem for remote dial-in access to your system. Contact your phone company to have them install a dedicated phone line if this is not currently available. You may want your hardware vendor to assist in the installation of a modem.
Finally, plan your space wisely. You should think about your future workflow and install workstations and printers accordingly. Some questions you may want to ask:
Where will your physicians enter clinical data?
• Where will your patients be scheduled and check in? • Will your clinical support staff need separate workstations? • Where will the transcription be done? • Where will your physicians pick up printed prescriptions? • When and where will schedules and charts be printed? • Who will be performing administrative functions such as sending out patient
letters, confirming scheduled appointments, and printing reports?
Many of these questions are analyzed and answered in the section of this guide entitled The Implementation Plan. You will determine which tasks will be automated, who will be responsible for completing the task and the time of day the task is completed. It is important that you install your hardware according to your ideal workflow.
Software Installation Once the hardware and network are installed and verified, your PracticeHwy Implementation Consultant will install the eIVF software. For post implementation installation instructions, please refer to Installation Instructions document in www.practicehwy.com/secures.
Interfacing with Analyzers LIS Setup is a joint effort between your PracticeHwy Implementation Consultant and your designated laboratory staff. A computer will be required to connect to your analyzer.
14 • Hardware, Software and Networks © PracticeHwy.com , Inc. Guide to Implementing eIVF™
Installation
1. eIVF interface needs to be configured by PracticeHwy. Remote access needs to be setup for this computer.
2. Setup needs to be changed to: • Receiver ID: LIS • Sender ID: LIS
3. Plug serial cable into the computer which eIVF interfaces with. 4. Barcode printer will be tested by eIVF.
Testing and Integration
1. Create a test patient. 2. Create a test schedule and lab (ex E2) 3. Print a bar code from eIVF for this test. 4. Run test sample with bar code. 5. LIS should pull order from eIVF. 6. Once lab result is processed, eIVF should populate result in test patient’s chart.
Electronic Connectivity with Ultrasound
Electronic connectivity with your ultrasound machine is a joint effort between your PracticeHwy Implementation Consultant and your designated clinical staff. A computer will be required to connect to each ultrasound machine.
Installation
1. eIVF interface needs to be configured by PracticeHwy. Remote access needs to be setup for this computer.
2. Plug serial cable into each U/S machine eIVF interfaces with.
Testing and Integration
1. Create a test patient. 2. Create a test follicular ultrasound and a test Ob ultrasound. 3. Transmit data from ultrasound to eIVF, to ensure measurements are populating in test
patient’s chart.
Portals Implementation eIVF Patient, Pharmacy, and Referring MD portals implementation is a joint effort between your PracticeHwy Implementation Consultant and your designated clinical staff.
Installing and Configuring
1. Get SSL from Verisign or other company 2. install on the server which running the web
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Hardware, Software and Net works • 15
3. Create a DNS name (eIVF.yourdomainname.com) 4. Configure DNS and Router direct to the web server. 5. Forward traffic port 80 and 443 to eIVF server. 6. Provide PracticeHwy with the following e-mail addresses to route patient and
referring MD correspondences to: • Email address for Issues or Problems • Email Address where New Patients information is to be sent • Email Address for Updated Patient information is to be sent
Testing
7. Type eivf.yourdomainname.com/patient and you should get the patient portal sign on screen.
Creating a Link from your website
In order to give access to your patients, referring MD’s and preferred pharmacies, you may choose to create links on your websire. To do so, please have your web designer insert the following code to your respective web pages.
Sample Code to secure address <a href="" onclick="var newP=window.open(‘http://<domain>/patient/ivflogin.asp','_ Blank','scrollbars,height=600,width=800');newP.focus();return false;" target="_Blank"> Patient Portal</a> <a href="" onclick="var newP=window.open('https://[yourIPaddress/patient/ivflogin.asp','_Blank','scrollbars,height=600,width=800');newP.focus();return false;" target="_Blank"> Patient Portal</a>
In addition, we need the following information for final configuration:
1. Email address for Issues or Problems
2. Email Address where New Patients information is to be sent
3. Email Address for Updated Patient information is to be sent
16 • System Configuration © PracticeHwy.com, Inc. Guid e to Implementing eIVF™
System Configuration
System Configuration Overview Now that you have completed your workflow analysis and planned which tasks will be automated, you are ready to configure your system. This chapter will provide you with worksheets to help assist you in the configuration process. These worksheets are simply designed as a guide. They will allow you to put your thoughts on paper before you enter information into the computer. If you would prefer to enter the data directly into eIVF, please feel free to use that approach.
One of eIVF’s most powerful features is its ability to be customized to meet the specific needs of your practice. Many areas of eIVF can be customized including:
• System Security • Scheduling • Clinical Parameters • General/Administrative Parameters • Letters, Patient Educational Material, and Forms
System Configuration Outline Remember, you do not need to complete every step of the configuration process to use eIVF. The outline below is all inclusive. You can work with your Implementation Consultant to determine those areas that are essential to set up before using the system. Go at your own pace and configure the system in a time-frame that works for you and your practice needs.
Configuration Outline List
System Security • Creating a Plan • User Roles, Groups, Individuals • Functional Access • Data Entry
Practice Set Up • Appointment Status • Visit Types • Specialties • Clinical Parameters • Clinical Data • General Data • Facilities (Monitoring, Testing, Resource) • Facilities Schedule (Testing, Resource) • Pharmacies • Insurance Companies • Insurance Verification Elements
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. System Configuration • 17
Provider Center • Demographics • Location • Schedule Center • Priority Variables • Days Off • Support Staff
Clinical Set Up • Diagnosis • Drugs • Procedures • Vital Sign Groups • Specimen Types • Elements • Labs • Problem Synonyms (Causes of Infertility) • Treatment Protocols • Flowsheet Layouts
Forms, Letters, Templates • Consent Forms • Click N Builds • DataPlates
Now that you understand the steps necessary for configuration of eIVF, you are ready to assign tasks to team members in order to be better manage the configuration process and ensure it stays on track. To help proper management of tasks, please complete the System Configuration Form, provided in the back of this guide, and share it with your PracticeHwy consultant as the first step in Configuration Process. Talk to team members, gather as much information as you can about your workflow, staff available times, their expertise, and willingness in order to set attainable expectations and due dates.
18 • Training © PracticeHwy.com, Inc. Guide to Implementing eIVF™
Training
Training Overview PracticeHwy provides a modular training program based upon a tested formula developed by PracticeHwy over a history of successful installations. This program covers both technical and end-user aspects of eIVF and allows our professional trainers to work with our customers to determine their training needs and design a customized training program.
The goal of the training is to bring the staff to a level of proficiency that will enable them to utilize the system appropriately from the time the system is considered “live”. To this end, there is training and practice to develop the level of competency required.
The following table contains time estimates for training. These estimates assume that the users will have a minimum level of computer skill that relates to understanding files, Windows and mouse operation. If this is not available in any trainee then a remedial course is required to address these deficits immediately prior to training. We actively seek a basic level of user knowledge before enrolling any staff in any course.
Training Type Module Trainee Role Time Needed
System Administration
Database Administration and Maintenance
System Administrator 4 hours
Installation I1 Hardware Installation and Configuration
System Administrator 1 hour
I2 Network and Client Verification
System Administrator 1 hour
I3 Database Installation System Administrator 1 hour I4 Client Installation System Administrator .5 hour I5 Backup Issues System Administrator .5 hour I6 Troubleshooting System Administrator 1 hour Configuration C1 Implementation Strategies System Administrator 1 hour C2 Security Configuration System Administrator 1 hour C3 Practice Setup System Administrator 2 hours C4 Provider Center Setup System Administrator 2 hours C5 Preferences Setup System Administrator .5 hour C6 Clinical Setup System Administrator 2 hours C7 Template Design and
Development System Administrator 1.5 hours
C8 Click and Build Design and Development
System Administrator 1.5 hours
End User U1 eIVF Basics System Administrator & End User 2 hour U2 The User Home System Administrator & End User 2 hours U3 Provider Center End User 2 hours U4 Schedule Center System Administrator & End User 3 hours U5 Report Center/Patient
Search System Administrator & End User 1 hour
U6 Patient Explorer System Administrator & End User 3 hours U7 Billing System Administrator & End User 2 hours
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Times are approximate and can vary depending on the abilities of the users and their familiarity with computers and the modules selected for training. Based on our experience and the input of our clients we recommend that the System Administrator(s) receive a minimum of two full days of initial training as well as attending the end user training. And End users should receive 4 – 8 hours (or more) of training, depending on the amount of functionality they will have on eIVF. This should be structured to include two thirds of the time spent in job specific training on eIVF and one third of the time with scenario based hands-on practice.
Job Description Hours Required for Implementation
Hours Required for Training
System Administrator 26 194 Registration / Scheduling Staff 16 16 Clinical Support 16 16 Provider 16 16 Transcriptionist 6 10
Training Room Requirements Your PracticeHwy Trainer will be available to train you throughout the implementation process and beyond. In order for that person to best assist you, it is important that the basic requirements for training are met. In order to do so, please review and complete the Training Room Requirements Form and contact your Consultant if you have any questions or if you have problems with meeting these requirements. Once these requirements are met, your PracticeHwy trainer and your trainees will be ready and prepared for eIVF training.
System Administrator Training We recommend that each site should designate one or more "System Administrators" to receive the most technical training in the Installation and Configuration of the system. If possible, this person should be competent in the use of Personal Computers and Microsoft software. We then work with these people to assess the needs and roles of the end users and develop a training schedule for them. If the customer prefers we can take the System Administrator and "train the trainer" giving this person the skills and information to train the end users. Although PracticeHwy installs eIVF, we provide installation training to familiarize the System Administrator with the structure of the system. The training for this person typically takes 22 - 26 hours.
End User Training This includes administrative and clinical users (separate courses) with the pre-requisite minimal skill level. Training for each user role takes approximately 12-16 hours, depending on the experience of the trainees and the complexity of the user role. We have found that separating staff by role tends to allow more focused training.
The training modules use the generic eIVF as the baseline configuration and illustrate how the different areas can be customized. Each organization of sites must first establish their own baseline
20 • Training © PracticeHwy.com, Inc. Guide to Implementing eIVF™
configuration. Information common to the sites (or particular to a single site client) should be identified and added to the baseline configuration. Such information includes referral specialists and lab facilities that are used by the client, guidelines for documents that are created within the system, and an agreement on who will use the system and how. Especially at larger sites, general consensus on the baseline configuration should minimize transition time and site-specific customizations.
The modules and the user roles, that typically receive the training, are set out in the following table. (Bear in mind that all end users may not need training in all functions):
Training Information Forms Your PracticeHwy Trainer will be available to train you throughout the implementation process and beyond. In order for that person to best assist you, it is important that he/she understand your user base and their specific roles within the organization. In order to do so, please complete the Training Information Form for the practice and Skills Analysis Form for each trainee and give it to your Consultant as the first step in the training/implementation process.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Going Live • 21
Going Live
Preparation for Going LIVE Often times the testing phase of the project gets overlooked. This phase is easy to dismiss since it is usually at the end of the project, when everyone is pressed for time and deadlines are tight. Lack of testing is a common mistake, but is directly related to the success or failure of the implementation project. Users must test the configuration in conjunction with the newly defined workflows. This will allow mistakes or missing steps to be uncovered and modified before Going Live. In addition to testing the system, you need to test the interfaces as well. You need to make sure data is being transferred between the systems correctly, in a timely fashion, and with the desired results. At the end of this document you will find a Go Live Check List Form that depicts the road map and project timeline for Going Live. Please keep this timeline updated as the project moves along and always communicate any discrepancies with your PracticeHwy Consultant immediately.
Be Prepared to Deal with the Psychological Impact Re-engineering your workflows is a large task that requires commitment and a positive approach. Quite often the benefits of implementing such a system become obscured by the magnitude of the project and the learning curve involved. Your current workflows may be inefficient, but they are still familiar and rote. When you talk about changing the workflows significantly, it is sometimes difficult to get buy-in from the staff. Many people feel threatened, frustrated, and upset by such changes. It is important to identify people’s anxieties and deal with them head on. Let your staff know the following:
• Using a eIVF may be more difficult at first but the learning curve evens out
quickly • You are always open to suggestions and value their input • You see many benefits to using a computerized patient record system (explain
what the benefits are) • The system is new to everyone and you can get through it together • Your vendor will be available to help you make the process as smooth as
possible
In addition, reward your staff for being patient and flexible throughout the process. They deserve positive reinforcement for dealing with the changes and will be more likely to help you make improvements in the future if you appreciate their efforts.
22 • Going Live © PracticeHwy.com, Inc. Guide to Imple menting eIVF™
Going LIVE Upon completion of the testing phase, you are ready for “Go Live”. A plan should be in place for Going Live which includes documented workflows and “cheat sheets”, tapered schedules, on-site vendor assistance, and back up plans for issues resolution. The attitude and mindset of the users must be flexible and willing to adapt to changes in workflow and how they use eIVF. A well-prepared site will be ready for the impact eIVF will have on the clinic, and have ideas on how to address issues as they surface. The following timeline depicts your expected experience with eIVF.
• Day 1 Kick Off • Week 1 Steep Learning Curve • Month 1 Experienced Users • Year 1 Continual Improvements
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Follow Up Plan • 23
Follow Up Plan
It is very important that after Go Live that the implementation team continues to analyze problems, issues, and concerns with the LIVE system.
• Continue Implementation Team Meetings • Schedule Conference Calls with Implementation Consultant • Continue Improvements of eIVF • Attend User Group Meetings
The implementation meetings should continue on a regular basis. These meetings will occur less frequently as time passes; however, they should never stop completely. There will always be ways to improve clinic operations through use of eIVF. Also, you will want the team to review upgrades to the system and determine how as new functionality can improve efficiency in the clinic. Finally, you may want to arrange advanced training classes after the users have mastered the basics. Remember that the learning does not end with Go Live, in fact, this is generally where it begins. Many unexpected factors can change the direction and timeline of an implementation project. However, with a good plan in place and a committed team, the issues that arise can be effectively managed. By adhering to the guidelines, mentioned above, you will be much more likely to enjoy a successful implementation.
24 • Customer Support © PracticeHwy.com, Inc. Guide to Implementing eIVF™
Customer Support
Customer Support Overview Following installation, the user will typically wish to rely on phone calls and on-site response where appropriate. Even though eIVF is a radical step for many users it is a robust product that is intuitive to use and has been designed for a high degree of system availability. This quality engineering permits a lower than industry average need for post installation support as the users, once trained, recognize and operate the system efficiently and effectively.
However, if the need for staff or other response is indicated then PracticeHwy is equipped to respond appropriately. Our Customer Support Services delivers information on our value-added services to get you started and help you along the way, frequently asked questions to help you gain product knowledge and expertise, and standard forms you can use to contact us with a question, comment, or problem you may have.
Phone Calls All support calls would initially be directed to the technical support response center where a precise identification of the issue will be logged and addressed immediately on the phone. Where an issue is not resolved on the phone then either a technical support specialist will be dispatched to the user site or the technical support team will log into the user system remotely via modem connection. This PracticeHwy response is available on a 7 day / 24 hours basis.
Online Customer Support PracticeHwy Customer Support Services is proud to offer a full range of integrated services to its customers and business partners. In our secure site (www.practicehwy.com/secures) we offer self-service and technician-assisted support services, including access to product-specific resources such as a searchable knowledgebase, Click N Builds, DataPlates, reports, tutorials and training information, downloadable files, and user forums.
If you have a login account, please Login to get access to both publicly available information and restricted content under your additional support entitlements.
Response to Ongoing Support Issues eIVF includes a built-in “Auto Update” functionality that automatically updates your system with latest patches, bug fixes, customization, enhancements, and new releases that are made available by PracticeHwy. eIVF “Auto Update” improves operating efficiencies and saves money in easily configuring and quick to deploying the latest version of the product; thus eliminating the need for help desk professionals.
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Customer Support • 25
Program Errors or "Bugs" Program errors and bugs are to be reported directly to PracticeHwy where they will immediately be identified, be categorized, and placed in queue for resolution. A bug report form set is provided at www.practicehwy.com/secures.
Customization Customization requires a specification to be drawn up by Clinical for the work with time and cost estimates which is to be accepted by the user prior to actual commencement of the work.
Enhancements Enhancements are typically recommended to PracticeHwy by the user on the bug report form. Where the enhancement is such that it will provide global benefit to typical eIVF users then it will be specified and scheduled for a future release. PracticeHwy actively solicits such enhancements at our regular User Group meetings. Many recent refinements have been a direct result of user enhancement requests.
New Releases New releases are categorized as either maintenance releases or major releases. A maintenance release is provided for bug resolution or essential critical innovation. They are provided on CD with a self-installation facility. Major releases are provided with enhanced functionality at regular intervals (twice each year) and also come with an automatic installation device on a CD.
Questions About Application Functions Such questions relating to application would be referred directly to the customer support department hot line response desk and would be resolved immediately on the phone.
Hardware or Operating System Issues Hardware issues would be reported directly to the hardware vendor providing the support for the hardware. Operating system issues would be isolated by the technical support hot line response center and referred to the appropriate channel.
26 • Exhibits © PracticeHwy.com, Inc. Guide to Implementing eIVF™
Exhibits
Practice Information Form
System Administrator Roles and Responsibilities Form
Implementation Milestones Form
Workflow Information Form
System Configuration Form
Training Information Form
Skills Analysis Form
Training Room Requirements Form
Go Live Check List Form
Network Verification Check List
eIVF Standard Tables/Templates
Chief Complaints
Clinical Value Sets
Diagnosis Codes
Guide to Implementing eIVF™ © PracticeHwy.com, Inc. Quick Note Templates • 27
Procedure Codes
Labs (Blood)
Labs (Follicular Ultrasound)
Labs (Obstretical Ultrasound)
Labs (Andrology)
Labs (Panels)
Infertility Drugs
Clinical Data
General (Administrative Data)
Protocol Instructions
Scheduling (Visit Types)
Scheduling (Provider Book)
Scheduling (Provider Non Schedule Days)
Scheduling (Facility Book)
Scheduling (Facility Non Schedule Days)
Quick Note Templates
28 • Infertility History (Female
Questionairre)
© PracticeHwy.com, Inc. Guide to Implementing eIVF™
Cycle Management Note
Established Patient Consult
Hysterosonogram
Intrauterine insemination from frozen specimen
New Patient visit
Semen Analysis Review
Embryo transfer
Hysterosalpingogram
Intrauterine insemination ALS
IUI
Oocyte Retrieval
Infertility History (Female Questionairre)