EMR Consulting Services | AdvanceHealthCareSolutions.com

EMR Transition Management – Phased Approach

AHS Value Proposition - Services

EMR Implementation – Common Problems

Major EMR Vendors and Products

AHS’s approach for successful implementation of EMR system

Assessment and Planning

Complete practice readiness assessment
Establish starting point on roadmap
Establish implementation goals
Conduct practice workflow evaluation

AHS completes a readiness assessment to overview practice’s technology and clinical procedures.

An understanding of where to start on implementation roadmap is established.

During this phase EMR implementation goals are defined .

AHS also conducts workflow evaluation, and suggestions on practice procedure redesign.

Activities

Complete practice readiness assessment
Create practice profile
Complete office staff skill assessment survey
Prepare list of hardware inventory
Select project team and define roles
Setup project management discipline
Prepare project schedule
Setup and conduct regular team meetings
Define EMR implementation Roadmap
Help defining EMR implementation goals
Identify and target workflow improvements
Define strategy for loading legacy patient records in EMR system

Deliverables/Tools and Techniques

Practice readiness assessment document
Practice profile worksheet
IT skill evaluation form
IT bill of material (ITBOM)
IT Team roles and responsibility matrix
Risk and issue log, risk mitigation plan, project plan, change management plan, meeting minutes and agenda template
Project schedule spreadsheet with activities and milestones
Implementation roadmap document
EMR goals document
Workflow checklist
Scanning/loading strategy document

Selection and Procurement

Select vendors
Conduct EMR demo
Evaluate EMR systems
Evaluate hardware and software requirements
Select EMR system

In this second phase of EMR transition roadmap, AHS examines EMR systems in detail based on specific needs of a practice.

Assuming the role of single point-of-contact to vendors, we work with practice to evaluate EMR systems.

Tools and templates are used to make vendor demo effective and productive. These tools assure that each vendors are evaluated and compared on same set of criteria.

AHS also provides overview on contract negotiation and SLAs.

Activities

Develop EMR system process and goals.
Define EMR goals
Review EMR system configuration
Evaluate EMR vendors
Prepare set of questions for vendors
Coordinate and conduct vendor demonstration
Coordinate site visits to vendor’s references
Hold internal team meetings and discuss evaluation results
Select EMR vendor

Deliverables/Tools and Techniques

Vendor evaluation matrix
Personal goal list
Master quote guide
EMR evaluation guideline
Vendor list
Vendor demo goals
EMR system configuration document
Demo Questionnaire
Vendor demo summary

Implementation and Testing

Implement EMR system
Prepare training plan
Conduct staff training
Conduct system testing

This phase heavily involves the selected vendor taking the lead in the project.

This phase include – installation, testing, staff training, and data input to EMR system.

AHS works in tandem with selected vendor to create and refine implementation plan with a realistic go-live date. AHS in coordination with vendor sets up different milestones.

AHS identifies training requirements for the staff and works out a training plan, schedule and agenda with selected vendor.

Based on the data input strategy finalized in initial phases, AHS facilitates loading of legacy patient charts.

AHS also works with vendor to develop a comprehensive system test plan including patient encounter simulations. System backup training is completed and downtime & system recovery procedures are put into place before practice signs off on the implementation

Activities

Develop implementation plan
Set a go-live date
Set up milestone and monitor implementation progress
Work on training plan and training agenda
Implement data input strategy and facilitate loading of legacy patient charts in EMR system
Develop system test plan, and test cases
Coordinate EMR implementation with vendor
- Install & configure H/W
- Install & configure S/W
- Begin staff training
Conduct system testing and prepare system test summary
Review and finalize system back up strategy
Conduct regular go-live meeting, review go-live issue log

Deliverables/Tools and Techniques

Implementation plan
Implementation checklist
EMR training plan
Go-live planning checklist
System test plan
System test cases
System test result summary
Back up strategy document
Disaster recovery plan
Issue log

Post Implementation Evaluation

Correct gaps
Resolve issues
Implement improvements

Post implementation evaluation is conducted after EMR system has been running for a while. AHS works with practice to address any gap between EMR system and the implementation goals.

AHS provides direction to continually evolve the practice workflows.

As staff becomes more proficient and familiar with the system, additional training may be required to learn advance features like advance scanning techniques, template customization, or report and registry creation. AHS will coordinate with vendor for additional post implementation training.

Activities

Conduct post implementation review
Update review journal
Conduct team meeting
Review requirements for additional training
Facilitate post implementation training
Update issue log

Deliverables/Tools and Techniques

Post implementation review summary
Team meeting agenda and minutes
Post implementation training plan
Training schedule and agenda
Updated project issue log

Post Implementation Improvement

Conduct gap analysis
Address EMR issues
Recommend improvements
Conduct additional training

The focus of this stage is on patient care and quality improvement.

The emphasis shifts to using the EMR to enhance and generate value added benefits to patient encounter.

In this phase, gaps that were identified in previous phase are addressed and corrected.

Roadmap - Paper Charting to EMR

Part of EMR Consulting

Practice Workflow Assessment
Project Management and IT Support
Vendor Selection and Recommendation
Hardware and Software Procurement Support
Implementation and Test Planning
RISK Identification and Mitigation
Train the Trainer
Strategic Planning and Support for Loading Paper Chart
System performance and contingency planning

EMR Implementation issues and suggestions to help successfully implement an EMR product

1 - Lack of Project Management

EMR vendor’s assigns a project manager who would need only one point of contact to coordinate implementation activities.
Assignment of an internal project manager is essential who would be your single point of contact for vendor
An Internal Project Manager
- Develops project plan
- Assigns roles and responsibilities
- Ensures sufficient allocation of vendor resources as well as resources from practice side
- Identifies project risk and prepares a mitigation plan
- Maintains a project issue log
- Prepares and maintains project status report
- Conducts project status meeting

2 - Lack of Project Planning

A project plan defines the work break down structure listing all the activities with a definite start /end dates.
It will also outline expectation, establishes deadlines, and assigns responsibility for implementation tasks.

3 - Staff Resistance

The change inherent to implementing an EMR system is often unsought by staff. Sometimes it results in highly resistant responses from the very staff who will be expected to use and benefit from an EMR
Identify and address staff concerns
Involve staff throughout the implementation process
Manage expectation by developing realistic goals and demonstrating progress
Establish project team consisting of physician champions and other motivated practice staff

EMR Implementation issues and suggestions to help successfully implement an EMR product

4 - Training

A highly expensive EMR is like a expensive grand piano. Whether you play the equivalent of Beethoven’s “Moonlight” Sonata or “Chopsticks” depends on your level of training
Plan your EMR education as carefully as you picked your system
Tailor training sessions to the roles and responsibilities of staff
Provide staff with time to play with the system outside of formal sessions
Implement the train the trainer concept and create super users
Develops training aids such as cheat sheets, quick reference guides to support staff learning

5 – Workflow Automation

An EMR implementation in a practice with failing or malfunctioning workflows does not increase efficiency. It provides for the same mistakes to be made with a difference of recording the results electronically.
Map out workflows to identify problem areas
Determine how system can be utilized within processes
Address identified workflow problems
If required, re-design workflow and re-map processes

6 – Legacy Patient Chart

Transitioning patient data from paper charts to EMR is the most time consuming and resource intensive task. In most of the scenarios a lack of careful planning and consideration turns into a nightmare and sometime derails the overall EMR implementation plan.
Prepare a well defined document scanning strategy
Determine key information and document that need to be plugged into the system
Establish process to load information into EMR system
Determine processes for handling new documents
Allocate appropriate resources based on volume

EMR Implementation issues and suggestions to help successfully implement an EMR product

7 – Lack Of Implementation Approach

Lack of a proper implementation approach for EMR often results into loss of revenue for practice, higher cost of implementation, and higher level of stress and dissatisfaction.
Determine a modular or big-bang implementation approach based on practice needs
Evaluate staff receptiveness to system
Develop rollout schedule of system modules or functions based on desired productivity and receptiveness level
Evaluate amount of training required based on the implementation approach

8 - System Performance and Contingency Planning

An EMR implementation in a practice with failing or malfunctioning workflows does not increase efficiency. It provides for the same mistakes to be made with a difference of recording the results electronically.
Hardware to meet the minimum system requirements, network capacity, verification of maintenance procedures are critical factors that can impact the performance of an EMR system.
Ensure hardware meets minimum requirements for running EMR system
Evaluate ability of network to handle increased traffic
Load test system to evaluate effect of typical number of users
Ensure system maintenance procedures are in place and working
Ensure disaster recovery plan is in place
Test system recovery procedures before go-live

List of Major EMR vendors and their products

Vendor	Product	Target Market	Comment
Epic System Corporation	Epic Care Ambulatory EMR	Medium-Large size Practices and Hospitals	CCHIT 2006 #1 Ambulatory EMR (over 25 physicians
McKesson	Horizon Ambulatory Care	Small-Large Sized Practices	CCHIT 2006
GE Healthcare	Centricity EMR	Small-Large Sized Practices and Hospitals	CCHIT Certified 2006
Cerner Corporation	PowerWorks	Small-Large Sized Practices and Hospitals	PowerChart (foundation of PowerWorks) CCHIT certified 7/2006
Allscripts	HealthMatics; TouchWorks	Small-Large Sized Practices and Hospitals	Both products noted are CCHIT Certified 2006
ABELSoft Corporation	ABELMed PM-EMR	Small-Medium Sized Practices	CCHIT Certified 2006, #1 in Electronic Charting by AC Group, Inc.
BizMatics	PrognoCIS	Small-Large Sized Practices	CCHIT Certified 2007, Java-based
ChartCare	ChartCare	Small-Medium Sized Practices	3 years at #1 Best in KLAS (2003, 2004, 2005)
Companion Technologies Systems	Companion EMR	Small-Large Sized Practices and Hospitals	CCHIT Certified 2006

List of Major EMR vendors and their products

Vendor	Product	Target Market	Comment
Epic System Corporation	Sunrise Clinical Manager; Sunrise Ambulatory Care	Hospitals and Health Systems	Sunrise Ambulatory Care 4.5 is CCHIT Certified
Electronic Healthcare Systems (EHS)	CareRevolution	Small-Large Sized Practices	TEPR Award 2004, CCHIT Certified 2006
Encite Inc.	TouchChart	Small-Large Size Practices and Hospitals	CCHIT Certified 2006
EncounterNOTES Inc.	EncounterNOTES	Small-Large Size Practices and Hospitals	CCHIT Certified 2006
iMedica Coporation	iMedica PRM	Small-Large Sized Practices	CCHIT Certified 2006
Infor-Med Medical Information Systems, Inc.	Praxis EMR	Small-Large Sized Practices	CCHIT Certified 2006
InteGreat, Inc	IC-Chart	Small-Large Sized Practices	CCHIT Certified 2006
LifeWatach Technologies, Inc.	LifeT.I.M.E	Small-Large Sized Practices	CCHIT Certified 2006
MCS-Medical Communication Systems	mMD.Net EHR	Small-Large Sized Practices	CCHIT Certified 2006
MedicWare	MedicWare EMR	Small-Large Sized Practices	CCHIT Certified 2007