EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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4 Key Considerations for Analysts When Implementing an EHR 

4 Key Considerations for Analysts When Implementing an EHR  | EHR and Health IT Consulting | Scoop.it

Implementing a new EHR system requires a great deal of collaboration between clinical and technical teams. Analyzing the legacy system and operational workflows, then successfully recreating—or better yet, improving—this experience in a new EHR takes finesse.

The foundation of every successful EHR and other large-scale implementation is a team of analysts who are knowledgeable, engaged and passionate about their work. From groundwork and discovery to build, acceptance testing and go-live support, analysts do it all. Here are four key considerations for analysts to keep in mind to help ensure their projects go well and they continue to thrive in their roles.

 

1 – Start with the end goal in mind.

When gathering requirements, project teams will often start by walking through every workflow in the legacy system with end users. This can be a long process and can lead to a lot of information gathering that is ultimately unnecessary. A better approach is to start at the end and work backwards. Ask users why they complete these workflows and what the expected outcome is. This will help get to the root of the requirements and allow analysts to immediately begin thinking in terms of the new EHR.

Here are several questions analysts can ask when gathering requirements:

  • What is the end goal or objective?
  • Why have you traditionally done it this way?
  • What would improve the process?
  • What is the clinical rationale for this workflow?

By starting at the end and asking users why they do what they do and what outcome they are hoping to achieve, analysts can more effectively and efficiently build a system that meets the needs of users.

 

2 – Be aware of the functional limitations of legacy systems.

A key point that is sometimes overlooked is that EHR workflows are often defined by—and limited by—the functionality of the EHR itself. Users will default to what they are familiar with, so if a certain workflow is used frequently in the legacy system, they will assume it is required in the new one. Some workflows may not be needed, however, because the new EHR is designed to achieve the objective in a different, more efficient way. If analysts do not understand this, they risk building in features that are counterproductive, or not needed at all in the new system.

For example, in her current workflow, a clinic manager needs to generate and print a report of all the assessments completed in the office each day. During requirements gathering, she may feel this is an important step to replicate in the new EHR. As it turns out, this workflow is a result of poor auditing functionality in the legacy system – to keep proper records, the clinic manager is required to generate and print these reports. Improved auditing functionality in the new EHR eliminates the need for the daily assessment report and makes this workflow unnecessary.

 

3 – Communication is key.

One of the most important things an analyst can do is to effectively translate the clinical and business needs of end users into technical requirements for the new EHR system. They must also communicate future-state workflows in a way end users can understand and relate to. Communicating effectively is vital to project success.

EHR transitions are often intimidating and frightening for users who have established a comfort level with the legacy system, and likely had little input in the decision to change platforms. Analysts can begin to alleviate concerns and increase user adoption by putting together a few “quick wins.” A quick win is when an analyst identifies a piece of functionality that is very important to users but is also easy to build and demonstrate in the new EHR. Quick wins communicate to users the team is not only listening to their needs but can also deliver solutions quickly and effectively. This also increases confidence, workgroup participation, and communication response time with users and stakeholders, all of which contribute to project success.

 

4 – Strike a balance between functionality and maintainability.

Enterprise EHR systems are complex and, depending on the size and diversity of the user base, may require a team of several hundred application analysts to maintain. In addition, it’s important to remember that every clinical user in a health system is depending on the EHR to complete their documentation and deliver the highest quality of care to patients. Because of this, it is important to strike a balance between functionality and maintainability.

 

If the project team attempts to build in every piece of functionality requested by end users, including things that are nice to have but not critical for the system to function, the EHR will become unwieldy and difficult to maintain. Future updates by the EHR vendor will likely break any customizations, cause unnecessary downtime, and push the volume of help desk requests beyond what the business can support.

In contrast, if the project team oversimplifies and standardizes too much, they risk building a system that does not meet the core requirements of end users. When users can’t leverage the system the way they need, they find “creative” approaches that don’t always work or simply don’t document everything needed. This can lead to a host of problems such as violating operational policy, regulatory reporting issues, loss of revenue due to incorrect documentation, HIPAA violations and, ultimately, lower quality of care for patients. A well-balanced system will keep the support team busy but not overwhelmed, include all required functionality as well as some quality of life features and allow clinicians to be at their best with patients.

In summary, by keeping workflow objectives in mind, understanding legacy system limitations, communicating effectively and balancing functionality and maintainability, analysts demonstrate the value of their critical role in EHR implementation success.

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8 Best Practices for Building Better Relationships During EHR Implementation and Training 

8 Best Practices for Building Better Relationships During EHR Implementation and Training  | EHR and Health IT Consulting | Scoop.it

New software implementations can be a high-stress scenario in the hectic and sometimes change-averse world of healthcare. End users are under pressure to adapt to new resources while continuing to tend to the high-stakes business of patient care. Instilling confidence in users’ ability to make thorough and efficient use of new technology plays a big role in successful tech adoption. Comfort with new tools is particularly important in patient-facing roles like scheduling where staff frustration can negatively influence a patient’s first impression of the facility.

 

As EHR consultants, project managers and trainers, one of our primary goals is to engage and encourage end-users during software transitions. We lead the charge to get projects done on time and under budget without having official authority over team members within the client organization. Throughout my years working as an Epic principal trainer one thing has consistently helped me garner buy-in with project teams: building good relationships.

Good relationships with stakeholders play a pivotal role in maintaining project momentum and getting through the inevitable stress points that arise during implementation. Here are some best practices to keep in mind to put your best foot forward when building relationships with clients and end-users.

Make communication a key priority. Make sure everyone clearly understands the objective of the project and the overall plan up front to set the tone and establish team buy-in. Demonstrate that leadership is on board.

Address team expectations openly and honestly. Clearly define the expectations you have of people involved in the project. Identify and articulate specific deliverables and due dates. Meet on a weekly basis to review plans, get progress updates and identify risks that may have cropped up. Maintain a living document that changes with every meeting.

Encourage team members to take ownership. No one likes a know-it-all. One tactic I use even when I know the answer to a problem is to pose a probing question to the team and let the group come up with the solution themselves. This boosts staff confidence, helps team members feel they are contributing and keeps you from having to micromanage.

Build trust with project staff. Teams want leaders who will act as a voice for end-users. Spend at least a couple of hours with team members each week to get to know them, their pain points and their motivators. Walk throughs offer great opportunities for engagement.

Honor individuality. Don’t expect individuals to change who they are to fit the culture of the team. Some people, for example, work better independently. Recognize that and let them go. Refrain from forcing end users too far out of their comfort zone to avoid unnecessary friction.

Leverage rewards and recognition. Make it a point to celebrate staff accomplishments big and small. Peer recognition can be a strong motivator, but not all people appreciate public acknowledgement. Different rewards work for different people. Find the trigger that works for that individual. Small things like taking people to lunch can help you celebrate achievements and further develop relationships.

Make team participation fun. Humor can help diffuse project resistance and apprehension. Open presentations with a cartoon to bring fun to team meetings. During stressful times, a cartoon slide that acknowledges the pressure staff members may be facing can remind end users that they are not alone.

Invite end user feedback. Feedback loops help project managers and trainers continually get better. All EHR trainers and classes should be evaluated by end-users. This helps reveal improvement opportunities for future client projects.

At the end of the day, EHR training is not about you and how much you know. It is about making sure that users get what they need out of class. Don’t overflood their minds on day one. Demonstrate patience as staff members acclimate. Remember that relationship building and team engagement is a great way to not only share your knowledge but to learn from others as well.

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9 Steps to Successful EHR Implementation

9 Steps to Successful EHR Implementation | EHR and Health IT Consulting | Scoop.it

Healthcare organizations need an efficient way to process and share care delivery information to increase productivity, deliver better quality care, save money and ensure compliance.

Properly Switch EHR can deliver on this promise and provide most benefits associated with adopting digital technology.

Are you ready?

It comes as no surprise that technology continues to be an increasingly prominent part of our society.  Technological advancement isn’t going anywhere, but does this mean your organization needs it? Determining whether or not your practice is ready for EHR is the first step toward reaping all the benefits that information technology provides. Get together with business leaders, managers, and other key stakeholders to determine, infrastructure, people, technology and investment challenges that come with this change. Carefully consider whether or not implementing an EHR would be a step toward reaching or exceeding your business goals and strategy.

Be honest about your current status

Before implementing the new system, you must have a clear understanding of where you and your team stand. Do you have a proper infrastructure (internet, computers, printers, scanners etc.)? Does your team run efficiently? Are there any clinical or administrative process that is creating the bottleneck. How information and documentation are currently organized and processed? Is the staff proficient with computers? Are they willing and able to learn? These are important questions to assess your readiness for a successful EHR implementation. Be sure to be critical, honest, and true; inaccurate assessments will only hinder your team’s progress.

Set goals

Goal setting is almost always a constructive pursuit, and when setting goals for your team it is crucial to consider what factors will drive EHR success. Goals should be relevant, specific, measurable, achievable, and deadline oriented. Work with members to brainstorm a set of realistic and attainable goals with a time limit and budget to achieve them. If you haven’t already, assess and fully understand the time needed to complete tasks and work with team members to set standards and requirements. Determine what actions are benefiting your organization and those that are not; identify processes that can be improved and work with your team to strategize and redesign standard operating procedures.

Assign Roles

Delegating clear positions and responsibilities to allow for a smooth and productive transition. Be certain that those in charge fully understand why changes are being made and have the resources and time available to effect such change. Having clear objectives established will help drive the team ownership and productivity. Ensure that team members understand their duties, how to best execute them, and who they can reach out to for assistance, questions, and collaboration. Communication is key in any group environment, especially one undergoing significant change.

Find the best tools for your organization

Tools are only as useful as you make them. Expand your perceptions and be fully aware of all available resources. Your Regional Extension Center (REC), IT and EHR vendors should be able to provide you with the tools necessary to ensure a smooth transition.

Consider cost

$12,000 is the average cost of an EHR system. This includes software, hosting, maintenance, support, and upgrades. Connecting with health information exchange (HIE), customized reports, and premium features may be more. Before jumping in, consult a legal or financial counsel to determine costs and contract terms. Medical associations provide many open source templates and checklists to help.

Pick a certified EHR

It is helpful to pick an EHR that will customize to support the way your organization runs and help achieve your objectives quicker. Take careful consideration of other products such as practice management software, patient portal, text messaging, business intelligence tools, and public health interfaces.

Implement and train

Designate a leader to manage the transition and work closely with them to create a clear plan. Figure out what technological elements will be needed in converting data and paper charts into your new EHR, and what sorts of limitations you may encounter. Consider the value of information such as patient demographics, insurance, and appointments. Familiarize yourself with how HIPPA and business associate regulations will impact your patient services process. In evaluating your current and future workflows, be sure to create a backup plan for problems that you might come across.

Revise and improve

During and after implementation, meet your team and consider whether or not your goals have been met. If so, is there a way to improve efficiency? Do not overlook the need for further training, as efficiency can be compromised if you don’t know how the new system works especially shortcuts. Adjustments often do not go as planned, the continuous evaluation will help reassure the team and fix problematic issues.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
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Is Your EHR On The Right Track ?

Is Your EHR On The Right Track ? | EHR and Health IT Consulting | Scoop.it

Medical Records Briefing (MRB) is conducting its benchmarking survey on electronic health record implementation, and we would appreciate your input. Please take a few moments to complete this survey.

 

To show our thanks, we will select one respondent at random to win a complimentary HCPro webcast of his or her choice. To enter to win, please include your contact information at the end of the survey once you have answered the questions.

 

Entering your contact information will also enable us to email you the results of the survey along with commentary from industry experts. The results will also be featured in the October 2015 issue of MRB. The link below will take you to the survey’s website; simply click on the link to answer the survey questions online.

 

If the click-through does not work, please copy and paste the URL below into the address bar of your browser.

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Solo Practitioners Exempt from EHR Implementation in Minnesota

Solo Practitioners Exempt from EHR Implementation in Minnesota | EHR and Health IT Consulting | Scoop.it

One of the key issues that some healthcare providers have found with the Medicare and Medicaid EHR Incentive Programs is the mere financial impact of EHR implementation. In Minnesota, small medical practices – particularly solo practitioners – will no longer have to invest in costly EHR implementation plans due to a bill that was passed by Minnesota lawmakers in both the House and Senate.


Under the Minnesota Department of Human Services policy omnibus bill, there are various healthcare reform objectives including exempting solo practitioners and cash providers from having to invest in health IT systems and EHR implementation.


While this may benefit these providers financially and allow them to run their practice without monetary disadvantages, paper-based patient records could potentially lead to safety issues and additional medical errors that impact population health outcomes across underserved regions within the state.


Nonetheless, Minnesota seems to be the only state in the nation where an EHR mandate required all healthcare providers and hospitals to install and implement EHR systems by January 1 of this year.

The bill’s amendment on EHR implementation is now in place and providers will have to comply with it starting in January 2015, according to a press release from the Citizen’s Council for Health Freedom (CCHF), a Minnesota-based organization aimed at protecting patient privacy and rights.


CCHF feels the EHR mandate that required all providers to participate in EHR implementation was too costly and had patient privacy implications the organization does not support. Essentially, Minessota was the only state that did not have an opt-out option. Other providers across the country could take the payment penalty hit from the Centers for Medicare & Medicaid Services (CMS) instead of being required to adopt certified EHR technology.


In particular, providers in Minnesota were required to implement an interoperable EHR system that was connected to a state government-approved Health Information Organization, which is a costly endeavor.

“We’re pleased that lawmakers have included this important amendment in Rep. Tara Mack’s bill that will allow small clinics and practices to continue to serve patients in Minnesota,” stated CCHF president and co-founder Twila Brase. “Many small clinics and practices cannot afford the cost of the EHR system, and many practices do not want to make their patients’ data accessible online.”

“This amended bill will allow small clinics to thrive in smaller communities,” Brase continued. “And it will allow single doctor’s offices to keep their doors open, rather than be forced to join a big practice.


Patients would be able to search for practitioners who hold their medical data truly confidential and for doctors that look them in the eye rather than turning their back on them and typing into a computer. Minnesota is the only state that, until now, did not allow healthcare providers to opt out of expensive, intrusive online-accessible EHRs. The federal HITECH Act mandates EHRs, but allows any provider to opt out. This amendment begins to give Minnesota the level of freedom and privacy available to doctors and patients in the rest of the nation.”


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Did Meaningful Use Requirements Propel Hospital EHR Adoption?

Did Meaningful Use Requirements Propel Hospital EHR Adoption? | EHR and Health IT Consulting | Scoop.it

Ever since 2009 when the Health Information Technology for Economic and Clinical Health (HITECH) Act became law, the majority of healthcare providers began adopting EHR systems and other health IT tools in order to meet the meaningful use requirements under the Medicare and Medicaid EHR Incentives Programs and avoid the financial penalties set for 2015 and the following years.

The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) supported EHR adoption among hospitals and physician practices through a variety of resources and advisories. Recently, ONC released a data brief that outlines the high EHR adoption rates among hospitals and other providers.


The brief outlines the trends in the adoption of EHR technology between the years 2008 to 2014. ONC also tracked the implementation of certified EHR systems that meet meaningful use requirements as well as general health IT systems.


The results show that 76 percent of hospitals have a basic EHR system. This statistic has increased tremendously over the years, rising by 27 percent from 2013. Out of these reported hospitals, 97 percent have adopted certified EHR technology that meets meaningful use requirements under the EHR Incentive Programs.


Hospital EHR adoption varies significantly across states, ranging from 50 percent to 100 percent. Delaware, South Dakota, and Virginia have the highest rates of basic EHR adoption among hospitals. Kansas, West Virginia, and Hawaii were the three states with the lowest adoption rate of basic EHR systems.

State adoption of EHR systems has also risen significantly from 2008 to 2014, the ONC data brief shows. In 2008, only Connecticut and New Mexico had adoption rates of basic EHR systems above 20 percent.


By 2011, this statistic rose and 32 states had a hospital EHR adoption rate above 20 percent while seven states had a rate above 40 percent. By 2014, hospital EHR adoption rates were above 60 percent in 48 states and above 80 percent in 17 of those states. Clearly, these trends are rising significantly to meet meaningful use requirements and prevent the financial penalties under the EHR Incentive Programs.


The use of advanced functionalities within EHR systems is also increasing. For example, many more hospitals are using EHR technology that includes clinician notes. Additionally, 34.4 percent of hospitals have implemented comprehensive EHR systems in 2014.

Essentially, the adoption of EHR systems among acute care hospitals has quickly increased once the HITECH Act was passed in 2009 and providers began pursuing meaningful use requirements. State EHR adoption rates have also steadily increased among hospitals since the legislation was passed.


“A favorite question of mine, asked during the sessions and included in the report, is the following: ‘The real question is not what data we want to collect, but what problem are we trying to solve?’ I believe the real problem we are trying to solve is how to advance the public’s health wherever people live, work, learn or play, using information and data as a tool,” National Coordinator for Health IT Karen B. DeSalvo stated on the ONC website.


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The Evolution of Enterprise Databases and EHR Interoperability

The Evolution of Enterprise Databases and EHR Interoperability | EHR and Health IT Consulting | Scoop.it

There are many parallels between the enterprise database sector and EHRs. Can the evolution of this database industry guide progress in the EHR front? I think there are a number of similarities and solutions which can address the proposed problems facing EHRs and the global healthcare system.

Oracle, the first commercially available database system, has been in existence for more than 35 years.  As a company, Oracle has encountered numerous competitive, technologic and economic challenges forcing it to re-think, re-engineer and re-develop its platform while maintaining backward access to huge volumes of data for its customers.  Many enterprise database companies have since entered the marketplace, all bringing a unique and proprietary set of options, designs and performance.

Despite these differences, enterprise database systems, along with open source and the relatively new NoSQL databases are able to interoperate to meet the demands of customers who are dependent on reliable, scalable, high performing, usable and secure access to data.

Dr. Donald Voltz

Hospital EHRs are babies when compared to enterprise database systems, but they share a great deal of similarities and have become a central player in our healthcare system. Physicians, patients and other healthcare providers are becoming dependent on EHRs for the daily management of patients. Meanwhile, administrators, insurers and regulatory bodies have been developing policies, process and practices to using EHR data for population health, patient engagement and development of best practices at a systems level. 

With the development of large scale, high performance ways to store and access increasingly larger data sets, enterprise applications have evolved to utilize the changing functionality with a commensurate understanding of customer demands leading to increased database functionality.

A cycle of sorts advanced the capabilities and allowed for the migration of application-centric software applications which were slow to change due to interdependencies. Looming was the real possibility of losing business critical functionality during upgrades to software as a service models (Saas) allowing for better scalability, more frequent software updates and higher reliability with lower overall costs.

The history of enterprise databases, and that of other enterprise software, shared similar criticisms as technologic advances occurred. The integration of legacy systems with evolving technology presented the greatest barrier to adoption, even when validated claims of higher performance, increased functionality, and lower costs were realized. These same criticisms have been voiced for EHR technology and are not likely to quite any time soon. 

The problem of integrating new and old technology or bringing technology into an area traditionally administered by manual, static and labor intensive means, boils down to the misapplication and misunderstanding of prior solutions. In enterprise database applications and others, middleware integration architecture was introduced, but was slow to fix these challenges.

Middleware was dispelled and slow to be applied to the enterprise software problem, stemming from attempting to solve integration problems of evolving technology with middleware platforms built upon prior technology.  

EHR interoperability in the early state of implementation and development does not have the legacy middleware problem since nothing existed before. In light of health information exchanges, proposals to develop data sharing standards, little has been presented on the middleware as a viable solution to the interoperability problem in healthcare. Although early in the implementation of EHR’s, they have made a large splash in healthcare and will be required to quickly scale to the available technology, including mobile.  Medicine is many years behind other fields in the deployment of enterprise software solutions to meet the needs of hospitals and patients. 

Oracle recently announced the release of a node.js database driver. This is yet another example of how large, proprietary enterprise software understands the need to implement middleware access so other innovative and motivated companies can develop new solutions to business, personal and social needs.

As we look forward, patient engagement with their health data, insurance, medical decisions and access to healthcare providers will necessitate additional development onto existing and emerging technologies.  If healthcare follows the trends of other enterprise software, and there is no reason to suggest it will not, middleware has been the only architectural pattern to solve the integration problem in a cost effective way while supporting scaling, security and reliability of critical business operations.



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EHR Optimization as a Bridge to Population Health Management 

EHR Optimization as a Bridge to Population Health Management  | EHR and Health IT Consulting | Scoop.it

In the quest to meet value-based care, population health and quality reporting goals, healthcare leaders face an array of avenues and tactics. While the strategies differ, one constant in virtually all efforts to bring structure to new care delivery models is the improved use of technology and systems, and the troves of data they store and transmit.

 

Analytics has a pivotal role in meeting healthcare’s triple aim of reducing the per capita cost of care, improving patient experience (including quality and satisfaction) and improving population health. Without the support of the clinicians using these technologies and the information they hold, however, it is difficult to succeed. This has prompted some healthcare organizations to champion a quadruple aim that also seeks to improve the work life of healthcare providers.

 

To develop and execute on a quadruple – or even triple aim – healthcare leadership teams must answer the question:

How can our organization capture the information needed to deliver effective, data-driven care in a manner that benefits patient outcomes and compliments provider workflows?

Through a disciplined EHR optimization methodology, a structured plan, and input from providers and clinicians on goals and practical ways to meet those goals, it is possible to adopt a data-capture care strategy that minimizes impact on provider workflow while maximizing return on reimbursement.

 

Optimization in Action
Consider how EHR Optimization can aid population health management efforts.

 

Many healthcare organizations are analyzing patient data to identify high-risk and/or high-utilization patient populations that could pose savings opportunities if their care interventions are migrated from high-cost emergency department and inpatient settings to preventive and primary care, but how many are truly looking up-stream at how the configuration and use of the EHR impacts their success?

 

When developing and deploying an organization’s population health goals and identifying target patient populations, consider how your organization can engage and support your clinicians in this evolution. What clinical workflow supportive functionality is available in your EHR to aid and prompt care team members to ask the right patients the right questions, proactively screen, and implement low-cost interventions to quickly put population health management into action?  How can these opportunities be implemented without disruption of patient care flow?

 

Here are specific strategies for building an EHR Optimization plan targeted toward enabling population health while supporting your providers:

  • Engage your clinicians early on. Including your providers and allowing them to tell you how they work and what will work for them to support your effort makes a successful initiative.
  • Integrate with established workflows when possible. Data entered correctly into your EHR supports your analytics needs. You will depend upon your providers to capture this for you.
  • Prioritize your target patient populations. Which initiatives will yield the highest return? Start with a single impactful goal and fine tune processes, measurement and engagement around it.
  • Ensure consistency in design. Provide consistency in data standards and naming conventions. This can go a long way to eliminate redundancy in documentation for clinicians. This is particularly important when planning to expand your program

EHRs and supporting technologies are an incredible data source and the key to value-based care and population health management success. EHR implementation and optimization strategies that keep the quadruple-aim top-of-mind can support organizational initiatives while enhancing, or at very least not burdening, clinical workflows of your EHR users.  Engaging your end users in the process inspires a collaborative, supportive environment while encouraging a successful outcome to organizational directives.

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EHR Training: How to Help Users End Frustration, Overcome Fear and Engage 

EHR Training: How to Help Users End Frustration, Overcome Fear and Engage  | EHR and Health IT Consulting | Scoop.it

During EHR implementations, trainers are frequently the first to introduce end-users to the new technology. Users often come to EHR training frustrated about the change and nervous about acclimating to a new system. Adding to the pressure they feel, EHR training may only entail a one-time training class that delivers an immense amount of information in a short period of time—unless the healthcare organization offers on-site interim training opportunities, users often never touch the EHR again until after go-live. Under those circumstances, trainee resistance and fear are understandable.

What I’ve discovered in my years as a trainer is that successful EHR adoption is not just about the technical training. The biggest part of my job is to give end-users encouragement and confidence that they will be able to adapt to the EHR even though they may forget some of what is taught during training. People learn the best when they feel personally engaged and know that the trainer cares about them. Trainers play a key role in promoting not only technical EHR know-how, but cultural buy-in.

Given the right training environment, EHR trainers can help healthcare organizations diffuse negativity and push-back while bringing end-users up to speed on new EHR workflows. A trainer’s ability to successfully empower users truly does come down to training delivery. Here are some of the best practices that I’ve cultivated over the years to help maximize staff acceptance of the EHR.

Little things matter when creating a welcoming learning environment. When EHR users come to class, stand by the door and greet them. Smile, ask trainees their name and introduce yourself. Don’t just sit behind the desk. Don’t underestimate the power of a smile to make people feel comfortable. Remind trainees that you are there as a resource for them.

Address end-user frustrations head-on. As part of class introductions, ask trainees to comment on how they are feeling about the EHR migration. If necessary, purge EHR transition angst and negativity by letting users briefly share how they feel at the very beginning of class. After that catharsis, implement a strict “no complaining” policy and start working to shift end-user thought patterns. I encourage users to change their internal talk track from one of resistance to one of acceptance.

Employ compassion and empathy to understand where end-users are coming from. Trainees may come to class with feelings of nervousness, fear and anxiety. This is particularly true among non-computer natives, who are pervasive in healthcare. I like to share my personal story of being hired to be a trainer based on my background as a speaker and a nurse, and having to learn the technical aspects of training along the way. Shared experience and understanding go a long way in establishing rapport.

Build a sense of safety and community among end-users. To avoid trainee feelings of inadequacy, I offer patience to those in the class and work to foster a growth mindset. In peer training settings, clinicians often feel they are expected to know everything. Actively work to make end-users feel comfortable asking questions. Remind them that just because they don’t know something yet does not mean they can’t learn it.

Create a different training environment than people expect. Infusing unanticipated elements into the training program can make it more memorable. I like to bring laughter to the training program because if people are laughing, they are learning. Humor can help diffuse tension and put people at ease.

Always opt for words of encouragement. Remind EHR trainees that they can all do it and they will succeed, regardless of age or technical aptitude. Point out that people often learn the same thing in very different ways and warn against comparing one’s learning speed to that of others. All end-users will inevitably forget a portion of what is covered in training but, with the right mindset, they will be able to learn it again.

I can’t say enough about the need for words of affirmation in healthcare. A lot is expected of staff members during an EHR implementation. The stress of training while managing the day-to-day work of patient engagement can be overwhelming. If nothing else, give them hope. We all feel the strain of change in healthcare and we could all use an encouraging word!

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Building the right IT team for a successful EHR go-live

Building the right IT team for a successful EHR go-live | EHR and Health IT Consulting | Scoop.it

In the world of healthcare IT rarely is one person or small group of individuals able to complete the entire value chain of delivering IT solutions that properly define operational requirements and workflows and translate these needs into technical programs or application builds. A variety of backgrounds are needed including input from people with diverse and unique expertise that lie in different areas of the organization. As a result, comprehensive teamwork is essentially required to successfully launch and deploy projects that result in ongoing improvement in patient care, advancements in research and overall operational efficiency. 

So what are some of the specific essential components of building the right team to ensure success in an environment that requires absolute preciseness and accuracy? 

 

Based upon my healthcare organization’s successful deployment of an integrated electronic medical record throughout the ambulatory, inpatient and homecare environments, the following are some elements that delivered optimal results via an integrated teamwork approach:

People: Recruiting the right people into the right roles is the number one starting point to begin an initiative. Clearly communicating each person’s role on a project accents the defined contribution expected from each participant. In our organization, we focus heavily on selecting people who exude energy, have a positive attitude and demonstrate a proven record of aptitude in their specific area of expertise.

Chemistry: Blending operational and information services personnel together is a critical component needed to collaborate and most effectively evaluate all required application functionality for delivery.

Project Leadership: Guiding the project and removing barriers from issues ensures that staff level employees can be successful in their role.

Process: Using a tried and proven methodology with agreed upon milestones binds the various teams together and aligns goals and tasks for execution.

Culture: Building an environment to foster recognition that we are all in this together results in developing respect for one another. This aspect is paramount to gaining positive momentum in working as a highly functioning team. No “drama” is tolerated.

Enterprise Leadership: Working with other leaders throughout the organization ensures proper staffing, goal setting and achievement of set objectives.

In a healthcare environment — which is characterized by continuous change, increased transparency and a wide variety of diverse accountabilities — the need for a solid, mission oriented team has never been greater. Organizations that have invested in using the integrated team approach are recognizing the benefits of their investment by more readily enabling their business objectives. And these organizations are better prepared for the next wave of challenges.

 

The journey on the road to achieve the many benefits of healthcare IT is long and winding, but the need for comprehensive teamwork along the way will always be vital to achieving success.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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4 Stumbling Blocks to Avoid in System Implementation

4 Stumbling Blocks to Avoid in System Implementation | EHR and Health IT Consulting | Scoop.it

Every organization, at one time or another, goes through some type of system upgrade or implementation. Common practice is to develop a very detailed project plan. These documents are laid out to ensure that all tasks are performed and that all deadlines are met. Meetings are scheduled, milestones are agreed upon, and staff are informed of what to expect. Unfortunately what may look like a well thought out plan on paper may not address the day-to-day issues that can often disrupt a thoughtful plan.


So how do you prevent this kind of interruption? It is good practice to think about possible stumbling blocks that can cause employee angst, reworking of project plans, and/or potential deadline delays. Take a look at the following potential road blocks and how to prevent them.


Potential stumbling blocks:


  • Calendar disruptors – Consider outside elements that may cause changes to the calendar. For example, are there holidays which need to be taken into account during the timeline development? A long three day weekend, like Memorial Day, typically means a reduced staff for testing and training. In the northeast, is it wise to plan for a winter go-live? In Florida, which of the months could impact a successful project during hurricane season? Weather conditions can have the potential to wreak havoc on a well thought out project plan.
  • Business office constraints – Take a look at potential business office constraints. If the expectation is to have business office staff training during month end close it is unlikely that those training sessions will be well attended. Are there any other upgrades or implementations that may be going on at the same time? If so, there may be a limited resource pool to pull from. Keep in mind that employees may already be concerned if they are currently spread too thin.
  • Training and testing limitations – Depending on the size of the office that is scheduled to attend training or provide testing assistance take all schedules and workloads into consideration. If it is a small office, where each provider has a heavy schedule, how likely will it be that staff can attend training classes or testing assistance while ensuring that patient care is not being compromised? Look at additional resources or supplemental staff to fill in so staff can leave the office and attend training sessions.
  • Inadequate go-live support – Another component worthy of evaluation and consideration is go-live support. Most organizations incorporate a “help line” to aid the staff after a go-live. But what happens to that large practice that has a long line of patients, phones ringing, providers requiring attention, and employee anxiety? There needs to be a plan in place to circle back with those practices and make sure they are getting the necessary support.


To ensure your system implementation goes smoothly, consider the following steps:


  • Develop a well thought out project plan.
  • Make sure the objectives are clear.
  • Coordinate training schedule with business office needs.
  • Allocate resources and back-up plans early in the planning process.
  • Provide consistent and clear communication.


It is important to understand that little changes may impact well intentioned go-live of a system implementation. A well thought out project plan that accounts for these stumbling blocks and has contingencies built in will help to ensure a successful go-live. You can then focus on ensuring employee and patient satisfaction, which helps everyone in the long run.

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Do Health IT Systems Need Greater Interoperability?

Do Health IT Systems Need Greater Interoperability? | EHR and Health IT Consulting | Scoop.it

The medical sector is aimed at reaching the triple aim of healthcare by incorporating health IT systems and EHR technology. The triple aim focuses on improving patient care, lowering medical costs, and boosting population health outcomes.


In a Health Affairs Blog, National Coordinator for Health IT Karen B. DeSalvo discusses the landscape of information technology in the medical space.  DeSalvo emphasizes the need for interoperability among health IT systems and mentioned how the Office of the National Coordinator for Health IT (ONC) is developing new implementation standards. Additionally, the need for privacy and security of patient data is also asserted by DeSalvo.


The sharing of patient data through health IT systems has been a major focus for the healthcare industry over the last year. To improve EHR interoperability, ONC has listened to the health IT community to develop a roadmap for establishing strategies and opportunities to move the country toward greater health data exchange.


DeSalvo has participated in many listening sessions across the country and learned about certain issues that harm the interoperability of health IT systems and plague hospitals and providers. Rural communities in Alabama, for instance, do not have full broadband access while bordering state privacy laws in New Jersey block medical data exchange. The overall essence of DeSalvo’s discussion revolves around the importance of interoperability among health IT systems.


“I also listened to my own experiences — as a doctor, as a daughter, and as a consumer,” DeSalvo stated. “I thought of countless patients whom I have seen and those I continue to see when I am in clinic. Of visits where I did not have the information needed to make a decision that day, requiring patients to return and miss work, school, or other obligations. Of patients who want to engage and feel empowered but need not only data, but information, to help them level the playing field, to allow them to meaningfully engage.”


“Of being a caregiver for a mother dying of dementia and being frustrated at just how hard it was to get access to the information I needed to help her. And, as a public health advocate and official, needing information about my community to prioritize resources to help them address the broad determinants of health,” said DeSalvo.

Over the last six years since the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed, the healthcare industry has gone forward with meeting many of the goals ONC established such as widespread implementation of EHRs and health IT systems. More and more eligible providers began meeting meaningful use requirements under the Medicare and Medicaid EHR Incentive Programs.


While these achievements are impressive, DeSalvo mentions the need to digitalize “the care experience across the entire care continuum” and gain “true interoperability.” ONC is currently working on a plan for both public and private sectors to gain interoperability. The next step for ONC and the healthcare industry is to go beyond meaningful use and EHR implementation in order to truly bring better health for patients across the country.


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Important Features For Your Practice Computers

Important Features For Your Practice Computers | EHR and Health IT Consulting | Scoop.it

Medical computers are an essential element of the modern health care system. They help increase efficiency in every setting from the front office to exam rooms, surgery, and radiology departments. Choosing computers for your practice is an important task, so here are some features to look for:


Sanitation Promoting Features


A clean environment is indisputable in health care facilities, and a critical component of a medical grade computer is their ability to support one. Hygiene-promoting features on your practice computers should include the following:


  • Sealed enclosure resistant to liquid and can be cleaned with disinfectant.
  • Antimicrobial coating on keyboards and monitors or all-in-one computers.
  • Fanless design to reduce dirt accumulation in the system and dust from circulating.
  • Minimal crevices that are potential homes for bacteria.


Mobility and Accessibility


When medical computers are mobile and accessible, health care organizations can save time, money and improve patient care. Nurses and doctors can bring computers with them on patient rounds or during check-in. This accessibility in medical computers lets doctors and nurses focus on patients, not hardware, during appointments. Look for computers that fit into a variety of settings, whether they can be placed on wall mounts, medical carts or nursing stations. VESA mountable computers are the preferred industry standard. The medical computer supplier you choose should offer assistance in installing your computers where you need them. Also, check for an internal lithium battery that allows for mobility without interrupting data management.

Touchscreens are another significant option that lets caregivers focus on patients. When they are easy to use, caregivers can easily enter data and interact with the computer, while still giving attention to patients. Medical Computer touchscreens are also more hygienic since they can come with an antibacterial coating.


Administrative Tools


A high performing and efficient hospital or clinic has central coordination, and medical grade computers reinforce this. With medical grade computers, administrative staff can enter and edit a patient’s medical, insurance and billing information in a patient environment. Each computer on the network should have access to this information, with a setup that allows for HIPAA compliance. Elimination of redundant inputs, reduction of errors and the switch to electronic rather than paper billings all save costs.


Low-Cost Installation


While changing to a medical computer system or getting an overhaul of your current system will undoubtedly involve some expense, you can minimize it in a few ways. One is by choosing a system compatible with as much of your existing systems as possible. For example, inquire about the extent of inputs and outputs that would be necessary with a new system; you may be able to make use of parts of your current system and thus save trouble and money from redundant equipment purchases.


Another way to reduce the initial investment cost is to consider the time and resources required to get doctors and other employees able to operate the system. First, software should be easy to use. Look for medical grade computers that support your preferred software programs or that come with new software that is simple to learn. Insist on getting a free trial before committing to a purchase.

Second, be sure to train employees before your upgrade is complete. Extra time from tutorials is expensive to a hospital or clinic, so find out how long it typically takes for users to master the system. If possible, purchase your medical computers from a company that provides follow-up support..


Cloud-Based Systems


Your practice computers need to be compatible with the cloud. As recently explained on this site, 96 percent of health care organizations are using or considering the cloud. Those who do can hope for average cost savings of 20 percent each year.


Using the cloud has additional advantages over cost savings. It allows for unlimited storage and frequent backups. Also, storage on a remote server rather than a large server on site prevents the risk of losing data in case of a flood, fire, etc. Check for a computer with EN/UL 60601 medical certification with which protects against power surges, failures and improves on-site safety.


A quality medical grade computer has a number of important characteristics that allow for reduced costs and upgraded patient care. Keep a list of necessary features in mind when you shop for your new computer or system, and your health care organization may soon see benefits.


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Deloitte Announces New Approach to EHR Implementation and Support

Deloitte Announces New Approach to EHR Implementation and Support | EHR and Health IT Consulting | Scoop.it

Today Deloitte announces Evergreen, a new approach to electronic health records implementation and maintenance designed to help reduce hospital system IT costs as health care moves to a value-based model more reliant on clinical and enterprise data.

Evergreen may help health systems save up to 30 percent on EHR operating costs by using a global staffing model and a standardized design that works to improve clinical optimization. Evergreen also leverages Deloitte’s acclaimed cyber risk services in providing advanced levels of data security and compliance.

In addition to supporting large providers and academic health centers, Evergreen may especially benefit mid-sized healthcare systems looking for more EHR innovation and efficiency as they move to a new environment marked by declining reimbursements and a focus on quality outcomes.


According to Mitch Morris, principal, Deloitte Consulting LLP, and Deloitte’s global healthcare leader, Evergreen’s potential savings will enable providers to put more capital back into caring for their communities. “Evergreen offers an innovative approach to achieving the expected benefits of clinical and revenue management systems in a post-reform world,” said Morris. “It can provide clinicians with the software applications they prefer while supporting the clinical and financial results that health systems are looking to achieve.”

Evergreen is modeled after Deloitte’s mature services approach developed for Catholic Health Initiatives’ Epic deployment, and it builds upon Deloitte’s extensive history in managing other application management services engagements. In addition to the core EHR benefits, Evergreen leverages Deloitte’s advanced analytics and reporting capabilities, which can improve clinical performance by gleaning insights from clinical and financial data.  It also wraps clinical transformation and workflow optimization into the approach.

“Evergreen draws upon Deloitte’s world-class capabilities in strategy, consulting and application management services,” said Tim Smith, principal, Deloitte Consulting LLP, and leader of Deloitte’s health care technology practice. “It brings the enterprise-wide view that organizations may need in retooling their cultures around a greater use of data.”

Catholic Health Initiatives is the first provider to implement the full Evergreen approach. The company said Evergreen is increasing its ability to capture, analyze and share information, which will help position the organization as a leader in the areas of evidence-based medicine and care coordination.

“Evergreen is part of our vision to become a forerunner as health care moves to a value-based model,” said Michael O’Rourke, chief information officer at CHI. “It will enhance our ability to deliver the right treatments to the right patients at the right time, with improved quality and reduced costs.”

Morris commented that there is “tremendous” market potential for Evergreen. “Health care is an industry looking for tools and direction on how to make the transition to population health,” he said.  “We anticipate that providers in the U.S. and abroad will be very receptive to an approach that makes EHRs more relevant to their missions.”


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