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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Pro-Active EHR Optimization is a Necessity

Pro-Active EHR Optimization is a Necessity | EHR and Health IT Consulting | Scoop.it

Everyone knows that routine maintenance is required to keep a home, car, or even a person in good shape and performing well. The same is true in regards to our electronic health records (EHR). To meet the requirements and capitalize on the benefits of meaningful use, the US market has seen an unprecedented amount of EHR implementations. However, many organizations aren’t seeing the expected benefits. Factors such as rushed, system-focused implementations, lack of standardization or focus on workflows, end-user and physician dissatisfaction, high ticket, and request volumes, and/or sub-optimal training are major drivers for optimization needs. Routine maintenance and pro-active EHR optimization are a constant and ongoing necessity and should be treated that way from a planning, budgeting and prioritization perspective. Here are some key areas to consider in a post-EHR go live world.

 

Thorough Assessment, Prioritization, and Management of Current Issues and Complaints

 

Most organizations use a ticketing system to log EHR issues. Following an EHR activation, ticket volumes often increase to the point where an organization cannot manage the volume and cannot differentiate priority issues from common, organizational issues. This is exacerbated by the constant “pull” of resources that are now needed for other organizational objectives and projects.

The truth is, your EHR “project” doesn’t go away when the system goes live. Rather, a program management organization, complete with an integrated Governance structure, must remain to manage upgrades, maintenance, and optimization. A great first step is understanding issues and prioritizing ongoing efforts for your teams and your organization. A thorough review, cleanup, validation, and categorization of all issues should be conducted. This requires the establishment and ongoing execution of a ticket intake and review process that identifies the priority and necessity, understands the source of the problem (e.g., user proficiency, workflow inefficiency, build defects) and reconciles that against the objectives of the organization. It is critical to include operational and clinical leaders in this process and often requires time for interviewing and even shadowing clinical and operational users to fully understand and accurately document issues.

 

Categorizing, Prioritizing, Integrating and Approving Effort

Most issues can be categorized into four areas:

 

Break/Fix
Break/fix are issues with the software functionality that need to be fixed by either the IT analysts or vendor.

 

System Enhancement
Enhancement issues pertain to desired functionality that is either not yet developed by the vendor or not yet implemented by the IT department.


Workflow
Workflow issues arise when a process or procedure is inefficient.

 

Training
Training issues occur when the system is functioning as designed but the end user is unaware of how to use it properly. Training may also be needed to teach advanced functionality.


After categorization, issues should be prioritized. The prioritization process should be carried out through the Program Management and Governance structure and is typically not simply an “IT” process. Understanding the issues and requests, prioritizing them against the organizational objectives and then including them in the ongoing capital and operating plans allows adequate focus, funding, and validation for the work. This may be simple and quick – break/fix items, refresher training, etc. However, the focus may be more complex and cross multiple areas of the organization – new system functionality, upgrades, workflow redesign, etc. The latter often requires the organization to move back into “project mode” with a detailed timeline, project plan and in some cases, capital funding.

 

Optimization Implementation and Ongoing Maintenance

Now that a structure is in place, resources are adequately funded and work is prioritized, the organization can move forward knowing that the EHR can be properly maintained, but also leveraged for its true functionality. There will be many moving parts that may involve system configuration, system upgrades, workflow redesign, and end user training. Having a dedicated optimization team and project manager that interacts and coordinates with the key operational and clinical leaders is key to ensuring success, but also aides in optimizing an EHR solution that supports the organization’s objectives as well as the patient experience.

 

Optimum Healthcare IT provides optimization services that are customized to meet our client’s needs whether a full assessment and plan are needed or just hands on resources. An example of our streamlined methodology is shown below:

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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Tips for Changing EHRs and Transferring Patient Data

Tips for Changing EHRs and Transferring Patient Data | EHR and Health IT Consulting | Scoop.it

One of the challenges of choosing a new EHR is considering the long-term investment.

Implementing any new system into a medical clinic is a potential short-term disruption, so there needs to be an assurance that your decision to change EHR services will serve you well moving forward.

The rapid pace of technological ensures that most doctors will switch their electronic records system throughout their career.

Some doctors start building a medical practice with a budget, and then become ready to pay more for a full service EHR. Others are simply dissatisfied with their current system and want to move to something more suited to their needs.

Very often the big issues that arises is with data continuity. Changing EHR systems should ideally mean that you retain access to your previous patient records. But this is not always the case. The fear of transferring data and losing vital information is a real threat.

With the recent growth in cloud-based EHRs, your patient data is no longer stored on a local server in-house, rather it is under the care of the EHR vendor.

The good news is that the ease of transferring medical records has been steadily improving over the last several years. The recent wave of federal regulations relating to Meaningful Use includes a set of standards developed to enable electronic referrals and cross-provider communication.

These standards describe the specific structure and elements of a patient record, so that any two EHR applications which adhere to the standards, should be readily able to exchange patient data from one to the other.


The creation of these standards makes it easier to transfer patient care data from one provider to another. This technology process is also used to import all patient records from one EHR to another.

For any two EHR applications, it is unlikely that all data will transfer over seamlessly. You need to check with your new vendor which information is essential.

Start with Structured Data.

This includes ICD9 Diagnosis codes, medication lists, procedure lists, allergies, and immunizations. Detailed chart notes and SOAP-type templates can prove to be difficult because the data is unstructured, and free text format may not transfer easily from one EHR technology to another.

In order to meet Meaningful Use certification, EHR vendors are required to be able to produce this data in a standardized, structured format for any given patient. However, they are NOT required to be able to automatically export all data for all patients.

With some EHR vendors, they may charge a processing fee for creating an export file of all of your patient data. A new EHR vendor may also charge you a fee for importing previous data.

This fee will vary based on the volume and complexity of your previous record set.

 

Testing the new System

Once the data transfer has been the second step is testing. Anyone familiar with the process will tell you the the transfers are rarely executed perfectly on the first round. So be patient and persistent.

It is necessary to perform careful quality testing to validate that your data in the new environment is accurate, just like in the old environment.

The simplest way to do this is to select a small test group of your patient population and manually verify that everything is exactly correct for those people. Check both systems to see that everything is correct and orderly. Ensure that you check more than contact information, also review medication lists, procedure lists, allergy lists, and immunization lists. Detailed chart notes and SOAP-type templates can also show if the data has transferred effectively.

If you find an error in the record of one individual, chances are that it is a systemic problem that is affecting many other patient records in your population.

If you identify any problems, you will then need to work with both EHR vendors to determine the origin of the issue and correct it. This can be time consuming, but also worth fixing early.

Even with cloud based date, and modern EHR systems, data transfer can still be a challenging process for any provider to undertake.

 

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

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

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Don't Overlook EHR Communication

Don't Overlook EHR Communication | EHR and Health IT Consulting | Scoop.it

Through all of the planning and preparation that goes into an Electronic Health Record (EHR) implementation, EHR communication is often overlooked and undervalued. With everyone focused on delivering the system, building applications, testing hardware and validating workflows, end user preparedness, outside of training, can be overlooked.

 

Sure, they’re going to be trained on the system, but it’s important to remain engaged with end users in the months and weeks leading to go-live, but also beyond go-live. In many aspects, post-live communication is more vital to day-to-day operations throughout the organization.

 

In this post, we’ll discuss the primary types of communication that must be considered, carefully planned for and thoughtfully executed to serve end users best as they prepare for and live in the new world of the EHR.

 

Types of EHR Communication

 

Internal Marketing, pre- go-live
Transitioning to an EHR is daunting for everyone. It’s exciting and new, but it is scary. It’s a daunting task for leadership and project teams, but for end users, this new technology will completely disrupt their professional lives – especially those that have never used the technology.


The merits of the new system, how it will help them in the long run, and how it will benefit patients must all be sold to end users who, in most cases, have always worked a certain way – without technology. The system must be sold to them because there will be resistance, some kicking and screaming, all the way through go-live.


Change Communications
Don’t listen to anyone that tells you that you’ll be able to relax once the system goes live. If anything, the importance of clear, concise communication escalates exponentially after go-live.


Technology, by its nature, evolves. And electronic health records are not exempt. One of the primary features of the technological age we live in is that the systems we use can, and will, be updated.
When changes are made to the system, there must be a coordinated Change Management procedure featuring robust communication to all impacted employees.


System Updates/Downtime Messaging
EHR’s and the infrastructure they run on are fallible. No matter how well the system is designed and built, there will be issues and downtimes that negatively impact end users, and if not planned for accordingly, patients.


System Update (SU) and Downtime procedures must be carefully developed and communicated throughout the organization to ensure that employees know the protocols that are in place in the event of a system outage.


Additionally, communications processes and protocols must be installed throughout the organization to ensure that vital information can be delivered to end users crisis situations – and that end users can communicate what’s happening on the ground with leadership and IT.


Ultimately the goal here is to ensure that clinicians can continue to care for their patients in the event of a system outage and proper communication is key.


Targeted Messaging
This comes down to a simple realization – clinicians are extremely busy people that don’t have time to wade through waves of content to find what pertains to them.
Messaging designed with a specific user group in mind that includes a concise, actionable message works best. Think providers or nurses.


This audience also benefits from a well-known or trusted sender. They don’t pay attention to mass emails from generic inboxes. Their bosses, Chief Medical Officers, Chief Nursing Officers, or a department head usually garner the most respect, and the most attention, in clinical circles.


Patient Communication
This change is disruptive for patients as well, especially during go-live. Taking the time to thoughtfully communicate the change to patients will help ease the transition for them as well.
They’ll have questions. Why is my doctor on that computer so much? Is my medical information online? Is it secure?
Without going into the minutia around the EHR, device integration, real-time data, secure servers, firewalls, data centers, etc. – take the time to explain the change to patients, at least at a high level. They will appreciate it.


myChart & Meaningful Use
On the surface, Meaningful Use and MyChart communication don’t immediately come to mind when thinking of the EHR communications plan. They should, though. Soon after go-live, the focus shifts to stabilization and optimization, which includes myChart and Meaningful Use.


While they’re paired together here because they’re add-ons that don’t necessarily fall under the initial communications scope, these two are very different and need their own comprehensive communications plans and delivery methods as the content, audience, and implications are drastically different.


While not explicitly responsible for building or activating the EHR system that will revolutionize your organization, it’s important to have a person or team dedicated to communicating with your end users – at all stages of the system’s life cycle. Uninformed end users are disgruntled end users, and it pays to have communications people that have experience with IT and EHR delivery as it is a world unto itself.

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

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

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