EHR AND IHIS DEVELOPMENT. Standards, Perspectives and Approaches. Rudi Samoszynski International Consultant Health Systems

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2 EHR AND IHIS DEVELOPMENT Standards, Perspectives and Approaches Rudi Samoszynski International Consultant Health Systems

3 Electronic Medical Records (EMR) and Electronic Health Records (EHR) 1. EMR: replicate all aspects of your paper charting. They facilitate all the documentation you do in medical office lab results, visit notes, diagnostic test results, insurance information, demographics, health histories, medication information, and more. 2. EHR: are EMRs with the capacity for greater electronic exchange; that is, they can follow patients and allow for data exchange and messaging between physicians.

insurance information, demographics, health histories, medication information, and more. 2.

4 What EHR does EHR systems help physicians and staff better navigate patient information before, during and after a clinical encounter.

5 EHR BEFORE Before a patient sees a health worker: manage scheduling patient registration and insurance status health history insurance status and medication lists electronically preview a patient's medical history.

status health history insurance status and medication

6 EHR DURING During a patient's clinical visit: type in clinical documentation electronically prescribe medication order tests and labs.

7 EHR AFTER After the patient leaves: manage billing claims submittal and coding Electronically communicate with consulting providers, payers, labs and pharmacies allow patients to view their results through a patient portal.

with consulting providers, payers, labs and pharmacies

8 FUNCTIONALITY EHR system can be defined within the context of patient care: pre-visit functionality visit functionality and post-visit functionality. Evaluate which functions are important before you begin development.

functionality and post-visit functionality.

9 THINGS TO CONSIDER Make sure that the EHR will "talk to" the current HIS. This ensures the 2 systems connect to the patient's insurance, demographics, coding and billing allowing information exchange between the two applications. In some cases it is better to choose an integrated HIS/EHR, which means replacing your HIS instead of paying to integrate your current system and the EHR.

allowing information exchange between the two applications.

10 9 IMPLEMENTATION STEPS 1. Plan Planning is key. Implementing an EHR is a large undertaking, and success depends upon how well you plan. The team should represent leaders who will manage and have ownership of the project. They should meet regularly and outline each stage of the preparation, selection, implementation, deployment and optimization of the EHR.

The team should represent leaders who will manage and have ownership of the project.

11 2. Focus on people and Change Management Getting everyone on board is key to success. IT-related projects, have a high failure rate that is largely due to poor change management. EHR system will change the roles and duties for every staff person, which, in turn, can lead to fear and anxiety. project champion(s) and project team must address staff concerns openly.

EHR system will change the roles and duties for every staff person, which, in turn, can

12 All staff must feel his or her feedback is important and that the change is in the best interest of the practice and its patients

13 3. Communicate Communicating the business case for change will help the staff see the reasons for the change. It s best to have a written vision statement. You must prove to the staff that the EHR system represents an improvement over your current paper process. Keep constant communication with staff throughout the project.

You must prove to the staff that the EHR system represents an improvement over

14 4. Select the right system Use Certified EHR technology. The key is to identify which system best fits your needs. You may only need basic functionality; anything else may be distracting or go unused. You may also opt to have someone else maintain and upgrade the EHR.

You may only need basic functionality; anything else may be

15 5. Visit Hospitals This will give you a far better idea how the system will work in a real practice than a vendor s demonstration.

16 6. Document Workflow & Processes Before you can implement an EHR system, you must understand how your hospital systems operate. patient flows for different types of visits point-of-care documentation in-office communication and document management (e.g., dealing with paper information received from other sources).

patient flows for different types of visits point-of-care documentation

17 7. Determine Data Conversion method Determine a process to get information from paper charts pre-loaded into the EHR. Before you go live, you will need to load demographic data for all patients from your management system (or billing service)

Before you go live, you will need to load demographic data

18 8. Train and Re-Train One-day training will not yield the type of system use you need. Staff will need training before go live and after. Taking on smaller pieces of technology may help make your staff s transition easier. There is nothing wrong with training staff to use the computer, then the practice management system, electronic prescribing and other small applications, and finally the EHR.

Taking on smaller pieces of technology may help make your staff s transition easier.

19 9. Avoid too much Customization A thorough system selection process should get you close to choosing a system you can use without modification. Customization will invariably cost you time and money. Instead, focus more on learning the system as it is designed and on selecting from the options provided.

Customization will invariably cost you time and money.

23 END

Meaningful Use Cheat Sheet CORE MEASURES: ALL REQUIRED # Measure Exclusions How to Meet in WEBeDoctor

Meaningful Use Cheat Sheet CORE MEASURES: ALL REQUIRED # Measure Exclusions How to Meet in WEBeDoctor 1 CPOE (Computerized Physician Order Entry) More than 30 percent of all unique patients with at least