Resource Planning Guide

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1 Version 2.2 Revised/Reviewed: July 16, 2014

2 Contents About This Document... 3 For More Information... 3 Software Availability... 4 Data File Conversions... F5 Hardware and Software Requirements and Recommendations... 6 Considerations... 8 Planning Committee... 8 Operational Issues... 9 Expenses Other Resources Training Staff on Software Best Practices Pre-Installation Best Practices How to Prepare for Installation Installation and Training Best Practices Post-Installation Best Practices Ongoing Best Practices and Other Considerations Version 2.2 Page 2 of 14

3 About This Document The purpose of this document is to communicate information that will help providers to: Understand the availability of the Hi-Tech Software (HTS) new Electronic Medical Records (EMR) application. Know what to expect when transitioning to HTS new EMR system. Decide when to transition to the new EMR System. Prepare for the installation of the EMR. For More Information (under development) Hi-Tech Software Solutions 114 East Madison Road Madison, ME Lynne Hammond Director of Marketing and Sales (207) Office (207) Mobile (207) Fax Support Team Hi-Tech Software Solutions (207) Office (207) Fax Training/Consulting Team Hi-Tech Software Solutions (207) Office (207) Fax Version 2.2 Page 3 of 14

4 Software Availability Quarter 4, 2014: Initial release of HTS new EMR: o Clinical Records for Nursing o Clinical Records for Residential Care / Assisted Living (Maine MDS-RCA only) HTS web-based applications will interface with other non-web-based HTS applications until those applications are available for release. The initial release will include processing that is now available in the non-web-based Clinical Records for Nursing and Residential Care/Assisted Living applications. The only exceptions are the Vermont version of the Residential Care Assessment (RCA) and the Clinical Calendar programs which will be included in upcoming enhancements. Quarters 1 and 2, 2015: HTS will enhance clinical applications and add new features, including: ADL/Care Real-Time Electronic Documentation (Daily Care application) Medication and Treatment Real-Time Electronic Documentation (Daily Med application) Integration of INTERACT (Interventions to Reduce Acute Care Transfers) Quarters 3 and 4, 2015: Rehab Therapy Vermont RCA form Future Development Respiratory Therapy Resident Billing programs General Accounting programs Your facility may convert to the new applications as they become available. Hi-Tech will schedule each deployment and conversion with our clients. All non-web-based versions of HTS applications will continue to be updated for State and Federal compliance. New features will be added on a case-by-case basis. These non-web-based applications will eventually become retired and will no longer be supported; however, that date will only be after our final deployment of all products. The current version of Hi-Tech will be fully supported until at least 12/31/2016. Version 2.2 Page 4 of 14

5 Data File Conversions Responsibilities Provider/Facility Assign a point person/liaison from the facility to work with the point person from HTS (This person will be responsible for communicating and verifying data with HTS point person) Review list of library items (provided by HTS) that facility wishes to bring forward Review list of residents that will be brought forward Review Allergy library for duplicate entries and correct them Print a list of current allergies for all residents and correct the data Hi-Tech Software Provide a point person to work with facility staff Assist and review current data for accuracy and reasonableness Work with facility staff before and during conversion to ensure accuracy and usefulness of information in the new system For Clinical applications, we will convert most library data, resident demographics, and MDS records with an assessment reference date of one year prior to implementation and later. We will work with facility staff to determine the quality of the data converted. Version 2.2 Page 5 of 14

6 Hardware and Software Requirements and Recommendations Web Application ASP.NET 4.5 Internet Information Server 7.0 or later Database Microsoft SQL Server 2012 Supports Express (free) versions of 2012 Supports up to 10GB of data.* This could typically be used for a single facility of 250 or fewer beds, or multiple facilities with 200 or fewer beds total R2 or later Supports unlimited database size.* This should be used for a single facility of more than 250 beds, or multiple facilities with more than 200 beds in total. *Total database size includes all system data as well as scanned documents and images. Supports IE 9 or later Safari, Chrome, and Firefox are not supported by Hi-Tech at this time. Data Hosting Options Locally installed on the facility s server Hosted by a Database Hosting Provider Hosted by Hi-Tech s partner. Partner(s) to be determined Tablets/Portable Devices Although the initial deployment of HTS EMR applications will not be optimized for use with portable devices, it is functional on the following devices and operating systems: ios IPad Android Nexus 7 Tablet Kindle Fire Windows Surface Directory Services The application supports user authentication through the following directory providers: Microsoft Active Directory Version 2.2 Page 6 of 14

7 Programming Languages Used to Develop HTS web-based application HTML CSS / CSS3 C# VB.net JavaScript jquery Version 2.2 Page 7 of 14

8 Considerations Planning Committee Each facility should identify or establish committee(s) that will be responsible for conducting an analysis of when and how to convert to the new web-based application. This committee should include representatives from each of the following departments: nursing, therapy services, administration, billing, information systems, and other departments deemed appropriate for your facility. Each facility should implement staff information and education sessions on the facility s decision to move to EMR system. Each facility should ensure that everyone understands the necessity and benefits of an EMR, such as: Reducing workload and duplication of entry Standardizing the information recording process Improving resident care and safety Increasing time spent with residents Reducing errors by making the chart information clear and legible Improving survey results and reducing deficiencies Storing more extensive medical records by eliminating space limitations of paper storage Sharing information with doctors and hospitals using electronic interfaces Having legible, clear medical records readily available Evaluate staff technology skills. A computer skills survey may help determine training needs and the available skills needed to implement the EMR. The survey should cover basic computer skills as well as advanced skills, such as the use of devices and specific clinical applications. From these sessions, create an Implementation Team that embraces the EMR system. Divide your team members by Trainers and/or Administrators, and Super Users. These employees will serve to help the rest of the staff by addressing immediate questions and concerns. Their enthusiasm and understanding will help to circumvent some negativity towards change. Their responsibilities will be to assist and educate their staff members during and after the transition. Version 2.2 Page 8 of 14

9 Operational Issues Consider options for access to IT expertise for the transition, as well as for ongoing support. IT support should be available 24 hours a day/7 days a week. If the facility does not have IT staff, research consultants fees and availability for 24/7 support during the transition to around-the-clock electronic documentation. The need for IT knowledge, related to the EMR, is greatly reduced if your software solution is hosted outside the facility. Analyze wireless network access. An IT services provider can help determine what will be needed and if an upgrade is required. Assess current hardware, i.e., laptops, desktops, kiosks, tablets, etc. Every user of an electronic system will need convenient access to the system to enter and review data. If staff does not have easy access to the system, they will quickly revert to paper. Review backup procedures. A reliable backup is absolutely critical to the success of an electronic conversion. HTS offers a cloud backup option, or the facility can continue to use the current backup process if it meets the requirements of data integrity and readily available support. Consider a scenario of a server failure; a daily backup will contain the only copy of the facility s data for residents records. Consider a redundant power source. If the facility has a generator, it must support the server. Evaluate scanning capabilities. During the transition from paper to electronic, scanning new and existing paper documents and saving them electronically will greatly reduce the paper chart. Consider the following operational issues: Identify the point person within the organization. Will that person have time available to devote to this project? How will the organization deal with emergencies such as loss of internet and equipment damage? Continued security of patient information is vital. Version 2.2 Page 9 of 14

10 Expenses Software and conversion costs including initial implementation/training time Technology costs: IT Consulting Service or IT Staff Wireless access throughout facility Server(s), if not hosted Hosting subscription (Cloud hosted data) Additional PCs or Laptops Other portable devices Other Resources Identify key staff who will: Lead the change in the facility/company Oversee data conversion Be trained by Hi-Tech and certified as the specialist (Train-the-Trainer) Train the new users in the facility/company Serve as the on-site support for system users Identify and maintain policies and procedures that change because of an EMR system: Electronic signatures Log in and log out procedures Role-based security Maintenance of the system libraries Disaster planning and recovery, including disaster drills HIPAA privacy and security Version 2.2 Page 10 of 14

11 Training Staff on Software Hi-Tech uses a train-the-trainer approach. Your facility will need to designate at least one person to become the in-house trainer for new EMR users. Each shift should have several champions (super users) who know the software well enough to act as the go-to-person for each shift. HTS will certify the in-house trainer(s) to use the new web-based applications. HTS will encourage the certification be taken annually. The facility must communicate with HTS when in-house trainers leave the facility or change job responsibilities and who the replacement will be. We will verify that the replacement is or becomes certified. Version 2.2 Page 11 of 14

12 Best Practices Pre-Installation Best Practices How to Prepare for Installation Prepare the staff for the transition. Communicate with staff that will be affected. Address their questions and concerns regarding the changes. Make them aware of the conversion timeline, as well as how and when they will receive training. Review existing data and make necessary corrections to eliminate conversion of unnecessary data. Review all paper documentation. Consider duplication of information and where this information will be saved in the EMR. Evaluate and make changes to current workflow to ease the transition to EMR. Form a committee to review your current Clinical Assessments: Remove duplicate information. Select someone to gather and assemble information. Review Activities, Social Services, and Nursing assessments to locate the most current, accurate and complete information that will be transferred into the EMR. For example, gather family contact information from various sources and maintain that information in the EMR under Contacts. Maintain current ICD-9/ICD-10 diagnoses in current medical records (residents demographics screen). Schedule one-hour sessions for staff with no computer experience to practice navigating the software and workstation peripherals, such as a mouse or touchpad on a laptop. Review library data (see Page 5) to ensure your data is accurate. Version 2.2 Page 12 of 14

13 Installation and Training Best Practices Maintain communication with all affected staff. Be aware of employee morale related to the change(s). Keep staff apprised of when the facility will discontinue access to the non-web version. Emphasize and encourage the importance of asking questions and taking good notes during training. Communicate with HTS. Set up goals, or stages, of the conversion. Celebrate goals met such as fulfillment of installation and implementation stages, everyone has logged in and used the system, new processes are being used, etc. Post-Installation Best Practices Schedule post-implementation sessions to continue communication with staff and allow for questions. This will help the facility determine where additional training is needed. Verify that the designated point-person(s) are ensuring that the new system is being used appropriately, efficiently and effectively. Monitor usage of the system to ensure that the rollout schedule set by the facility is maintained. Be aware that many of the staff will resist changing their long-time processes. Provide supervision and encouragement to continue change and improvement. Be aware of employee morale related to the change(s). Continue to celebrate small strides for example o one month and six months post implementation o when all MDS users have completed and signed their designated sections o when each department is documenting notes on a timely basis o when all required assessments are done on time, etc. Continue communication with HTS. Version 2.2 Page 13 of 14

14 Ongoing Best Practices and Other Considerations Excerpts from Five Tips for Successful Tech Adoption, by Jim Rubadue, from the April 2014 Provider Magazine. For the full article see pdf/5_tips_for_successful_tech_adoption.pdf New Technical Applications that promise easy access and fast results can fulfill expectations only if someone is managing the team....all successful technology implementations require a foundation of people, process, management commitment, and best practices to deliver the benefits that they promise to deliver. MIND THE CHANGE Commonly, the most overlooked piece of implementation is the organizational change that may be required to get the most value out of the technology. 1. GET INVOLVED AND STAY INVOLVED Management support for introducing a new technology product and promoting adoption among users is critical. In fact, lack of management support is often the primary reason an implementation fails in a senior care organization. 2. COMMUNICATE CHANGE Managers should make sure that stakeholders, technology users, and anyone affected by the new products understand what's coming before it gets there. Managers should set expectations for how the technology will affect each and every person involved. 3. TACKLE TRAINING Continue with the important messages about the value, objectives, and change during employee inservicing and training sessions. 4. CREATE A TURNOVER PLAN Education and re-education are critical in minimizing disruption. 5. MANAGE, MONITOR, AND MEASURE...managers should continually monitor progress toward the goals of the technology initiative and understand where adjustments need to be made. And remember, ongoing support, best practices, and successful service from the technology partner along with internal teams and processes are just as important as the new products themselves. Version 2.2 Page 14 of 14

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