Health Information Technology Toolkit for Critical Access and Small Hospitals - Section 1. Adopt

1.1 Assess

The Adopt - Assess section provides tools to start using the Health Information Technology (HIT) Toolkit for Critical Access and Small Hospitals. The tools in this section include surveys, inventories, and assessments of your staff's current attitudes toward information technology, computer skills, and technical infrastructure. The tools will help you develop a communication plan and business case, and can be used throughout the remainder of your project.

Overview of Tools. This overview provides an inventory of all the tools in the toolkit. The tools are listed in the order in which they would be used for a comprehensive HIT or electronic health record (EHR) project. Select tools may be used for acquiring individual applications, planning a major system acquisition, or overhauling existing systems. (5-page Word doc)

How to Use the Toolkit. This Word document, PowerPoint presentation, and Webinar introduce the toolkit, with descriptions of its purpose, instructions for use, types of tools, and how individual tools are structured. (4-page Word doc)

How to Use the Toolkit. (19-slide PowerPoint)

How to Use the Toolkit. (15-minute Webinar)

HIT Project Governance. Establishing an HIT governance structure provides authority for decision making at the lowest level possible for each type of decision to be made. Use this tool to identify the decision making tasks you may encounter and at what level each decision should be made. (3-page Word doc)

Visioning and Strategic Planning. This Word document, PowerPoint presentation, and Webinar describe a vision for HIT in home health agencies, including the purpose of implementing an EHR, along with a conceptual model of an EHR and suggestions for strategic planning. (4-page Word doc)

Visioning and Strategic Planning. (23-slide PowerPoint)

Visioning and Strategic Planning. (31-minute Webinar)

Implementing Systems Overview. This tool provides an overview of a typical implementation of an EHR system for a hospital. (7-page Word doc)

Communication Plan. Regular communication with all stakeholder groups helps reduce the uncertainty inherent in adopting HIT, and engages all stakeholders. Build your communication plan using this template. (6-page Word doc)

Organizational Readiness Assessment. Use this tool to help understand your organization's readiness for adopting an EHR and other HIT. (4-page Word doc)

HIT Attitudes Assessment. Use this assessment to help understand your organization’s readiness for adopting an EHR and other HIT. Understanding early attitudes and beliefs can help with effectively planning and providing the right education. (5-page Word doc)

Financial Assessment. Paying for a major HIT investment is challenging for every organization, but especially for independent home health agencies. This tool provides a description of various sources of funds that may be available for HIT if you are in an independent facility. (5-page Word doc)

Financing Resources. This tool describes the various sources of funds that may be available for HIT. While not every source is applicable to every organization, the list may generate ideas you previously have not considered. (4-page Word doc)

IT Staffing Inventory. Use the IT staffing inventory to determine which information technology (IT) staffing skills may be needed to implement specific HIT components. (6-page Word doc)

IT System Inventory. Use the IT staffing inventory to identify and document all existing IT hardware in order to assess and budget for hardware required for each HIT application acquired. (5-page Word doc)

Application Interface Inventory. This inventory identifies all applications currently existing, who is reponsible for the application, and describes how they interface with one another. It serves as a foundation for assessing what interfaces may be needed with new applications. (2-worksheet Excel doc)

HIT Security Risk Analysis. Use this tool to help assess needs related to compliance with HIPAA Security Rules and data breach notification laws in Minnesota. (7-page Word doc)

Contingency Plan Assessment. Use this assessment to identify and document all existing backup, business continuity, and disaster recovery plans—collectively referred to as contingency plans—that you already have in order to assess and budget for enhancements as more mission critical, clinical information systems are adopted and paper-based systems go away. (5-page Word doc)

Computer Skills Survey. This survey helps identify the skills needed for implementing an EHR and other HIT. (2-page Word doc)

1.2 Plan

The Adopt - Plan section emphasizes the importance of planning ahead. Investing the time and resources up front will mean spending less time and resources during implementation, and reaping greater value. Don't overlook dependencies or important steps that reduce risk. Many HIT vendors do not support the planning effort, focusing instead on selling and installing systems, and moving on to the next customer. Vendors who recognize the need for a focus on planning have higher customer satisfaction. Yet, the onus for the majority of planning is on the organization.

HIT Steering Committee. A major investment in HIT requires engaging representatives from all key stakeholder groups. This tool helps you determine how to best to form and operate the HIT steering committee for in HIT planning, including using domain teams. (3-page Word doc)

HIT Project Documentation. Committee meetings are essential for planning, making decisions about HIT, and optimizing the use of HIT. This tool includes tips to help you find ways to work more effectively in meetings, along with a sample agenda and minutes. (4-page Word doc)

Clinical IT Leadership. HIT projects demand leadership from nurses and physicians. Other clinicians and administrative/financial staff also play key roles. This tool outlines their roles. (3-page Word doc)

Project Management. This tool differentiates the roles of project management and program management, and lists the general functions a project manager is expected to perform, including project documentation. (2-page Word doc)

Project Manager Job Description. This job description provides the key functions, responsibilities, skills, and experience required by an HIT project manager. (2-page Word doc)

HIT Strategy/Migration Path (6-page Word doc)

Goal Setting. Each organization needs to evaluate what it wants out of HIT, and define its own goals. This tool provides an overview of goal setting and template for tracking goals. (5-page Word doc)

Change Management. This overview describes change management, including change stages, transformation, agents of change, and possible barriers to making changes in your home health agency. (6-page Word doc)

Workflow and Process Redesign. This Word document, PowerPoint presentation, and Webinar provide information on the purpose and steps involved in workflow and process redesign, as well as setting expectations to achieve goals, initiating change management, and using process mapping as a means to manage change. (6-page Word doc)

Workflow and Process Redesign handouts. (20-slide PowerPoint)

Workflow and Process Redesign. (32-minute Webinar)

Chart Conversion Planning. Determine how to move key information from paper charts into an EHR system. (3-page Word doc)

Total Cost of Ownership and Return on Investment. Use this spreadsheet to describe your actual expenditures (real total cost of ownership), and to determine actual return on investment (ROI) for any applications acquired. This tool should have been developed during planning, and updated throughout implementation in order to monitor the project budget. It should now be used to link the achievement of your goals with cost for a return on investment. (2-worksheet Excel doc)

1.3 Select

The Adopt - Select section helps home health agencies understand the marketplace and conduct all aspects of vendor selection and contracting. The extent to which an agency needs to review the marketplace depends on its overall IT strategy. If you are part of a corporate structure, the selection process is performed for you. However, the assessment, planning, implementation, effective use, and exchange tools will still be very important for you to use.

HIT Code of Conduct. In the process of selecting a vendor for new HIT, home health agencies need to be as unbiased as possible, assuring that the selection process does not give unfair advantage to any one vendor. Review your own code of conduct or adopt a code of conduct such as the one in this tool. (2-page Word doc)

Vendor Selection and Understanding the Marketplace. This Word document, PowerPoint presentation, and Webinar provide a picture of the marketplace for HIT and EHR, including what products are available, how to navigate the marketplace, and buyer beware tips, as well as information on vendors, CCHIT certification, requirements analysis, request for proposal (RFP), due diligence, key differentiators, and contracting. (4-page Word doc)

Vendor Selection and Understanding the Marketplace. (17-slide PowerPoint)

Vendor Selection and Understanding the Marketplace. (20-minute Webinar)

Requirements Analysis. A critical step to acquiring HIT is to perform a requirements analysis. Although this step is typically aligned with preparing a request for proposal (RFP), the exercise to define the requirements specific to your organization needs can be a very important part of your education about HIT and EHR. (7-page Word doc)

Request for Proposal. Use this template to structure your request for vendors to send you proposals on the specific HIT you are interested in acquiring. (12-page Word doc)

Input Device Planning. Determine the most appropriate input devices for your HIT applications. (3-page Word doc)

RFP Analysis. Use this tool to serve as a guide for sending out the RFP and analyzing the results. Because many products will include many of the same functions, using responses to the RFP can be very difficult for narrowing the field of vendors for further due diligence. This tool can be helpful for conducting an objective, side-by-side comparison of vendors. (6-page Word doc)

Key Differentiators. Many products will include many of the same functions. Use this tool to help do an objective, side-by-side comparison of the vendors on key selection differentiators. (4-page Word doc)

Due Diligence: Demonstration Plan. Arrange for product demonstrations as part of your due diligence for evaluating vendors using your key differentiators. (3-page Word doc)

Due Diligence: Site Visit Plan. Arrange for and conduct site visits as part of your due diligence for evaluating vendors against your key differentiators. A secondary value to site visits is learning about implementation strategies. (3-page Word doc)

Due Diligence: Reference Check. Arrange for and conduct reference checks as part of your due diligence for evaluating vendors against your key differentiators. (3-page Word doc)

Vendor of Choice. Determining the vendor of choice may be the most difficult aspect of the acquisition process. This tool points out a few of the realities in selecting an EHR or other HIT. (2-page Word doc)

Contract Checklist. Use this tool to assist with negotiating a favorable contract with your vendor of choice. (5-page Word doc)

Support

Stratis Health has extensive experience in working with health care facilities to help them adopt and utilize HIT systems and to prepare them for exchanging information.

For support using the toolkit, contact: Stratis Health - Health Information Technology Services 952-854-3306, info@stratishealth.org

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