Health Information Technology Toolkit for Critical Access and Small Hospitals - Section 2. Utilize

2.1 Implement

The Utilize - Implement section builds upon the foundation of the Adopt tools to help you address the specific application, technology, and operational elements that have been acquired for the electronic health record (EHR) system or health information technology (HIT) and will now be implemented. These tools will help with the tactical issues that need to be addressed in any implementation, from sample project plans to issues logs, training plans, testing plans, chart conversion techniques, and more.

Project Planning. Use this tool to review the implementation plan provided by the vendor, and prepare to develop a project plan for your organization that reflects milestones from the vendor’s plan and all other tasks you need to perform. (3-page Word doc)

Project Plan. Project planning is designed to identify all tactical elements that must be managed during HIT implementation. For a large HIT project, the level of planning detail may be equivalent to that of a building project. (3-worksheet Excel doc)

Issues Management. During and after implementation of any information system application, many issues will arise. All issues need to be resolved using an issues management program, which includes an escalation policy, an issues log, and tracking for issues status and resolution. (3-page Word doc)

Workflow and Process Improvement. The workflow and process improvement tool highlights certain elements that organizations need to consider during implementation. (3-page Word doc)

Policy and Procedure Checklist. During the course of implementing HIT, many existing policies and procedures will likely need review and modification. New policies and procedures may need to be created. Use this checklist to evaluate policies and procedures you may need to add or modify as you implement various applications. (2-page Word doc)

Forms and Reports Analysis. Plan for system build activities that take place during actual implementation of an application and to ensure you collect the data you need to perform the work you do. (5-worksheet Excel doc)

System Build. The system build tool will help ensure your understanding of the tasks performed during system build for clinical information systems, and will enable you to plan appropriate time and resources to accomplish your responsibilities in this area. (6-page Word doc)

System Build. (27-slide PowerPoint)

System Build. (42-minute Webinar)

Space Planning. Plan and manage your HIT space needs. This inventory includes not only physical layout considerations, but safety and security measures that will help you keep your equipment in good working order, assure availability for your information needs, and protect your staff and patients from potential safety problems. (5-page Word doc)

Change Control. A formal change control process ensures that changes requested in applications, hardware configurations, networks, and other information system components are addressed in a timely manner. (2-page Word doc)

Security Risk Analysis and HITECH Requirements. Use this tool to support your compliance with the HIPAA Security and Privacy Rules as they are enhanced by the HIT for Economic and Clinical Health (HITECH) Act relating to access controls and audit controls. (6-page Word doc)

Data Dictionary and e-Discovery. Even if your organization does not have the ability to maintain its own data dictionary, understand the complexity and level of detail involved in its maintenance. This will help you appreciate why the vendor may be reluctant to make certain changes or why a change is costly to make. (3-page Word doc)

Vocabulary. Use this tool is to review how data are stored in a computer, the nature of the data that must be collected so the data may be processed by the computer, and the importance of planning for the use of standard vocabularies. (6-page Word doc)

Incorporating Clinical Practice Guidelines. Incorporate clinical practice guidelines and critical pathways into EHR systems and other HIT. (3-page Word doc)

Incorporating Clinical Decision Support. Optimize the use of clinical decision support (CDS). CDS is an interactive part of an application that assists clinicians with decision-making tasks—it is a hallmark of any clinical information system. (4-page Word doc)

Training Plan. Use the training plan tool to help you identify special considerations related to implementing training for EHR and other HIT. The tool describes the type of training required and provides a table to record who needs what training and to track that each person has been trained accordingly. (4-page Word doc)

Testing Plan. Although vendor products vary in the complexity of testing needed, every system must be tested to ensure that data tables and files have been loaded properly, data collected are processed and stored correctly, interfaces work, work flow is appropriate for the organization's processes, clinical decision support rules fire correctly, and reports are generated accurately and completely. This tool describes the types of tests typically performed on EHR and other HIT. (3-page Word doc)

Rollout and Turnover Strategies. Organizations might roll out clinical information system applications in a number of ways. This tool describes how an application may be rolled out if for multiple locations, as well as ways to transition individual users. (3-page Word doc)

Go-live Checklist. Use the go live tool is to ensure that you are truly ready to go live with a system after all other elements of implementation have been performed. (4-page Word doc)

2.2 Effective Use

The Utilize - Effective Use section provides examples of how tools may be used for specific types of implementations. This set of tools provides tips for workflow and process improvement for various types of applications, such as for document management, physician documentation and e-prescribing use, assessment completion, point-of-care charting, etc. Resources to support quality measurement reporting are also included.

Monitoring Goal Achievement. Measure the extent to which your HIT or EHR activities are adopted by their intended users to determine that your goals have been achieved. (4-page Word doc)

Benefits Realization. Use this tool to ensure that the benefits expected from health information technology (HIT) are realized, including quality, safety, productivity, cost reduction, revenue improvement, etc. The tool focuses on achieving non-monetary values; use the return on investment analysis (1.1 TCO and ROI Analysis) for evaluating the financial impact of HIT. (1-page Word doc)

HIT User Satisfaction. Conduct a formal user satisfaction survey within a month to three months following go live. A user survey demonstrates that ongoing input from users is important and helps motivate them to continue to work with the new HIT systems. (3-page Word doc)

HIT Patient Satisfaction. An important indicator of overall success with HIT can be obtained from the patient perspective. (3-page Word doc)

Optimization Strategies for Point of Care Charting. Use this tool to help EHR users make the cultural shift to using the system at the point of care (POC). EHR users. (3-page Word doc)

Optimization Strategies for Clinical Decision Support. Clinical decision support (CDS) is a hallmark of the enhanced utility provided by EHR. This tool describes the types of CDS and the levels of CDS complexity available in EHRs. (7-page Word doc)

Utilizing Registries and Registry Functionality. This tool provides guidance on utilizing registries and registry functionality. A registry  is a collection of care information related to one or more specific diseases, conditions, or procedures that makes health record information available for analysis and comparison. (3-page Word doc)

Utilizing Electronic Document Management Systems and Hybrid Record Risk Management. Understand the purposes that electronic document management systems (EDMS) serve in acute care and ambulatory care environments and the key functions supplied by EDMS, and to prepare and assist you in successfully implementing some or all of these functions. (7-page Word doc)

Routine System Maintenance Checklist. Understand the importance of and provide guidance on ongoing system maintenance and to evaluate system administration. (2-page Word doc)

HIT Upgrades. This tool describes the importance of managing health information technology (HIT) upgrades and enhancements. (4-page Word doc)

Optimization Strategies for CPOE. Use this tool is to distinguish between computerized provider order entry (CPOE) and e-prescribing. It describes various strategies for implementing these two similar applications. (11-page Word doc)

Optimization Strategies for Electronic Medication Administration Record. Use this tool to help distinguish among the different forms of electronic medication administration record (EMAR). (4-page Word doc)

Quality Measurement Reporting and Improvement. This tool helps you to consider how to best measure quality in your organization and how to effect improvements beyond mere reporting of measures. (2-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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