Health Information Technology Toolkit for Nursing Homes - Section 1. Adopt

1.1 Assess

The Adopt - Assess section provides tools to start using the Health Information Technology (HIT) Toolkit for Nursing Homes. 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.

1.1.1 HIT Toolkit Overview. 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. (4-page Word doc)

1.1.2 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)

1.1.3 How to Use the Toolkit. (PowerPoint)

1.1.4 How to Use the Toolkit. (14-minute Webinar)

1.1.5 HIT 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)

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

1.1.7 HIT Vision and Strategic Planning. (PowerPoint)

1.1.8 HIT Vision and Strategic Planning. (22-minute Web seminar)

1.1.9 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. (7-page Word doc)

1.1.10 HIT Attitudes Assessment. Use this tool to help understand your organization's readiness for adopting an EHR and other HIT. (5-page Word doc)

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

1.1.12 TCO/ROI Analysis. Use this spreadsheet to estimate the total cost of ownership (TCO) and return on investment (ROI) for HIT applications being considered for acquisition, and to evaluate benefits realized. (Excel file)

1.1.13 IT Staffing Inventory. Use the IT staffing inventory to determine which information technology (IT) staffing skills may be needed to implement specific HIT components. (5-page Word doc)

1.1.14 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)

1.1.15 HIT Security Risk Analysis and Controls Assessment. 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)

1.1.16 Contingency Plan Assessment. Use the contingency plan assessment tool to identify and document all existing back up functions, emergency mode operations, and disaster recovery plans in existence, and to plan for enhancements as more mission critical, clinical information systems are adopted and paper-based systems are eliminated. (5-page Word doc)

1.1.17 Application Interface Inventory. This inventory serves as a foundation for assessing which interfaces may be needed with new applications. Use the inventory to identify all current applications, to identify who is responsible for each application, and to describe how they may interface with one another. (Excel file)

1.1.18 Financing Resources. Paying for a major HIT investment is challenging for every organization, but especially for independent nursing homes. This tool provides a description of various sources of funds that may be available for HIT if you are in an independent facility. (4-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.

1.2.1 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)

1.2.2 Meetings, Agendas, and Minutes. 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)

1.2.3 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)

1.2.4 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. (3-page Word doc)

1.2.5 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)

1.2.6 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)

1.2.7 Change Management. This overview describes change management, including change stages, transformation, agents of change, and possible barriers to making changes in your nursing home. (5-page Word doc)

1.2.8 Workflow and Process Mapping. 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. (5-page Word doc)

1.2.9 Workflow and Process Mapping handouts. (PowerPoint)

1.2.10 Workflow and Process Mapping. (26-minute Web seminar)

1.2.11 Chart Conversion Planning. Use his tool to determine how to move key information from paper charts into an EHR system. (3-page Word doc)

1.3 Select

The Adopt - Select section helps nursing homes understand the marketplace and conduct all aspects of vendor selection and contracting. The extent to which a nursing home 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.

1.3.1 HIT Code of Conduct. In the process of selecting a vendor for new HIT, nursing homes 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)

1.3.2 Vendor Selection. 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. (3-page Word doc)

1.3.3 Vendor Selection. (PowerPoint)

1.3.4 Vendor Selection. (34-minute Web seminar)

1.3.5 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)

1.3.6 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. (13-page Word doc)

1.3.7 RFP Analysis. Use this tool to serve as a guide for sending out the RFP and analyzing the results. (3-page Word doc)

1.3.8 Key Differentiators. 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. (4-page Word doc)

1.3.9 Due Diligence: Demonstration Plan. Use the demonstration plan in arranging for product demonstrations as part of your due diligence for evaluating vendors against your key differentiators. (3-page Word doc)

1.3.10 Due Diligence: Site Visit Plan. Use the site visit plan in arranging for and conducting site visits as part of your due diligence for evaluating vendors against your key differentiators. (4-page Word doc)

1.3.11 Due Diligence: Reference Check Plan. Use the reference check plan in arranging for and conducting reference checks as part of your due diligence for evaluating vendors against your key differentiators. (3-page Word doc)

1.3.12 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)

1.3.13 Contract Checklist. Use the contract checklist to assist in negotiating a favorable contract with your vendor of choice. (6-page Word doc)

Support

Stratis Health has extensive experience in working with health care facilities to help them adopt and utilize EHR 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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