Health Information Technology Toolkit for Nursing Homes - 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 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.

2.1.1 Project Planning. 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. (2-page Word doc),

2.1.2 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. (Excel file)

2.1.3 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. (2-page Word doc)

2.1.4 Workflow and Process Improvement. The workflow and process improvement tool highlights certain elements that organizations need to consider during implementation. (2-page Word doc)

2.1.5 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)

2.1.6 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. (Excel file)

2.1.7 Input Device Planning. Use this tool to assist in determining the most appropriate input devices for your HIT applications. (2-page Word doc)

2.1.8 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. (4-page Word doc)

2.1.9 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. (5-page Word doc)

2.1.10 Clinical Decision Support. Clinican decision support (CDS) is an interactive part of an application that assists clinicians with decision-making tasks and is the hallmark of any clinical information system. Use this tool to optimize the use of CDS. (3-page Word doc)

2.1.11 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. (3-page Word doc)

2.1.12 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)

2.1.13 Roll Out 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. (2-page Word doc)

2.1.14 Space Planning. Use ththe space planning tool to plan and manage your HIT space needs. The inventory includes physical layout considerations and safety and security measures. (5-page Word doc)

2.1.15 Go-live Planning. 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. (3-page Word doc)

2.1.16 HIT Technical Security Controls. Security controls become increasingly important as more HIT is adopted. This analysis identifies the technical security controls in place in your current HIT applications, helps you determine where controls are adequate or where they may need to be made stronger, and which controls you will need in new HIT acquisitions. (Excel file)

2.1.17 Implementation Strategies for Assessment Documentation. Use this tool to help ensure that all assessment requirements prior to and during a resident's stay in your facility can be documented in an efficient and effective manner. (4-page Word doc)

2.1.18 Implementation Strategies for EDMS & Hybrid Record Risk Management. Orientation to the purposes of EDMS, description of key functions supplied by EDMS, and preparation for implementation. (6-page Word doc)

2.1.19 Implementation Strategies for Physician Documentation and Use of eRX. Identify the automation support available for physician documentation in a nursing home. (8-page Word doc)

2.1.20 Implementation Strategies for Electronic Medical Adminstration Records (E-MAR). Distinguish among the different forms of E-MAR, and to utilize a set of tools that have been developed by the American Hospital Association, Health Research Trust and the Institute for Safe Medication Practices. (4-page Word doc)

2.1.21 Ongoing System Maintenance, Administration, and Data Quality Management. Guidance on the importance of ongoing system maintenance, tools to evaluate system administration, and tips to ensure data quality management. (3-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, electronic medication administration record (EMAR), assessment completion, point-of-care charting, etc. Resources to support quality measurement reporting are also included.

2.2.1 Quality, Measurement, Reporting, and Improvement. The power of HIT lies in its ability to provide real time reminders and alerts for actions that support quality and safety. Used within an overall framework of clinical transformation, HIT can make an impressive difference in reducing costs and assuring optimal reimbursement for the best possible care for residents. (3-page Word doc)

2.2.2 HIT Adoption Milestone Results. Use this tool to help measure the extent to which your HIT activities are adopted by their intended users and to determine whether your SMART goals have been achieved. (4-page Word doc)

2.2.3 Monitoring SMART Goal Achievement. Make sure that your SMART goals are being achieved and consider corrective action strategies when they are not using the Monitoring SMART Goal Achievement tool. (5-page Word doc)

2.2.4 Benefits Realization. Use the Benefits Realization tool to complete the cycle of goal setting, ensuring that benefits expected from HIT are realized. (1-page Word doc)

2.2.5 User Satisfaction. When implementing HIT, communicate with all users and stakeholders, and be aware of user concerns, expressed or implied. Conduct a formal user satisfaction survey within a month to three months following go live. (3-page Word doc)

2.2.6 HIT Resident Satisfaction. While some nursing homes conduct resident and/or family satisfaction surveys, none focus specifically on the impact of HIT adoption. An important indicator of overall success with HIT can be obtained from their perspective. (3-page Word doc)

2.2.7 TCO and ROI Assessment. 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. (Excel file)

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

HIT Toolkit for Nursing Homes >

Receive Toolkit Updates