Repurposed: “This task contains portions of material that were originally submitted during the May 17, 2015 in HCI490-1502B-01: Health Informatics Capstone with Andrea Mignott.”
Used material from DBs and Individual Projects submitted during this course.
Electronic Health Records
Health Informatics Capstone
Colorado Tech University
The Yorkshire clinic is an acute care clinic located in Tacoma, Washington who is considering the implementation of electronic health records (EHR). To begin the process they will conduct a Readiness Assessment of the clinic and discuss the benefits and issues of implementing EHR system. They will also complete a project plan, which will include the goals and objectives, an implementation process, discuss staffing needs and the need for data migration and the risk of not implementing data migration. The EHR vendor under consideration is MediTouch, which will be discussed in detail. Lastly, we will discuss the request for proposal (RFP). This section will include their qualifications and experience in the EHR systems.
The readiness assessment includes discussing the goals and the objectives. These goals relate to patient quality, patient satisfaction, practice productivity and efficiency, improved quality of work environment, and most important to the overall goal, which is to improved health care (Health IT, 2014). During the assessment process, we will identify the implementation team, also known as the steering committee. The members of the Steering Committee should include members with a wide array of knowledge and skills, ability to devote their time to the implementation process, and have a positive view towards the implementation and have differing views on the use of the EHR system.
During the assessment, you also want to review the clinical workflows, administrative practices, data collection and reporting processes. In addition, assess the staff members to find out how familiar they are with computers and IT. Understanding the present situation of your clinic and distinguishing what your main goals for areas of improvement before the implementation will make for an easier transition (Health IT, 2014). The Yorkshire clinic must ensure the computers in the facility meet the requirements to function accordingly. The organization will need to know the vendor’s requirements and recommendations for the server and hardware. In addition, the clinic must also determine if to use hardwired desktop computers, laptops, tablet devices, or a combination of all.
The benefit of using EHRs for the clinic includes enhancing the overall health care that is provided to patients. The applications in the EHR will assist the clinic in meeting their objectives. Applications such as the Computerized Provider order entry (CPOE) that assists physicians in reducing medication errors, reducing unnecessary duplicate testing, has alarms to let physician know there is a drug contradiction for the patient and has reminders of any preventive services the patient might need. Clinical Decision Support Systems (CDSS) assist healthcare providers in the actual diagnosis and treatment of patients (Johns, 2011).
Training is a critical part of the EHR process; all users must be trained prior to the implementation of the new system. There are training strategies that can be used to train the staff, which includes Super Users, Role-based training, and Process based training. During the assessment, you will decide who will be the Super User; the vendor will train these users and in turn will train the staff in the organization or be available to support new users.
The project plan for the clinic includes the implementation process, staffing needs, and data migration. The implementation process ensures the facility is ready for the EHRs. During the overview, the clinic will discuss the major milestones and deliverables for the planning, implementation, and post-implementation phases of the electronic health record. The implementation budget is to ensure there is enough funding to cover the entire process, not only the initial phase, but also the post phase and any other requirements such as upgrades, hardware and training. The projected staffing needs for the Yorkshire Clinic as the EHR begins implementation will not change except for adding It personnel to the staff.
Data migration is the process of making a copy of data and moving it from one device or system to another, preferably without disrupting or disabling active business processing. There are four recommended routes to migrate your data, which include one-time data conversion, create a system-to-system interface, use multiple systems, and install a vendor neutral archive (VAN). If a data migration plan is not use, they can run into risks or complications where it concerns their patients’ health information. Among the unintended costs of poorly executed conversions such as frantic weekend data migrations there are business operations slowdowns that can triple the cost of the conversion itself (Tech Target, 2015).
After reviewing three vendors, the clinic has chosen to use the MediTouch EHR. MediTouch EHR is a complete electronic health record (EHR) that was designed to be both web-based and offer a touchscreen user interface (Software Advice, 2015). The MediTouch EHR is certified by an ONC-ATCB. The MediTouch EHR has features such as the integrated patient portal. This patient portal allows patients to access their own personal health records. The patient Portal gives the patient the ability to easily ask questions and request medication refills online improves patient satisfaction (Health Fusion, 2015). It is cloud-based EHR software that is preloaded with templates and care plans to assist the providers with charting the patient’s records. In addition, has Meaningful Use built into the system, which allows the clinic to use software that has been certified and will qualify for the EHR incentive payments.
The Request For Proposal (RFP) is a valuable tool for the Yorkshire Clinic. It includes the information about the clinic itself, the vendor qualifications, the vendor proposed solutions and general requirements. The Yorkshire clinic is an acute care clinic located in Tacoma, Washington. The clinic is comprised of a group of 10 physicians, 2 physician assistants, 1 nurse Practioner, and several ancillary staff. The clinic serves a patient population of approximately 14,000. The various stakeholders include physicians, nurses, administrators, and patients. Our goal is improve the quality and safety our patients. In addition, to improve workflow and have training and support as part of the EHR. Vendor will have 4-6 weeks to respond so that they have adequate time to prepare an appropriate response. All Response should be in PDF format and must be e-mailed to the clininc.
As part of the RPF, we are asking you (MediTouch) to please reply to the following questions in regards to the EHR.
Vendor Qualification- In this area please answer the following:
(1) vendor profile, (2) how long have you been in business, (3) number of EHRs installed in the last 3 years, (4) retention on EHRs, (5) implementation time-frame, number of live sites, (6) breakdown of sites by specialty, (7) breakdown of sites by provider # (1-5, 6-9, >10), and (8) number and percentage of practices in 2014, that did not get installed within four (4) months after signing contract.
Product Information- In this area provide the following:
- (1)Product name and version#, (2) When is your next version release? (3)Single Database for scheduling, billing, and EHR? (4) Is it a Client Server, ASP or Hosted model? (5)Does product include a patient portal? (6) Does the product meet meaningful use guidelines (7) Was the acquired from another company?
- Proposed Solutions: please provide information on meeting our needs
- (1)CPOE customizable per provider or are templates available? (2) Does the system allow free text ordering? (3) Does the system utilize ICD9 or ICD10 coding (4) recommended workstation requirements (5) List all security enhancements (6) maintenance performed. Please include any other information that the vendor will like to include that will assist the Yorkshire clinic’s goal of enhancing patient care and improving the workflow.
- General Requirements: please provide the following information
- (1)Warranties, (2) monthly subscription fees, (3) customer support available (4) Problem/Resolution Process (5) Upgrade Process (6) Practice/Specialty Specific Training Offered (7) Cost of Training, (8) Post Go-Live Training and Support (9) Contract Terms and Vendor Guarantees (10) Other Vendor Services Offered (11) Specialty Specific Requirements
- Cost Estimate Template: please answer the following:
- (1)Cost estimate (2) One time fees (3) Initial year costs (include all fees for license, use, access, etc. (4) Ongoing annual costs (include all fees for maintenance, support, use, access, etc. (5) Five year cost of ownership
- Information submitted in response to this RFP will become the property of Yorkshire Clinic. The Yorkshire Clinic reserves the right to modify this RFP at any time and reserves the right to reject any responses to this RFP, in whole or in part, at any time.
- The Yorkshire Clinic has considered all the phases to implement the electronic records to its facility. They have conducted a readiness assessment to ensure the facility and staff is ready to implement a new system. Through the Steering Committee, they have set their objectives and have an implementation process in place. The MediTouch EHR is certified and provides meaningful use and provides the clinic with the capabilities to improve patient care and meet the standards to receive the government incentive payment. Through the RFP, the Yorkshire clinic has received the required information to make their decision to proceed with the implementation of the electronic health records.
AHIMA. (2015). RFP Process for EHR Systems (Updated) – Ahima. Retrieved Jun 12, 2015, from AHIMA: http://www.library.ahima.org
Health Fusion. (2015). MediTouch. Retrieved Jun 8, 2015, from health Fusion: http://www.healthfusion.com/ehr-features/ehr-vendor-comparison/
Health IT. (2014). How to Implement EHRs. Retrieved May 21, 2015, from Health IT: http://www.healthit.gov/providers-professionals/ehr-implementation-steps/step-1-assess-your-practice-readiness
Johns, M. L. (2011). health Information Management Technology (3rd ed.). Chicago, Ill: AHIMA.
Levine, R. (2015). Data migration strategies. Retrieved May 31, 2015, from Wikibon : http://wikibon.org/wiki/v/Data_migration_strategies
Software Advice. (2015). MediTouch EHR Electronic Health Record Software. Retrieved Jun 8, 2015, from Software Advice: http://www.softwareadvice.com/medical/healthfusion-meditouch-profile/
Tech Target. (2015). Four recommended migration routes. Retrieved May 31, 2015, from Tech Target: http://searchhealthit.techtarget.com/tip/Taking-the-pain-out-of-EHR-data-migration-process
Van Gordern, C. (2012). Modern Helathcare. Retrieved June 6, 2014, from Modern Healthcare.com: http://www.modernhealthcare.com/article/20120512/MAGAZINE/305129882