EHR Implementation

EHR Implementation: Investigating Vendors   The HIM Director assigns you a very important task in rolling out an EHR: investigating vendors.  The two of you discuss some important questions to determine which software best meets your organization’s needs:  · What features are must-haves?

o   CPOE

o   Scanning

o   Patient Portal

o   System communication with other systems

o   Hospital System (be careful – don’t confuse a physician based EHR system with a hospital based system.

o   Must be able to migrate legacy data to new system.

o   Interoperability

o   Functionality for the SNF and Ambulatory Care – they have to be able to interface with the hospital ·  Should we consider a cloud based system?  What is a cloud based EHR system? ·      

What features are strong wants, but not absolutely necessary? o   ONC Certified system preferred over a non-certified system but not required.

o   ROI Tracking

o   RCM & Coding Dashboard ·

What does one vendor have that another doesn’t?  Compare and contrast.

·  Your budget has a limit; will this vendor meet your budget? o   $450,000 (this includes peripheral equipment needed) · How might this system impact staffing in the HIM Department? ·      

What’s needs to be included in a RFI – a request for information from an EHR Vendor At an online meeting next week, you will make a presentation to the Director about what you learn. Create a power point that will allow you to go over the information the two of you have discussed previously.  Include the type of information needed for a RFI and what the next steps should be.  You’re only going to have 10 to 15 minutes maximum to present your findings.

Case Scenario Rasmussen Medical Center (RMC) is a 250 bed acute care rural critical care medical facility with the following centers:  general medical services, surgical care services, emergency department, cardiac intensive care, general intensive care, laboratory, radiology, physical therapy, respiratory therapy, nutritional services and nursing services. 

The administrative departments are HIM, Claims and Billing Management, Quality Management, Patient Access and Risk Management.  The Medical consists of 25 physicians and surgeons, 5 Physician Assistants, and 5 general medical Hospitalist.  The Emergency Department is operated by an outside emergency medical physician services and radiology services send radiology to an outside service to read the x-rays.  The outside service has a routine turn-around of 5 hours.  

The facility also includes a 20 bed SNF and an Ambulatory Center for day surgery and diagnostic services.   The HIM Department has kept transcription and coding in-house along with records review, compliance, CDI but release of information has been out-sourced to a ROI company who placed a ROI clerk on site.  The hospital has an outdated electronic health records system which needs to be replaced.    The old legacy system has the following issues:   ·     

  Poor mobile access and communication – there is no patient portal system available and physicians cannot access their incomplete records outside of the hospital · Lack of built in tracking of suggested screenings, test and medication interaction to improve patient care. – No effective physician reminder or clinical alert system · 

No monitoring or alerts for incorrect or coding errors ·  Poor integration with other systems or portals – unable to complete required exchange of health information.  (System is unable to communicate effectively with E-prescribing, billing, data sharing other clinical facilities and reporting to CMS). ·      

Time consuming documentation workflow – documenting and updating patient information is difficult and time consuming.  Clinicians are complaining that it takes too long to input patient data.   The new system should be able to do all of these functions for the facility.   EHR Implementation: Gathering Information  

This is your first day on the job as Assistant Director in the HIM department at Rasmussen Medical Center (RMC).  You meet with the HIM Director and she explains that RMC has given her the go-ahead to begin the process of implementing a new electronic medical record.  As Assistant Director, you will have responsibility for several phases of this important project. 

Your Director knows that while you have earned an RHIT certification, you still need to learn some background before you begin.  You have one week to learn as much as you can about EHR implementation.   You know that you may have more questions as the process goes along, think about collecting additional resources as you do your initial research.  

The HIM Director has given you some things to think about while you’re researching the implementation process.  Those items are:        

What steps are needed to transition from a legacy EHR to a new EHR system? ·What’s involved in a data migration from the legacy system to a new EHR? · Who would be the best members of an EHR Task Force and Work Team? · How can you verify that an EHR system is ONC certified? ·     

What type of issues can we expect to have during this transitioning process? What other questions can you think of to add to this list as you research the process of implementing a new electronic health records system?

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