1. What is the Best Way to Select an EHR
What is the Best Way to Select an EHR? Its Time to Upgrade… How Do We Get The Most Out of Our EHR?
Presented by: Shelley Samuels Denise Majka

2. Introduction www.esnjsolutions.com

3. Vendor Selection Selection Process Selection Team Criteria
Will the product accomplish your key goals?
Decision Making Process
Its not majority rules
What is your timeline for “go live”?

4. Selection/Reselection
Negotiations and Contracts
Clarify start up pricing
Define implementation support
Clarify roles for data migration
Consider costs of legal review of contracts
Will you need an outside consultant to provide Project Management?

5. Average Timeline Vendor Selection Contracting
Months 1-3
Contracting
Month 4
Establish team, Culture and Workflow Design
Month 5
Implementation and Staff Training
Months 6-8 can be up to Month 12
Utilization
Begins between Months 9 and 13

6. Solutions Average Timeline
Vendor Selection
Months 1-2
Contracting
Month 2
Establish team, Culture and Workflow Design
Month 3
Implementation and Staff Training
Months 3-4
Utilization
Begins between Months 4-5

7. Implementation Establish Expectations
Clearly define agency’s expectations for staff utilization of software
Access to Equipment and Tools
Determine what type of equipment end users will need in order to accomplish agency’s goals.
Ensure that you have the appropriate bandwidth to support the software

8. Strategic Purpose
What is the goal your agency would like to accomplish?
Assess Agency Readiness
Financial Readiness
Technical Readiness
EHR Culture
Its not a tool it’s a culture
Staff investment

9. Team Selection and Leadership Buy-In
Team should include clinical, administrative and billing staff
Executive leadership must be responsible for setting EHR goals.
Dedicated System Administration
Who will be monitoring the system?
Who will be updating system as regulations change?
Who will be assisting end users with questions or concerns?

10. Full Organization Implementation
Cost savings
Interdepartmental training
Decrease duplicative workflows and documentation
Increase ability to provide more comprehensive person centered services

11. Realistic Project and Implementation Plan
Data migration including staff and consumers
Will service plans need to be manually entered?
Will external documents need to be scanned and uploaded?
Forms need to be configured
Workflows need to be mapped, standardized and tested
Reimbursement rate need to be entered and tested
Develop workflows that decrease duplication in data
Review current processes in order to reevaluate and restructure for better efficiencies.

12. Staff Training
Training needs to begin prior to “go live”
Training plan needs to include specific goals and objectives
Train staff in the workflows they will be using
Provide detailed step action guides
Give staff specific homework

13. Internal policies and procedures need to be in writing such as:
P&Ps
Internal policies and procedures need to be in writing such as:
Adding and removing staff
Protecting ePHI information
Who has access to EHR at what privilege level
Operational policies and procedures
Compliance with Meaningful Use

14. Utilization-Roadmap to User Adoption
Technology Literacy
Does the staff have basic computer literacy?
End User Support and Feedback
Who will provide end user support on a daily basis?
Implement a system for end users to provide feedback
They have valuable information on what will make their workday more efficient
All requests must be answered in order to keep end user engaged in the process.

15. Utilization-Roadmap to User Adoption
Practice, Practice, Practice
Adequate training time must be afforded to staff to learn to maneuver the system
Hardware Support
IT support must be available to support operational staff to ensure equipment is working properly
Utilization Fatigue
Plan for minimal time of duplicative paper and electronic documentation

16. Successful Billing EHR MUST SCRUB CLAIMS FOR ERRORS Clinical scrub
Billing rule scrub
Set up billing rules to maximize revenue
Test billing prior to sending in live claims
Develop procedures for interdepartmental collaboration between billing and services
Second signatures?

17. Continuous Quality Improvement Reports?
Review workflows regularly for evaluation of improved efficiency
Utilize system for review of services rendered and consumer progress
Develop a procedure for internal chart review
Monitor staff productivity

18. Measuring Outcomes Does the system measure outcomes?
Is there an ability to configure for the outcomes your agency wants to capture?
Are you able to develop reports to capture outcomes?

19. Emerging Model: Triple Aim
Value Payments
Current Model
Emerging Model: Triple Aim
HEALTH STATUS OF THE POPULATION • PERCEIVED VAUE / SATISFACTION • COST PER CAPITA FOR PROVIDING CARE
Future Model: Healthcare Movement
Value =
Quality
Cost
Value =
Effectiveness + Experience
Efficiency
Value =
Consumer meets outcomes + satisfaction + functional status
Cost of service + consumer investment (time/effort)

20. What We All Want to Know How will we bill Medicaid and other payers?
Choosing a comprehensive flexible billing platform to bill all payers electronically and developing internal procedures that incorporate and service lines working collaboratively.
How will we clinically document in a compliant manner?
Choose a system that is capable of: (1) concurrent documentation; (2) flexibility and (3)safeguards to assess all clinical documentation prior to it reaching the claim engine.
How will we meet the ever changing requirements?
Leveraging the opportunity to switch from paper to electronic documentation by: (1) review documentation for duplication; (2)optimize workflows and (3) provide staff with adequate training and support to maximize user adoption.
How do we optimize service delivery and maximize revenue?
Ensure software has the ability to track authorized service units and reporting capabilities to track and monitor utilization.
Develop procedures: monitoring & reporting service utilization
How do we prepare for the future of value based payments?
Establish outcomes for services: review and update annually.
System flexibility to manage/report on outcomes that directly tie to your ability to bill in a value based payment model.

21. Questions/Need more info?
Denise Majka