2. Series 2: Project Management Advanced Project Management for Behavioral Health Electronic Health Records (EHRs) 9/2013 From the CIHS Video Series “Ten Minutes at a Time”

3. Module 9: Identifying EHR System Requirements Overview In depth review of “Systems Requirements Definition” and “Requirements Traceability Matrix” 4 functional categories for identifying and assessing requirements Tracking groups of requirements against the Requirements Matrix Realistically and accurately evaluating EHR capacity to meet requirements

4. Understanding “System Requirements” Patient population Drivers for business processes Requirements for grants and contracts State, Federal and certification requirements Licensing requirements Tools for managing daily tasks Assessment, evaluation, treatment planning, progress notes Managing standard patient documents (Living Wills) Maintain current licensing and credentialing information Ease of use Support for managing workflows Clear improvement in processes

5. Four Functional Categories for Identifying EHR System Requirements Infrastructure – see Module 6 on Information Technology Architecture; consider “transparent functionality” Practice Management – includes scheduling functionality Clinical Data – EHR should support evidence-based practices; billing for services Meaningful Use – “Certified” does not mean “robust” in Meaningful Use functionality.

6. Examples available online California Request for Information to behavioral health EHR businesses – can be used as a template http://www.dmh.ca.gov/Prop_63/MHSA/Technology/docs/EHR_Project/CA_BH- EHR_RFI_v10_091708.pdfhttp://www.dmh.ca.gov/Prop_63/MHSA/Technology/docs/EHR_Project/CA_BH- EHR_RFI_v10_091708.pdf (note- does NOT include Meaningful Use System Requirements) Meaningful Use Electronic Standards and Specifications Stage 1: http://www.gpo.gov/fdsys/pkg/FR-2010-07-28/pdf/2010-17210.pdf http://www.gpo.gov/fdsys/pkg/FR-2010-07-28/pdf/2010-17210.pdf Stage 2: http://regulations.vlex.com/vid/implementation-certification-396307770 http://regulations.vlex.com/vid/implementation-certification-396307770 Requirements specific to Behavioral Health https://www.cchit.org/documents/18/158304/CCHIT+Certified+2011+Behavioral+ Health+Criteria.pdf Systems Analysis – System Requirements Definition

7. Assessing EHR Capacities- Describing Functionality “Demonstrated existing functionality” “Not demonstrated, will be available in the next version” (obtain date of release) “Not demonstrated, can be added with minor modification (usually a configuration or the addition of a script or Web-based service)” “Not demonstrated, customization possible” (obtain Level of Effort Estimate – how long, how much?) “Not demonstrated, no possibility of customization”

8. Example and information available online From NYS Office of Mental Health http://www.omh.ny.gov/omhweb/rfp/2011/emr/updates/20120305 qa.pdf From SlideShare http://www.slideshare.net/sks2009/requirementstraceabilitymat rixsimplehttp://www.slideshare.net/sks2009/requirementstraceabilitymat rixsimple Systems Analysis –Requirements Traceability Matrix

9. About Developing Use Case Scenarios Developed in Business Process Analysis (look for Series 3 modules on this, coming January 2014) Refines requirements identification to the workflow level Taps into the expertise of the individuals meeting the requirements - they understand the nuances of the requirements Results in Business Process Narrative - Collection of “Use Case Scenarios,” the individual business processes that staff engage in on a daily basis Captures “As Is” state, used to develop “To Be” vision Can be used to validate the final system configuration http://www.himss.org/files/HIMSSorg/content/files/Code%20119%20- %20EHR%20Usability_Evaluation%20and%20Use%20Case%20Framework_AHRQ.pdf

10. Summary Identifying system requirements in advance is helpful to selecting an EHR and defending any choices that need to be made Start with the existing requirements defined by various system drivers (funding sources, 3 rd party payers, state and federal regulations, etc.) Assign a numeric value to the requirement and track it to its source Understand that no EHR will be able to meet all requirements Therefore, it is essential to select an EHR based on its capacity to meet non-negotiable requirements Confirm the status of the EHRs capacity to meet necessary requirements with EHR business principles before signing a contract Track any assurances made about future functionality and obtain promises about future capability in writing in the final contract (Module 12)

11. We Have Solutions for Integrating Primary and Behavioral Healthcare Contact CIHS for all types of primary and behavioral health care integration technical assistance and training needs 1701 K Street NW, Ste 400 Washington DC 20006 Web: www.integration.samhsa.govwww.integration.samhsa.gov Email:integration@thenationalcouncil.orgintegration@thenationalcouncil.org Phone:202-684-7457 Prepared and presented by Colleen O’Donnell, MSW, PMP, CHTS-IM for the Center for Integrated Health Solutions