EHR Implementation: A Step-by-Step Guide for the Medical Office

by Hartley, Carolyn P.

• ISBN13: 9781579476434
• ISBN10: 1579476430
• Edition: 1st
• Format: Paperback
• Copyright: 2005-02-01
• Publisher: AMERICAN MEDICAL ASSOCIATION

Summary

Guides users through the research, selection, negotiation, and implementation of an electronic health record (EHR) system into the healthcare environment. Text is organized in a step-by-step format and features abundant flow charts, graphs, checklists, and clear steps for implementation into the system. Softcover.

Table of Contents

Dedication	iii
Foreword	v
Preface	vii
Acknowledgments	xi
About the Authors	xiii
PART 1 A Step-by-Step Guide Through the Selection, Purchase, and Implementation of Electronic Health Records	1	(124)
Chapter 1 The Basics of Electronic Medical Records and Electronic Health Records	3	(34)
What You Will Learn in This Chapter	3	(1)
Key Terms	4	(1)
Institute of Medicine Identifies Priority Areas for National Action	5	(1)
Health Level Seven Leads the Standardization Process	6	(1)
Physician Groups Are at the Center of Health Information Technology Adoption	7	(4)
A Physician Leads Health Information Technology Adoption	8	(1)
National Health Information Technology Plan From the Department of Health and Human Services	9	(1)
Patients Await Electronic Health Record Technology	10	(1)
The Difference Between Electronic Medical Records, Electronic Health Records, and Personal Health Records	11	(3)
The Electronic Medical Record	11	(1)
The Electronic Health Record	12	(1)
The Personal Health Record	12	(2)
The Electronic Medical Record and the Electronic Health Record as Standard References	14	(1)
The Move to Interoperability	15	(1)
What an Electronic Medical Record Should Do for You and Your Practice	16	(11)
Reduce Administrative Burdens	16	(1)
File, Retrieve, and Sort Medical Records	17	(1)
Gather and Help Analyze Data	17	(1)
Improve the Prescription Process	18	(1)
Check Billing Codes to Reduce Rejected Claims	18	(1)
Reduce or Eliminate Transcription Fees	19	(1)
Increase Patient Throughput	19	(3)
Improve Patient Safety	22	(1)
Improve Patient Communication and Relationships	23	(1)
Improve Workflow Management	24	(1)
Conduct Clinical Research	24	(1)
Provide Clinical Decision Support	25	(1)
Enhance Practice Management Software for a Robust Collections Module	25	(2)
Industry Trends	27	(1)
Start EMR Implementation With a Plan	28	(4)
Step 1: Appoint an Electronic Health Record Physician Advocate	29	(1)
Step 2: Establish an Electronic Medical Records Implementation Team	29	(1)
Step 3: Determine an Adoption Plan and Timeline	29	(1)
Step 4: Establish a Want List	29	(1)
Step 5: Evaluate Your Onsite and Offsite Business Partners That Send and Receive Electronic Health Records	30	(1)
Step 6: Review Research Reports and Electronic Medical Record Studies	30	(1)
Step 7: Evaluate Your Current Technology Capabilities	31	(1)
Step 8: Forecast Your Budget	31	(1)
Summary	32	(1)
Endnotes	32	(5)
Chapter 2 An Electronic Medical Record System: Your Electronic Workflow Assistant in the Medical Office	37	(44)
What You Will Learn in This Chapter	37	(1)
Key Terms	38	(1)
Step 1: Evaluate Your Workflow to Understand What Will Change	39	(3)
Step 2: Map Your Paper Workflow	42	(3)
Step 3: Evaluate Work Modules for a Layered Adoption of an Electronic Health Record System	45	(29)
Workflow Module: Scheduler	47	(1)
Workflow Module: e-Prescribing Management	48	(10)
Workflow Module: Billing and Coding	58	(9)
Workflow Module: Clinical Decision Support	67	(2)
Workflow Module: Medical Charts and Medical Transcription	69	(2)
Workflow Module: Connectivity With Other Providers, Labs, and Radiology	71	(3)
Step 4: Evaluate the Patient's Role in Workflow Management	74	(4)
Step 5: Bridge the Workflow Gap From Paper to Electronic Medical Record	78	(1)
Summary	78	(1)
Endnotes	79	(2)
Chapter 3 Making the Purchase	81	(34)
What You Will Learn in This Chapter	81	(1)
Key Terms	82	(1)
Step 1: Establish Your Budget for an Electronic Health Record System	82	(1)
Step 2: Establish Your Implementation Dream Team	83	(1)
Step 3: Engage the Team but Be Clear About Who Will Make the Final Decision	84	(1)
Step 4: Prioritize What You Want	85	(2)
Step 5: Assign Fact-Finding Duties and Responsibilities to Each Member of the Implementation Team	87	(4)
Step 6: Develop a Request for Proposal and Submit It to Three or Four Vendors	91	(6)
Step 7: Develop a Scorecard and Rate the Vendors on Your Short List	97	(5)
Step 8: Schedule Onsite Demonstrations	102	(5)
Vendor Presence in the Marketplace	102	(1)
Vendor EHR Certification	103	(2)
Vendor Customer Service and Technical Support History	105	(1)
Vendor System Interoperability and Integration	105	(1)
Vendor Implementation Plan	106	(1)
Vendor Training Plan	106	(1)
Vendor Upgrade Plan	106	(1)
Step 9: Ask About the Return on Investment	107	(1)
Step 10: Negotiate the Contract	107	(3)
Step 11: Agree on a Purchase Plan	110	(1)
Step 12: Ask for Help When You Need It	111	(1)
Include the Patient in the Electronic Medical Records/Electronic Health Records Procurement Process	111	(1)
Some Early-Adopter Consumer/Patients Already Own Personal Health Records	112	(1)
How the Federal Government Plans to Help	112	(1)
Summary	113	(1)
Endnotes	113	(2)
Chapter 4 Making the Switch From Paper to Electronic Medical Records	115	(10)
What You Will Learn in This Chapter	115	(1)
Step 1: Plan the Implementation	115	(1)
Step 2: Know Your Workflow	116	(1)
Step 3: Transition Paper to Electronics as Part of Your Electronic Medical Record Implementation Workflow	117	(1)
Step 4: Create a Combination of Training Experiences for Your Workforce	118	(1)
Step 5: Provide Computer Training to the "E-challenged"	119	(1)
Step 6: Prepare Your Workforce by Using Key Messages	119	(1)
Step 7: Give Content Time to Sink In	120	(1)
Step 8: Develop Internal Trainers	120	(1)
Step 9: Make a Practice-Wide Commitment to Enter Clinical Data	120	(1)
Step 10: Celebrate Small Victories	121	(1)
The Next Steps: Integration and Interoperability	121	(2)
Begin Interoperability With One Module	122	(1)
Summary	123	(1)
Endnotes	124	(1)
PART 2 Standards Relevant to the Physician's Practice	125	(66)
Chapter 5 Clinical Data Set Standards for Providers	127	(20)
What You Will Learn in This Chapter	127	(1)
Key Terms	127	(1)
The Government's Approach to Electronic Medical Records and Electronic Health Records	128	(1)
Federal Government's E-Government Program	129	(3)
Consolidated Health Informatics Initiative	132	(11)
Summary	143	(1)
Endnotes	143	(4)
Chapter 6 Electronic Health Record Systems: The Health Level Seven Draft Standards for Trial Use	147	(44)
What You Will Learn in This Chapter	147	(1)
Key Terms	147	(1)
The Decade of Health Information Technology	148	(2)
Health Level Seven's Draft Standard Electronic Health Record	150	(1)
Physician Input Into the Electronic Health Record Model	151	(1)
Functional Areas of the Electronic Health Record System	151	(1)
Direct Care	152	(15)
Care Management (DC 1.0)	152	(5)
Clinical Decision Support (DC 2.0)	157	(7)
Operations Management and Communication (DC 3.0)	164	(3)
Supportive	167	(9)
Clinical Support (S 1.0)	167	(2)
Measurement, Analysis, Research, and Reports (S 2.0)	169	(1)
Administrative and Financial (S 3.0)	170	(6)
Information Infrastructure	176	(9)
EHR Security (I 1.0)	176	(4)
Electronic Health Record Information and Records Management (I 2.0)	180	(2)
Unique Identity, Registry, and Directory Services (I 3.0)	182	(1)
Health Informatics and Terminology Standards (I 4.0)	182	(1)
Standards-Based Interoperability (I 5.0)	183	(1)
Business Rules Management (I 6.0)	184	(1)
Workflow Management (I 7.0)	185	(1)
Summary	185	(3)
Endnotes	188	(3)
Appendix A US Department of Health and Human Services News Release: HHS Launches New Efforts to Promote Paperless Health Care System	191	(4)
Appendix B Health IT Strategic Framework: Executive Summary	195	(10)
Appendix C Information Technology Trends and Solutions: 2004 Summary Report	205	(16)
Appendix D Operating in a Vacuum: New York Times Editorial	221	(4)
Appendix E Test Your Knowledge of EMR/EHR Implementation	225	(4)
Index	229