What You Can - and Should - Do Now
The later a healthcare provider starts the EHR implementation process, the faster ramp-up or implementation process will be required. There is a great incentive to start now - and much progress can be made with your EHR implementation.
As an example, Capital Region Healthcare in Concord, N.H., led by CIO Deane Morrison, devised a nine-step process. Called "Nine Meaningful Steps to Success," the process has focused on understanding the HITECH Act, determining its ramifications for Capital Region Healthcare, and putting teams and plans in place to achieve the organization's agreed-upon goals.
- Understand the HITECH Act. Morrison advises that this is a responsibility of the organization's chief information officer. "It's too big of a turning point for your organization for the CIO to delegate," he says. Morrison formed a three-person team, including himself, to review the HITECH Act in detail. Team members compared conclusions and assessed their organization's strengths and weaknesses.
- Calculate the financial "do nothing" potential. Morrison created a financial worksheet to calculate the inpatient and physician financial incentives - as well as the penalties. He used this worksheet to educate the organization's senior leadership team as well as the finance and planning committees of the board of directors. Morrison describes his worksheet as the way to create the compelling reason that spurred Capital Region executives to take action.
- Perform a gap analysis. Using the same team that assessed the HITECH Act, Morrison evaluated his organization's readiness against the published meaningful use criteria. Team members compared their individual assessments and agreed on their recommendations for next steps.
- Estimate future capital requirements. In the case of Capital Region, Morrison's budget includes software system and capital requirements for phase one through three of the HITECH Act. Morrison included his CFO and budget finance committee in the process.
- Establish a governance oversight group. This group becomes your go-to body to keep plans in scope and realign everyone to expectations as needed. At Capital Region, the CEO and CMO co-chair the governance group, which also includes the COO, CNO, CIO and any other vice president whose organization will be impacted by the projects. The governance oversight group also comprises teams and group projects within teams. The governance group meets monthly to review plans and progress. In particular, the group established and monitors progress against timeframes to achieve inpatient and physician incentives. Morrison emphasizes that these are two separate objectives.
- Create a Program Office. Morrison recommends appointing a leader who has solid project management skills and an understanding of everything that needs to occur. At Capital Region, the director of IT Clinical Applications serves as Program Office leader. This group includes clinical informatics representatives: the CMIO and CNIO, along with pharmacists and other physicians and nurses. Other team members represent the IT and Finance departments. This group meets biweekly.
- Define (meaningful use criteria) Project Charters. At Capital Region, Morrison and his team have created projects and charters for each criteria the organization does not meet, as outlined under meaningful use. Project charters include objectives, scope and necessary resources based on the meaningful use metrics established for the particular criteria. A project leader is assigned and responsible for each project and its charter.
- Develop a timeline. Inpatient and outpatient projects are separate, as are certification and meaningful use projects. Morrison recommends that your team conduct its own certification process gap analysis. "Don't assume your vendors have everything covered specific to your needs," he says. Also, you should know and understand your vendors' timelines. Once you've gathered all the information, plot all your projects on a comprehensive calendar. Be sure to accommodate any necessary pre-requisites in your planning (such as being on a certain software release before you can implement e-prescribing).
- Monitor your progress. Review your overall progress or lack of progress with your governance group. Again, this team should be used to address organizational barriers and keep focus on your goals and objectives.
