Running head: INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR

Memo
TO: FROM: DATE: SUBJECT: Joe Ward, Acting Director Dr. Paul Sullivan, Director Joan Kronlein RN, Staff Nurse March 29, 2011 Instructions for Implementing an Electronic Medical Record at Birkam Health Center

Enclosed, please find instructions for implementing an Electronic Medical Record/Electronic Health Record (EMR/EHR) at BHC. As you requested, the instructions include four separate phases/parts. All staff members are to be involved in the initial phases of planning. Joe Ward will oversee the first two parts, followed by the Coordinator. The Coordinator will be chosen by the staff at BHC. If you have questions or would like additional information, I can be contacted at Birkam Health Center, Monday-Friday 0800-1645 at 231-591-2614 or email at kronlej@ferris.edu.

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR

Instructions for Implementing an Electronic Medical Record/ Electronic Health Record at Birkam Health Center March 29, 2011 By Joan A. Kronlein RN To Joe Ward (Acting Director) And Dr. Paul Sullivan Director of Birkam Health Center At Ferris State University

English 321-Ruzicka

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR

Instructions for Implementation of an EMR/EHR at BHC

Purpose: All staff members at Birkam Health Center have agreed that an EMR/EHR is needed to save time and reduce costs. The following are instructions and timelines for implementation. An EMR/EHR will be up and running in approximately four months. The following provides an overview of what will take place, by whom, and when. It is broken down into four parts. Please keep an open mind about the transition. Change is always difficult, but if we work together, we can make this happen. Try to enjoy the process! Overview/Resources: Prior to the purchase of an EMR/EHR, the coordinator of this implementation process will be Joe Ward (Pharmacist). Joe will be contacting multiple software companies to set up meetings within 1 month of assembling a capabilities list (See part 1). He will also be contacting Ferris State Universitys (FSU) legal affairs regarding any legal issues with using an EMR/HER. He will also set up appointments with the Information Technology (IT) department at FSU. A committee will be formed by, and a coordinator for the EMR will be chosen from, all staff members, by the staff. Joe will supply blank capabilities/items list forms and blank committee selection ballots. The main break room is where all software demonstrations and committee meetings will take place. This will allow for staff members to be informed about the functioning of the Health Center during demonstrations, as well as, enabling staff members to step in and try the software during low patient volume times(UC). Individuals/Companies to be contacted include;(SC) M-CEITA (Part 1) Legal Affairs (Part 1) Dan Burcham VP-Student Affairs (Part 1) Pediatric Associates/ Kitty Harrington/Office Manager (Part 1) Denise Grinnell-Information Technology Manager (Part 2) Software Companies (names yet to be determined)

Instructions
Part 1
(Start Date: __/__/2011)

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR All Staff: -

Complete a list of capabilities/items you would like to see in an EMR/EHR. Submit your list to Joe Ward (pharmacist) within 2 weeks. Compile a list of who would best represent BHC on a committee to select a software System (Each person to list 3 people ). Submit the list of whom (for the committee) to Joe Ward, within 1 week.

Joe Ward (Acting Director)/ Paul Sullivan: After 1 week, compile names for the committee, and select the people (4) most often listed. After 2 weeks, combine capabilities/items lists to a single document. Assemble the meeting and discuss capabilities list, add to the list where necessary. Contact Pediatric Associates, Big Rapids, to verify capabilities required of an EMR/EHR. Contact M-CEITA for assistance and get the costs of utilizing their services, if any. Set up a meeting with M-CEITA and the committee (This should be within 1 month of the initial contact). Set up a meeting with Dan Burcham to discuss financing of the EMR/EHR and MCEITA costs (You may want the committee members at this meeting). o Have insurance information (especially Medicaid) available to discuss with MCEITA. o Have the capabilities/items list compiled and narrowed down prior to the meeting. After the meeting with M-CEITA, contact software companies for demonstrations on products. Obtain cost estimates from all of the companies. Schedule the staff members to attend all of the demonstrations; 3-4 people at a time. Allow for 2 hours away from work for each group per software product. Provide information sheets for the staff to rate the products, and what was liked or disliked about each. Give to the staff prior to them attending the software evaluation session. Groups for the demonstrations will be: (C) o 2 billing people and Joe Ward. Close the pharmacy and billing office at this time. The nurses will cover the billing office. Patients are to initial their chart. After the demonstration, the office will send a bill when the office is open. o 1 front office worker, the nursing supervisor, 1 physician, and1 nurse. Make the sure the student workers are available to staff the front office. o 2 nurses, 1 physician, and Paul Sullivan.

Front Office Staff/ Student Workers:

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR -

The student workers are to begin, immediately, pulling files and tallying health insurance policies. Carefully, look at all Medicaid policies. Medicaid includes Medicaid, Tencon, and Priority Health-Medicaid, etc. If the insurance is questionable, bring it to Carol Johnson at the billing office to verify what type of policy it is. Keep an accurate record of these policies.

Physicians: (Dr. Newell and Dr. Davis) - Compile a list of skills you would like help with i.e. typing, computer skills, etc. - Compile a list of how the flow of work will be different by using an EMR/EHR for documentation. Would it be easier to have the electronics in the room, or move from room to room with the same laptop? - Have the above lists to Joe Ward within 2 weeks and prior to the meeting with MCEITA). Nurses: (Melissa, Joan, Julie, and Candie) - Compile a list of how the flow of patients should be carried out using an EMR/EHR. - Compile a list of skills you would like help with. - Please have both lists submitted to Joe Ward within 2 weeks. Billing Office: (Carol and Sharon) - Pull out the policy and procedures for billing/finance. - Compile a list of important items/ capabilities necessary from a new EMR/EHR system. - Coordinate the policies and procedures with capabilities/items and make changes as you deem necessary. - Submit this list to Joe within 2 weeks. - Make a copy of the policies and procedures and make notes for future changes to the policies and procedures if using an EMR/HER.

*After all of the above is completed continue with part 2(CI)

Part 2
(1and1/2 months after start date) Joe Ward: After all staff members have viewed, asked questions, and have tried each software product, call a full staff meeting together. At the meeting: o Discuss each software product, the likes, the dislikes and the costs. o Decide which product best fits with BHCs needs. o Consider the hardware: laptops versus electronic tablets. o Discuss the budget and total costs to BHC.

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR -

After the staff meeting, contact Information Technology to set up a meeting with Denise Grinnell regarding interfacing with the Banner system. Discuss: The need for a dedicated IT person to go through software training with the BHC staff to understand the software and ask appropriate questions. Having IT look at the system the staff at BHC has decided on. The costs for utilizing the IT staff for BHC software. *After the above go to part 3(CI)

Part 3
(2 months after the start date)

Joe Ward: With approval from IT regarding the choice of software system, call a full staff meeting together. At the meeting: (C) o Discuss the outcomes of all IT conversations. o Determine a timeline for the purchase and implementation of the EMR/EHR. (Should be within 4 months). o Determine the EMR/EHR coordinator. The staff can decide by an anonymous ballot. Have slips of paper for the staff to write down their choice for a Coordinator.

EMR/EHR Coordinator (?) After the purchase of software, schedule aneducation timeline. o Will schedule yourself first, for at least 2 days. o Will schedule the staff (see the groups above) for training. Have on-site representatives available to the staff for 2-3 days after training. o Will block off the schedule to keep patient volumes low on training days, to decrease frustration/anxiety over the transition.

Part 4
Evaluation
All Staff:

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR

After 2 weeks of using the EMR/EHR, all staff members will meet to go over the praises and problems of the first 2 weeks. The Coordinator will keep a list of both. All staff members will participate in problem solving. If an issue cannot be solved within Birkam Health Center, the coordinator will then call the software support service for resolution of the issue. The coordinator may delegate duties to others, if necessary. Front Office: A separate meeting is to be held with the front office staff. This meeting will discuss the check in, scheduling and chart retrieval process. Questions to discuss: - Is the amount of time needed for chart retrieval/locating decreasing? - Is the front office staff better able to get other duties done? - What has the staff heard from patients/students about the check in process? - Does BHC still need to fill the open position in the front office?

Billing Office: A separate meeting will be held with the billing/finance department. Questions to discuss: - How is the billing/finance process going? - What are the issues? - What would you like to do differently? Students: The evaluation for students/patients must be our priority. A satisfaction survey, in regards to the new EMR/EHR, will be sent out, via the Banner system, to all students on campus. The survey will be sent out after 6 and again at 12 months after the implementation of the EMR/EHR. The Coordinator, along with Joe, will compile a list of student answers. From the answers, Birkam Health Center will evaluate the effectiveness of using an EMR/EHR to save time and money.

*I appreciate your willingness to put an EMR/EHR in place at BHC. Over time, the system will save time and money; and over time, we will look back and wonder how we ever survived without it! Hang in there!
English 321 Ruzicka Assignment Evaluation instructions Front matter: __X__Effective use of transmittal memo, title _____Adequate use of transmittal memo, title _____ Inadequate use of or missing transmittal memo, title

INSTRUCTIONS FOR IMPLEMENTING AN EMR/EHR

Content: __X__ Thorough use of sequential steps and specific directions, explanations _____ Inconsistent use of sequential steps and specific directions, explanations _____ Generally lacking in sequential steps and specific directions, explanations Introduction/conclusion: __X__ Effective Overview & Supplies/Resources sections that include needed background information _____ Adequate sections _____ Weak sections __X__ Effective conclusion evaluating the policys or technologys effectiveness _____ Adequate conclusion _____ Weak conclusion Organization: __X__ Information presented in logical order with effective use of transitions _____ Generally logical organization, some information and ideas out of place _____ Poorly organized and difficult to follow Format: __X__ Correct, consistent use of appropriate format _____ Inconsistent use of appropriate format _____ Incorrect use of appropriate format _48__content score __2__ Points lost for grammar, punctuation, and spelling errors _____ Late or incomplete rough draft _____ Late final draft _46__ Final score

Joan, Youve done a nice job of unraveling a complex process and setting these instructions up so the various people can easily follow them. Good work. DR