CareTracker EHR Implementation
Promote non-stressful implementation
Mindful of physician loss of productivity
Best practice recommendation for a new EHR practice is
to implement components of EHR over time to promote
staff acceptance & develop content gradually
CareTracker EHR Implementation in a Nutshell
1. Planning
2. Attend webinars
3. Identify limited items in medical record to be scanned prior to patient’s next visit
4. Create problem list, medications, allergies, immunizations, patient pharmacy and specialty information prior to patient’s next visit
5. Identify incremental opportunities for incremental adoption practices
Select “soft” live date for each component for incremental adoption, or
Select a go live date to implement full component utilization
6. Work with templates, develop quick text, practice
7. Document note electronically (incrementally or all at once)
CareTracker EHR – Planning
Most important step!
Plan, Plan, Plan and then plan some more
Keep office informed of changes
Work with staff for buy in
CareTracker EHR – Planning
Identify EHR project planning committee
¾ Office point person
¾ Physician champion
¾ Meeting frequency
¾ Determine projected time line
9 Different from practice management live date
9 Incremental adoption
9 Building EHR content
9 Focus on cultural changes within office
CareTracker EHR - Planning
Schedule physician & staff CareTracker training
¾ Recorded WebEx sessions
¾ Instructor lead WebEx sessions
¾ Personalized telephone WebEx sessions
¾ Practice, practice, practice!
Schedule staff meetings to discuss:
¾ Cultural changes
9 Organizational change management
9 Clinical workflow process analysis
9 Office redesign
9 Clinical staff using CareTracker
¾ Workflow changes
9 Utilize Clinical Today Dashboard (ToDo’s, Check In / Out)
9 E-prescribing
9 How to / who will handle lab results
9 Documenting during or after visit
CareTracker EHR - Planning
Determine method of data entry
¾ Motion C5 (Portable)
¾ Tablet PC (Portable)
¾ Laptop (Portable)
¾ PC (stationary)
Exam room options for carrying portable devices
¾ Music Stand
¾ Hang on wall
¾ Table
CareTracker EHR - Planning
Security Issues
¾ Securing laptops
¾ Locking tablets
Unattended Browsers
¾ Need quick log on/off if the patient is in the exam room with access to a system
¾ For example:
9 Finger print log on
CareTracker EHR - Planning
Determine if any P4P data points are required
¾ Make sure info is captured on template
Determine reporting requirements
Discuss method to use for progress note data entry
¾ Point & click templates
¾ Quick text
¾ Dictation
¾ Voice recognition
¾ Handwriting recognition
¾ Combination of methods
CareTracker EHR - Planning
Data Points:
¾ Problem List
¾ Medications
¾ Allergies
¾ Past Medical, Family & Social History
¾ Immunization History
¾ Patient Registries
¾ Pediatric practices: growth chart
¾ Cardiology practices: INR tracking
¾ Pregnancy history (OB/GYN)
Consider who should enter medical data & by when:
¾ Providers
CareTracker EHR - Planning
MD identifies items to be scanned Patient Name: Date(s):
Pharmacy entered: □ Yes □ No
Medications entered: □ Yes □ No
Allergy list entered: □ Yes □ No
Lab results: Pap smear: EKG: Mammogram: Colonoscopy: X-ray report: Discharge summary:
Annual physical exam:
Progress note:
Letters from consultants:
Health care proxy:
CareTracker EHR - Planning
Scanning Considerations:
¾ Once items flagged in chart to be scanned, support staff can scan documents prior to patient’s next appointment
9 Be consistent in naming conventions of documents scanned
9 Be consistent where documents are scanned in EHR
9 Determine resources & time line needed for scanning
¾ Scanned documents help develop electronic medical record content, but remember to limit historical scanning
CareTracker EHR - Planning
Discuss Business Continuity Plan (Disasters)
¾
Sample items
:
9Rx pads
9Paper progress note templates
9Paper encounter forms
9Lab/radiology order forms
9Patient clinical summaries for appointment list printed and “Locally Secured”
CareTracker EHR – Attend Webinars
Working with your Implementation Specialist identify staff
members who will need to attend training
Register for instructor lead Webinars, or
Listen to pre-recorded Webinars, then
Schedule personalized one-on-one training
Practice using templates and creating quick text
CareTracker EHR Implementation
Incremental Opportunities for Incremental Adoption
STEP A: Clinical Today, Messaging, & Inbound
Correspondence
¾ Clinical Dashboard, Quick Tasks, ToDos, Mail, and Faxing
STEP B: ePrescribing
¾ New and refill prescriptions
¾ Order Rx paper from Dr. Stuff (203) 785.8475 or www.doctorstuff.com
STEP C: Using Clinical Tool Bar for Lab Orders and
Managing Electronic Results Via Quick Tasks
¾ East Side Lab, Quest, Care New England, Lab Corp, Open MRI, Rhode Island MRI, Rhode Island Imaging Institute
¾ Orders and Order Sets
¾ Results Management
CareTracker EHR Implementation
Incremental Opportunities for Incremental Adoption
¾
STEP D: Health History Panes & Progress Note
Preparation
(still have a paper record)
Create registries and enroll patients
Identify templates to be used and build Quick Text PRN
WEEK ONE: Schedule 1 new patient per day for a week to
record progress note using EHR application
WEEK TWO: Schedule all new patients to record progress
notes using EHR application
WEEK THREE: Utilize progress note for 1 follow-up encounter
each day; keep doing all new patient notes in EHR
WEEK FOUR TO SIX: Continue new patients and add at least
2 follow-up patient records using the EHR Application
¾
STEP E: Provider Portal & Outbound Messaging
CareTracker EHR Implementation
New Practices and Transitioning EHR Practices
Attend Full Series of Training
Clinical Today
¾ ToDos, Messaging, Schedule, Visit Capture…
Health History Panes
¾ Pre-load patient information as identified in planning, registries…
Clinical Toolbar
¾ ePrescribing, lab orders, letters, patient education…
Progress Notes
¾ Templates, practice, signing, printing
CareTracker EHR – Go Live
No more paper chart
Document electronically for all appointment types
Continue planning meetings
¾ Continuing education for employees
¾ Training of new employees
¾ Determine what to do with paper charts once desired information is in EHR (according to state law)
¾
EHR Implementation Specialist will continue to be point
of contact for first few weeks of live use
CareTracker EHR – Monitoring Workflow
Identify workflow challenges; use the CareTracker EHR
Task Sheet
¾ Are refill requests being approved?
¾ Are To Do(s) being responded to?
¾ Are Lab/Radiology results being committed to the chart?
¾ Are notes being signed?
¾ Are visits being entered?
¾ Are attachments being signed?
¾ Are notes being dictated on a timely basis?
¾ Are open orders followed up?
