SLFC EMR application playbook template
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The implementation of an EMR application. The project manager playbook strawman.

The implementation of an EMR application. The project manager playbook strawman.

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SLFC EMR application playbook template Document Transcript

  • 1. International HealthCare Electronic Health Records Practice Implementation PlanInternational Health Care San Jose ePrescribe Module
  • 2. Table of ContentsInternational Health Care San Jose Practice Profile ........................................................... 4EHR Initiative ..................................................................................................................... 5 Project Background ......................................................................................................... 5 Project Scope .................................................................................................................. 5 Project Timeline .............................................................................................................. 5Project Communications Materials ..................................................................................... 8 EHR ePrescribe Devices ............................................................................................... 10 Requirements List ..................................................................................................... 10 Placement Floor Plan / Drawing ............................................................................... 12 EHR Role Assignment and Access List........................................................................ 13 Project Plan Activities List ........................................................................................... 14 Master Schedule ............................................................................................................ 16 Practice Signoff ............................................................................................................. 18Application Preparedness.................................................................................................. 19 Practice Configuration .................................................................................................. 19 Roles Assignment ......................................................................................................... 19 User Access ................................................................................................................... 19 Abstraction .................................................................................................................... 19 Application signoff ....................................................................................................... 20Technology Preparedness ................................................................................................. 21 Survey ........................................................................................................................... 21 Installation..................................................................................................................... 22 Technology Signoff ...................................................................................................... 23Staff Preparedness ............................................................................................................. 24 Staff training plan ......................................................................................................... 24 Staff Training Check-off List........................................................................................ 24Go Live ............................................................................................................................. 26 Day -1............................................................................................................................ 26 Day 0 ............................................................................................................................. 27 Day +1 ........................................................................................................................... 28 Week 1 .......................................................................................................................... 29Transition to Production ................................................................................................... 30Project complete sign off .................................................................................................. 34
  • 3. Table of FiguresFigure 1 – Map to International Health Care San Jose ....................................................... 4Figure 2 - Vitalized EMR eP Deployment Time Pipe at International Primary care ......... 6Figure 3 - Vitalized EMR eP inter-coordinated deployment time pipe for Group 1 .......... 7Figure 4 - EMR equipment request for International Health Care San Jose .................... 10Figure 5 - Practice eP Device Placement Floor Plan Drawing ......................................... 12Figure 6 - International Primary Care Device Placement Floor plan ............................... 12Figure 7 - Roles and Access Assignment List .................................................................. 13Figure 8 - International Primary Care Project Plan Activities List ................................... 14Figure 9 - Three Module Implementation Sets ................................................................. 15Figure 10 - Master Module Set Deployment Schedule ..................................................... 16Figure 11 - Project Launch Sign Off................................................................................. 18Figure 12 – Application Readiness Sign Off .................................................................... 20Figure 13 - Technology Request List................................................................................ 21Figure 14 - Technology Acceptance Checklist ................................................................. 22Figure 15 – Technology Readiness Sign Off .................................................................... 23Figure 16 - ePrescribe training plan document ................................................................. 24Figure 17 - Training Check-off List.................................................................................. 24Figure 18 - Command and Control structure .................................................................... 27Figure 19 - Responsibility Matrix ..................................................................................... 32Figure 20 - ePrescribe Module Set Transition To Production documentation ................. 33Figure 21 – Vitalized EMR ePrescribe Implementation Sign Off .................................... 34
  • 4. International Health Care San JosePractice ProfileName International Health Care San JoseLocation 123 Kincora MOB, West 100 E. Lancaster Avenue San Jose, CA 95100Phone 408-555-1234Fax 408-555-4321Back Office 408-555-9876Physicians and staff David A. Smith, MD Daniel Anderson, DO Steven Fritz, MD David A. Kemp, DO James C. Jones, DO Stan Lawson – OMPractice Administrator Susan FlanneryPhysician Assistant Michael AndersonMedical Assistant Eric AndersonDeployment Team Cynthia Fritz, Lead Fred Smith – Trainer / Coach Sally Smith – Trainer / CoachCostCenter 4321Miles 19.1Map Figure 1–Map to International Health Care San Jose
  • 5. vEHRePrescribe InitiativeEHR InitiativeProject BackgroundA project to develop a deployment model leveraging the pilot experience was undertaken.This model is the source material for the rollout of the EHR solution across theenterprise.The implementation of the Vitalized Electronic Practice Management (vEPM) solutionwas completed in 2008 across all facilities.Early in 2010 the pilot deployment of the Vitalized Electronic Health Records (vEHR)solution was completed at three practices.Project ScopeThe enterprise deployment of the HER solutions is being accomplished in three phases.Each phase is partitioned into three waves. Each wave includes a defined function of thevEHR software.The Scope of Phase I, Wave I, is to deploy the ePrescribe module set of theVitalizedEHRsolution.Wave II is to deploy Tasking, Orders & Results, and the Provider Approval Queue (PAQ)modules. Wave II is defined in a separate project plan.Wave III is to deploy the Point of Care (POC) modules. Wave III is defined in a separateproject plan.Project TimelineThe project is scheduled to run for 25 days and will culminate with the successfulimplementation of the ePrescribe module set in full use at the practice.The foldout illustrates the timeline and activities required for the endeavor.Page 5 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 6. vEHRePrescribe InitiativeThese are the major events associated with the implementation of the ePrescribe module set in the vEHR application. The deployment team will coordinate these activities withthe practice administrator and staff to ensure implementation success.This time pipe in inter-coordinated with the other practices going live at the same time. Figure 2 - vEHReP Deployment Time Pipe at International Primary carePage 6 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 7. vEHRePrescribe Initiative Figure 3 - vEHRePinter-coordinated deployment time pipe for Group 1Page 7 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 8. vEHRePrescribe InitiativeProject Communications MaterialsTo facilitate the highest quality communications and expectations management, a seriesof control documents have been created. They are provided as a baseline for the differingproject team members – Executive Management, Practice Administration, IT ProjectManagement, Desktop Management, Network Management, Operations Management,the Help Desk teams, and the staff and management at theInternational Primary CarePractice. Description and Document Owner Input Editing View Approval PurposevEHRePDevice Detail the International International All All IHCRequest List equipment Primary Primary Primary required for the Care Care Care use of the ePrescribe module in the practice. Used to create a purchase order for the practice.Staff Roles and Shows the IHC IHC All All IHCResponsibilities people Primary Primary PrimaryList responsible for Care Care Care each process at the practice. Includes the security and access assessment. Used to add users and access privileges to the ePrescribe module set for the practices staff.Project Plan Details the task, IT All IT All Alland Timeline critical path, due dates, and assigned resources for each step in the deployment of ePrescribe. Used to drive work and interdependencies between staff, IT, vendors, and subcontractors.Practice Signoff for the All IT IT All IHCSignoff start of the PrimaryPage 8 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 9. vEHRePrescribe Initiative ePrescribe Care deployment project. Document that the project has been reviewed and approved by the practice.All project materials are available any time on the SharePoint document server athttps://sharepoint.IHC.org/EHR-EP/IHC Primary Care.The deployment team willestablish user access to this important communication gateway.Page 9 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 10. vEHRePrescribe InitiativeEHRePrescribeDevicesRequirements ListFigure 4 - EHR equipment request for International Health Care San Jose Flat Cart / Lab Screen Laser Jet Data Electrical Table for IHCSJ PCs Monitors Printer Ports Outlets PC RX Ptr Label Ptr Vertical Scanner Flat Bed Scanner Need Need DataPort Need DataPort and Electric and Need DataPort Need Electric Only - Electric only Electric and Electric Device connected to PC Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Existing Existing Existing Existing Existing Existing Existing Existing Name of Room/Area or User Check In 2 2 0 2 2 0 2 2 0 2 2 0 3 3 0 2 2 0 0 0 0 0 3 3 0 0 0 0 Check Out 1 1 0 1 1 0 1 1 0 1 1 0 2 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 Telephone Room 3 3 0 3 3 0 0 0 0 3 3 0 3 3 0 3 3 0 0 0 0 0 0 0 0 0 0 0 Billing/Phone Area 2 2 0 2 2 0 0 0 0 2 2 0 2 2 0 2 2 0 0 0 0 0 0 0 0 0 0 0 Managers Office 1 1 0 1 1 0 1 1 0 1 1 0 2 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 Medical Records 1 1 0 0 1 1 0 0 0 1 1 0 4 3 1 1 1 0 0 0 0 0 0 0 0 1 1 0 Physicians Office 8 5 3 7 5 2 2 3 1 5 5 0 5 5 0 5 5 0 0 0 0 0 0 0 0 0 0 0 Lab 0 1 1 0 1 1 1 1 0 2 1 1 4 3 1 1 1 0 0 0 1 1 0 0 0 0 0 0 Nurses Station 5 5 0 5 5 0 1 1 0 6 5 1 6 6 0 5 5 0 2 2 0 0 0 0 0 0 0 0 Pod Area 1 1 0 1 1 0 0 0 0 1 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 Hallway StandUp Desk 0 1 1 0 1 1 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 Exam 1 not used now 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Page 10 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 11. vEHRePrescribe Initiative Flat Cart / Lab Screen Laser Jet Data Electrical Table for IHCSJ PCs Monitors Printer Ports Outlets PC RX Ptr Label Ptr Vertical Scanner Flat Bed Scanner Need Need DataPort Need DataPort and Electric and Need DataPort Need Electric Only - Electric only Electric and Electric Device connected to PC Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Needed for EHR Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Need to Order Existing Existing Existing Existing Existing Existing Existing Existing Name of Room/Area or UserExam 2,3,4,6 (a) 0 4 4 0 4 4 0 0 0 4 4 0 4 0 4 4 4 0 0 0 0 0 0 0 0 0 0 0Exam 5 (b) 0 1 1 0 1 1 0 0 0 1 0 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0Exam7,9,10,11,12,13,14,15 0 8 8 0 8 8 0 0 0 8 0 8 8 0 8 8 0 8 0 0 0 0 0 0 0 0 0 0Empty physician office 0 1 1 0 1 1 0 0 0 1 1 0 2 2 0 1 1 0 0 0 0 0 0 0 0 1 0 1Exam 8 0 1 1 0 1 1 0 0 0 1 0 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1Totals 4 6 1 3 6 0 2 1 0 1Page 11 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 12. vEHRePrescribe InitiativePlacement Floor Plan / Drawing Figure 5 - Practice eP Device Placement Floor Plan Drawing Figure 6 - IHC Primary CareDevice Placement Floor planPage 12 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 13. vEHRePrescribe InitiativeEHR Role Assignment and Access ListFigure 7 - Roles and Access Assignment List Sorian Remote Name Role vEHRLogin Login Access David Cohen, MD Physicians or Mid Level Providers David Targan, DO Physicians or Mid Level Providers James Solava, DO Physicians or Mid Level Providers Daniel Lazowick, DO Physicians or Mid Level Providers William Schetman, MD Physicians or Mid Level Providers Michelle Weir Clinical Staff Catherine Bodkin Clinical Staff Jennifer Janusziewicz Clinical Staff Frances Grace Lodise Clinical Staff Kathryn Spellman Clinical Staff Thomas Herrity Clerical Staff JacylnSioutis Clerical Staff Sheila Bryant-Destine Clerical Staff Melanie Rae Caruso Clerical Staff Jennifer Lord Clerical Staff Danya Newton Clerical Staff Evellin Rosa Clerical Staff Jean Sweeney Clerical Staff Sylvia Thompkins Clerical Staff Stephanie Lawson Clerical StaffThe deployment team will pre-populate this list with normal role assignments. If changesare requested they will be edited prior to configuration of the ePrescribe module set.Changes can be made at any time using standard request documentation.Page 13 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 14. vEHRePrescribe InitiativeProject Plan Activities ListFigure 8 - IHC Primary CareProject Plan Activities ListThe deployment team is responsible for maintaining the project plans timeline. IHCPrimary Care is responsible for providing key information about devicesrequirements/placement, staff roles/access, and workflow knowledge. The PracticeAdministrator will work interactively with the deployment team to keep the rollout onschedule.Page 14 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 15. vEHRePrescribe InitiativeThe ePrescribe module set is the first of three sets of modules to be deployed. The secondmodule set includes Tasking, Orders & Results, plus Physician Approval Queue (PAQ).The third module set is Point of Care (POC). ePrescribe Group One 1 } Three Week Offset Task, } One Week Offset O&R, PAQ Group Two 1 POC Group One 1 Group Three 2 Group One 1 Group Three 2 Group Four 2 Group Three 2 Group Four 2 Group Five 3 Group Four 2 Group Five 3 Group Six 3 Group Five 3 Group Six 3 Group Six 3 Group Two 1 Group Two 1 Figure 9 - Three Module Implementation SetsThe start of the ePrescribe module deployment is July 22, 2010. The second module set isscheduled to begin three weeks later on August 12th, 2010. The third module set isscheduled to begin one week later on August 19th, 2010.Each implementation team (shown is grey numbers to the right of each group) beresponsible for the deployment activities for the same practices, for all module sets. Thisleverages a deeper understanding of the specific workflow and operating details of thepractice and its staff. Team one will be responsible for groups one and two. Team two willbe responsible for groups three and four. Team three will be responsible for groups fiveand six.Due to the complexity of the development of templates for the Cardiology practices, theyare placed at the bottom of the second and third module sets to provide for adequate timefor development.Page 15 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 16. vEHRePrescribe InitiativeMaster ScheduleFigure 10 - Master Module Set Deployment Schedule ** Tasking, Orders & Results, Physician *** Point of Care Approval Queue Group Number Team Number * ePrescribe Group Step Sequence Practice 1 1 1.1 1 IHC Primary Care 330 7/22 8/12 8/19 2 1 1.2 1 IHC Physicians – Internal Medicine & Geriatrics 7/22 8/12 8/19 – San Jose 467 3 1 1.3 1 IHCSan Jose 904 7/22 8/12 8/19 4 2 2.1 1 IHC Cardiothoracic Surgeons **** 8/5 10/21 10/28 5 2 2.2 1 IHC Cardiology - Arrhythmia Consultants 556 **** 8/5 10/21 10/28 6 2 2.3 1 IHC Interventional Cardiology **** 8/5 10/21 10/28 7 2 2.4 1 IHC Cardiovascular Group 356 **** 8/5 10/21 10/28 8 2 2.5 1 IHC Cardiovascular Group 233 **** 8/5 10/21 10/28 9 2 2.6 1 IHC Cardiovascular Group 375 **** 8/5 10/21 10/28 10 3 3.1 2 Ashby, Klinzing& Sharma BMH MOB 8/19 8/26 9/2 11 3 3.2 2 Ashby, Klinzing& Sharma Quad 8/19 8/26 9/2 12 3 3.3 2 Malcolm S., MD 425 8/19 8/26 9/2 13 3 3.4 2 Internal Medicine Associates of San Francisco 8/19 8/26 9/2 County 3001-C 14 3 3.5 2 IHC Family Medicine 121 8/19 8/26 9/2 15 3 3.6 2 Internal Medicine Associates of San Francisco 8/19 8/26 9/2 County 16 3 3.7 2 Rid Primary Care CPC 8/19 8/26 9/2 17 3 3.8 2 Internal Medicine Associates of County 8/19 8/26 9/2 18 4 4.1 2 Upper Family Medicine IHC 9/2 9/9 9/16 19 4 4.2 2 Upper Pediatrics IHC 9/2 9/9 9/16Page 16 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 17. vEHRePrescribe Initiative ** Tasking, Orders & Results, Physician *** Point of Care Approval Queue Group Number Team Number * ePrescribe Group Step Sequence Practice 20 4 4.3 2 Valley Family Medicine 491 9/2 9/9 9/16 21 4 4.4 2 IHC Physicians – Internal Medicine & Geriatrics 9/2 9/9 9/16 22 5 5.1 3 Nansteel& Morris Associates 304 9/16 9/23 9/30 23 5 5.2 3 Nansteel& Morris Associates IHC 9/16 9/23 9/30 24 5 5.3 3 Newtown Family Medicine 5048 9/16 9/23 9/30 25 5 5.4 3 OB/GYN Associates – Westtown 9/16 9/23 9/30 26 6 6.1 3 OB/GYN Associates 3106 9/30 10/7 10/14 27 6 6.2 3 OB/GYN Associates MLHC 9/30 10/7 10/14 28 6 6.3 3 Pediatric Associates 3403 9/30 10/7 10/14 29 6 6.4 3 Vascular Surgery 3308 9/30 10/7 10/14Note:*Group rollout begins once every 10 days** Gap between module set 1 and 2 is 21 days*** Gap between module set 2 and 3 is 7 days.**** Moved to group 6 for module sets 2 and 3.Page 17 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 18. vEHRePrescribe InitiativePractice SignoffThe deployment team lead will need a signoff from the practice management acceptingthe scope of the initiative - vEHRePrescribe module implementation, and that the taskassignments have been communicated and acceptable.The signoff takes the form of an email. Immediately following the successful completionof the project launch meeting and supporting documentation, the practice and appropriatestakeholders will receive asignoff email communiqué. Acceptance of the signoff email isthe practices granting the deployment team permission to proceed.Figure 11 - Project Launch Sign OffPage 18 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 19. vEHRePrescribe InitiativeApplication PreparednessThis chapter details the work required to get the application ready for the IHC PrimaryCare practice. Most of this work is the responsibility of the IT department in general, andthe Application Group specifically.Practice ConfigurationAn enterprise model for the practice site, department, coding,Roles AssignmentAn enterprise model for role definition and the module / feature access lists.User AccessConfiguration details for adding roles, users, andAbstractionThe data abstraction activities and tasks.Page 19 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 20. vEHRePrescribe InitiativeApplication signoffThe Deployment Team Lead will need a signoff from the Application Group detailing theapplications readiness for the IHC Primary Carepractice.The signoff takes the form of an email. Immediately following the successful completionof the application preparedness completion the Application Group and appropriatestakeholders will receive a signoff email communiqué. Acceptance indicates that thetasks have been completed.Figure 12–Application Readiness Sign OffPage 20 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 21. vEHRePrescribe InitiativeTechnology PreparednessSurveyAll technology requests need to be verified by a site visit of all appropriate parties. Cart / Table for PC Lab Label Printer Electrical Outlets Flat Bed Scanner Vertical Scanner Laser Printer RX Printer Data Ports Monitor PC IHC Name of Room/Area or User Check In 0 0 0 0 0 0 0 0 0 0 Check Out 0 0 0 0 0 0 0 0 0 0 Telephone Room 0 0 0 0 0 0 0 0 0 0 Billing/Phone Area 0 0 0 0 0 0 0 0 0 0 Managers Office 0 0 0 0 0 0 0 0 0 0 Medical Records 0 1 0 0 1 0 0 0 0 0 Physicians Office 3 2 1 0 0 0 0 0 0 0 Lab 1 1 0 1 1 0 0 1 0 0 Nurses Stration 0 0 0 1 0 0 2 0 0 0 Pod Area 0 0 0 0 0 0 0 0 0 0 Hallway Stand Up Desk 1 1 0 1 0 0 0 0 0 0 Exam 1 not used now 0 0 0 0 0 0 0 0 0 0 Exam 2,3,4,6 (a) 4 4 0 0 4 0 0 0 0 0 Exam 5 (b) 1 1 0 1 1 1 0 0 0 0 Exam7,9,10,11,12,13,14,15 8 8 0 8 8 8 0 0 0 0 Empty physician office 1 1 0 0 0 0 0 0 0 1 Exam 8 1 1 0 1 1 1 0 0 0 0 Totals 14 16 1 13 16 10 2 1 0 1 Figure 13 - Technology Request ListPage 21 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 22. vEHRePrescribe InitiativeInstallationAs the technologies are review and approved they will be checked off from this list. Cart / Table for PC Lab Label Printer Electrical Outlets Flat Bed Scanner Vertical Scanner Laser Printer RX Printer Data Ports Monitor PC IHC Name of Room/Area or UserCheck InCheck OutTelephone RoomBilling/Phone AreaManagers OfficeMedical RecordsPhysicians OfficeLabNurses StationPod AreaHallway Stand Up DeskExam 1 not used nowExam 2,3,4,6 (a)Exam 5 (b)Exam 7, 9,10,11,12,13,14,15Empty physician officeExam 8 Figure 14 - Technology Acceptance ChecklistPage 22 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 23. vEHRePrescribe InitiativeTechnology SignoffThe Deployment Team Lead will need a signoff from the following groups – Technology(Desktop & LAN), Practice Administration, and Office Management, detailing thetechnologies readiness for the ePrescribe module set at the IHC Primary Care practice.The signoff takes the form of an email. Immediately following the successful completionof the technology preparedness and the appropriate stakeholders will receive a signoffemail communiqué. Acceptance indicates that the tasks have been completed.Figure 15 – Technology Readiness Sign OffPage 23 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 24. vEHRePrescribe InitiativeStaff PreparednessStaff training planA training plan has been established to provide for the proper skills assessment andknowledge transfer to each ePrescribe user. The Practice administrators and officemanagers should collaborate to enroll all practice staff in this mandatory training class.Supplemental tutoring and coaching is available prior to the go-live upon request.Figure 16 - ePrescribe training plan documentThere are three stages of training for the ePrescribe module. 1. Training system setup and access setup 2. Classroom training on the features and functions of the ePrescribe module set 3. One-on-One tutoring and refresher prior to the go-live.Based on the staff role assignments, each practice employee will be given access to thetraining systems. The state of the data base will be reset to a base condition. Thecurricula will be distributed electronically and in hard copy. Everybody is encouraged tovisit the site, log in, navigate through the screens and functions, and complete as manytransactions as possible. End of Day transactions should be exercised as well.The training materials should be studied in advance and questions compiled as thematerials are being reviewed. The FAQ ledger should be studied.All training will take place in a classroom. For those facilities that are located aconsiderable distance from the IT general office, a suitable remote classroom may beestablished. The deployment lead or practice administrator will notify you of the locationof the classroom.Training is mandatory and strict. Please attend all classes you are requested to, and arriveready as the start time indicates. Cell phone, pager, and laptops are permissible but allefforts should be made to keep distributions to a minimum. The knowledge obtainedhere is key to the success of the rollout.The ePrescribe module set is a ½ day (4 hour) class.Staff Training Check-off ListFigure 17 - Training Check-off ListPage 24 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 25. vEHRePrescribe Initiative Feature 1 Feature 2 Feature 3 Feature 4 Feature 5 Feature 6 Feature 7 Feature 8 Feature 9 Feature 10 Feature 11 Feature 12 Feature 13 Feature 14 Feature 15 NameDavid Cohen, MDDavid Targan, DOJames Solava, DODaniel Lazowick, DOWilliam Schetman, MDMichelle WeirCatherine BodkinJennifer JanusziewiczFrances Grace LodiseKathryn SpellmanThomas HerrityJacylnSioutisSheila Bryant-DestineMelanie Rae CarusoJennifer LordDanya NewtonEvellin RosaJean SweeneySylvia ThompkinsStephanie LawsonRemote Access Service training of key practice members will be scheduled andconducted one-on-one. Please ask the deployment leader or the practice administrator forclassrooms and times.Page 25 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 26. vEHRePrescribe InitiativeGo LiveDay -1The day prior to the go-live, the deployment team and practice administrator will visit thepractice site for a run through.The technology will be reviewed to ensure all workstations, printers, and scanners areperforming to specification. The application module set will be exercised to ensure that itis available to the site. The user community will log in, navigate to the appropriateePrescribe screens and functions depending on the users role and access configuration.A final go, no go decision is required to proceed. If all systems are go, the applicationwill proceed to go the next day. If there are issues that would prevent a go-live, thedeployment team will review the corrective actions and advise the stakeholders on stepsrequired to neutralize the obstacle. Initials Deployment Practice Office Technology Operations Lead Administrator Manager Management ManagementGoNo GoNotes:Page 26 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 27. vEHRePrescribe InitiativeDay 0Command and ControlThe on-site team is comprised of the project lead and two application coaches. They willcoordinate all go live activities with the Practice Administrator and Office Manager. Figure 18 - Command and Control structureThe physician and support staff are pivotal to the success of the implementation of theePrescribe module set. In-office operations are the primary focus of the go-live. All staffwill have sign-on identification, password assignments, and permission to access therequired functions within the ePrescribe module set.The off site team is comprised of the helpdesk as well as key technology contributors -Desktop support, Local Area Network support, Wide Area Network support, and DataCenter support. To keep corrective time to its bare minimum, the helpdesk will beinstructed to collect issue information and immediately dispatch it to the on-site teammembers for resolution.Page 27 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 28. vEHRePrescribe InitiativeDay +1The day after the go live is structured the same as the go-live days from a coverage pointof view. If all goes according to plan on day 0, some of the on-site personal may berecalled to the IT office.Response time to issues will remain at its highest level.Performance monitoring of the technology landscape will be done at the IT office. Theperformance of the Local Area Network, Wide Area Network, Application Server(S),Data Base systems, and storage performance will continue through the go live week.Statistics on capacity and performance will be review daily to avert user responseproblems. Metrics will be provided to the IT and ASP groups to reinforce qualityobjectives.End of Day debriefings will review the day’s transactions, workflow review, andrefinements needed to meet quality objectives. Best practice business process review willbe documented and added to the projects archives.Page 28 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 29. vEHRePrescribe InitiativeWeek 1The operations of the ePrescribe module set will continue for the remainder of the week.Documentation will be compiled to transition the support of the module to the sustainingsupport group.Recommendations on Help Desk knowledge transfer will be documented and review withHelp Desk team members and management. Ticket triaging scripts will be developed andprovided to the call center personal. The information collection and knowledge transferdocumentation will follow the enclosed questioning guidelines. 1. Issue encountered by user. 2. Application the user is running 3. Function the user is running 4. Is the system slow, or not working at all 5. Specific actions being taken (save, exit, tab, enter, etc.) 6. Specific patient or transaction being worked on 7. Specific computer being worked on 8. Specific document being printed or reviewed 9. Is the transaction missing data or contains invalid data 10. Has user tried to perform this function on other computers 11. Have other users experiences this issue 12. When did this issue arise – Has it been misbehaving all dayThe formal turnover from the project team to the sustaining support team will close theproject.The expected service levels of the practice will be documented by the deployment teamand IT management.Page 29 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 30. vEHRePrescribe InitiativeTransition to ProductionOnce the module implementation stabilizes, it is transferred to the sustaining supportteams within the organization, and at the application service provider – Siemens. Theknowledge of how to take helpdesk calls, add new staff, and diagnose operating issueswith the solution is embodied in the Transition To Productions (TTP) documentation.The sustaining support of the ePrescribe module set is one of many informationtechnologies utilized at the Practice. The responsibility matrix provides a coverage mapfor each component or process. IS EHR Application Analyst IT Storage Mgmt. Team IS Ambulatory Team International Health IT Security Admin. IT Desktop Team Vitalized EHR IT Site Mgmt. IS DBA Team IT Intel Team IT HL7 Team Help Desk Category TaskProblem Report X XFirst Call Resolution (passwordreset, Account unlocks) XPrinter Setup: (printer must be setfor each form) Individual Forms X Print Server X Install Physical printer X Activate printer XApplication Errors: Base X X Problems X X RX+ X X Allergies X X Note X X Vitals X X Task X X Dictate X X Charge X X Order X XPersonal Computer Errors XApplication Administration Creation/Support of templates X Support of libraries/dictionaries XPage 30 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 31. vEHRePrescribe Initiative IS EHR Application Analyst IT Storage Mgmt. Team IS Ambulatory Team International Health IT Security Admin. IT Desktop Team Vitalized EHR IT Site Mgmt. IS DBA Team IT Intel Team IT HL7 Team Help Desk Category TaskServer Support Monitor Production Database Backups X X Monitor Data Storage Consumption X X Monitor Failover Servers X Monitor All server performance XInterface Monitoring & Support Reg/Sched inbound to EHR X X X Dictionary XML inbound to EHR X X X Cerner Lab Results inbound to EHR X X X Cerner Lab Orders outbound from EHR X X X IDXRad Results outbound to EHR X X X IDXRad Orders outbound from EHR X X X MedQuist (Hospital Documentation) dictation outbound from EHR X X X MedQuist (Hospital Documentation) transcription inbound to EHR X X X Charges outbound from EHR X X X Middleware Engine X Monitor Registration Interface Logs X Monitor Scheduling Interface Logs X Monitor Transcription Interface Logs X Monitor IDXRad Interface Logs X Monitor RX Fax Logs XDatabase Support XSecurity Provisioning X Password Resets, Account Unlocks X Impac MD User Setup X X Maintain Security Classifications/Groups XVitalized Contact Reporting Issues X X Production Support X XTraining XCreation/Maintenance of Customer XPage 31 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 32. vEHRePrescribe Initiative IS EHR Application Analyst IT Storage Mgmt. Team IS Ambulatory Team International Health IT Security Admin. IT Desktop Team Vitalized EHR IT Site Mgmt. IS DBA Team IT Intel Team IT HL7 Team Help Desk Category TaskSystem Downtime ProceduresTraining EnvironmentMaintenance Coordination with Sites/Orgs X Wipe clean/recreate X XTesting Environment Maintenance Coordination with Sites/Orgs X Wipe clean/recreate X XChanges to productionenvironment Coordinate with IT and provide change details X Open change mgmt ticket X X X X X X X X Coordinate change with vendor & Customers X X X X X X X X Testing signoff XApplication Upgrade Testing X Scheduling with vendor and IS X Change Management X Project Mgmt (If needed) X Figure 19 - Responsibility MatrixPage 32 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 33. vEHRePrescribe InitiativeThe documentation covers the following topics: 1. Top ten support issues of the user community 2. Interface technologies that transport data in and out of the ePrescribe module 3. Administrative and maintenance instructions – Staff, department, site, coding, etc 4. Infrastructure monitoring – diagnostics 5. Shutdown and startup procedures and sequencing 6. Manual and automatic periodic batch processing 7. Applications availability schedule 8. Error Log monitoring and corrective action procedures 9. Responsibility Support MatrixFigure 20 - ePrescribe Module Set Transition To Production documentationPage 33 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx
  • 34. vEHRePrescribe InitiativeProject complete sign offThe Deployment Team Lead will need a signoff from all groups for the ePrescribemodule set at the IHC Primary Care practice.The signoff takes the form of an email. Immediately following the successful completionof the implementation and the appropriate stakeholders will receive a signoff emailcommuniqué. Acceptance indicates that the tasks have been completed.Figure 21 – vEHRePrescribe Implementation Sign OffPage 34 of 34 ihcplaybooktemplate-121217134510-phpapp02.docx