Matt and Erin's presentation at TEPR 08 about Electonic Health Record optomization This presentation provides guidance on how to optimize and standardize during the implementation process to promote utilization of an EHR.

1. Optimization and Standardization to Promote Utilization in an EHR Matthew J. Davis and Erin Sain TEPR 2008 - Ft Lauderdale April 2008

2. The focus of this lecture is to provide guidance on how to optimize and standardize during the implementation process to promote utilization of an EHR. June 4, 2009

9. Standardization Level Matrix June 4, 2009 Required EMR Content Subgroups Level of Standardization Level of Appeals User User Functions Database Specialty Sub-Group Database Specialty Sub-Group Favorites Override (NMG) (Practice) (NMG) (Practice) Chart Notes Note Type Naming X X No No Structure of Index X X No Yes Input Forms X X No Yes Output Forms X X No No Output Style X X No No Allergies Medications X¹ X Yes Yes Non-medications X X Yes Yes Vital Signs X X No Yes Medications X¹ X Yes Yes Immunizations X¹ X Yes Yes Problems (PMH/PSH/FH/SoH/etc.) (Master²) X³ (Master²) X³ Yes Yes Assessment X X Yes Yes Orders Laboratory X X Yes Yes Radiology X X Yes Yes Procedures X X Yes Yes Referrals X X Yes Yes Other X X Yes Yes Charges Charge X¹ X Yes Yes Care Guides* Category Structure X X No No Content X X No Yes QuickSets X¹ X Yes Yes HMP Screening X X No Yes Disease Management X X No Yes Tasking Task Naming X X No No Workflow X X X X No Yes ChartViewer Scan/Document Naming X X No No Views X¹ X Yes Yes Chart Sections X X Yes Yes Reviewed 03/09/08 Definitions: A. Required EMR Functions - areas of ehr that require full adoption by all users in order to ensure successful communication and database sharing throughout Sample Medical Group. B. Level of Standardization - the organizational level at which ehr content will be standardized at the time of implementation . This may occur at the Sample Medical Group, specialty, or practice levels. C. Level of Appeal - the organizational level at which ehr content may be modified after implementation . D. User Favorites/User Override - identifies the areas of ehr that allow for customization at an individual level. Notes: 1. Denotes a starter set that might be modified by the user over time. This requires less individual feedback up front. 2. These areas will have a standardized " master " list to help problem list organization in the medical chart. 3. A personal " Quick List " of about 50 terms will additionally be available to each user for easy access to common conditions & terms. This can be modified by the user over time. * This function is not required. The subsets of functions within the Care Guides are required and utilized in other modules.

10. Standardization Committee Decision Calendar June 4, 2009