Posted by
Ben Fyvie on Thu, Feb 16, 2012 @ 09:51 AM
Submitting a billing claim, getting a list of vaccinations for a client, faxing orders to a physician and emailing a client about their next visit; what do all of these have in common? Well, you likely wouldn’t be able to do any of them without the power of the internet. With recent technological advances you’re likely finding that more and more of your work requires a connection to the internet. Today we are going to talk about the efficiencies and money savings gained when moving to a hosted EHR solution.
The first thing you’re likely to notice when moving to a hosted EHR solution is that there is no need to install any software. This means huge time and cost savings for your information technology department. In fact, you don’t even need an IT department; you can think of it as a “geek free” solution!
The second thing you’re going to benefit from is that you are no longer tethered to your office workstation. You can get your work done from anywhere that you have an internet connection. This means you can leave work on time even if you haven’t finished your charting for the day. You can make time for dinner with your family and then later that evening you can sign in to the EHR application from home to finish your work. Think of the possibilities of being able to get your work done from anywhere…anytime!
Finally, there are numerous efficiencies gained by software vendors who offer hosted solutions. These are often passed down to users in the form of:
- Lower costs
- More frequent releases and bug fixes with no end-user intervention required
- Better stability and reliability of the application
As you can see there are many benefits to moving to a hosted EHR solution. One thing you’ll want to keep in mind is that with any hosted solution the data is not stored in your office. You’ll want to verify that the software vendor gives you full ownership rights over your data and the ability to retrieve a complete backup of your data.
The internet is already playing a major role when it comes to EHR and that role will only be expanded upon in the future. Having a hosted EHR solution will put you in a position to take advantage of the latest technology and integrations available to provide the best care possible to your clients.
Posted by
Ben Fyvie on Tue, Feb 14, 2012 @ 04:51 PM
This is the last in our series of blogs on electronic health records. The first two covered physical and digital security. The focus of this article is data confidentiality.
Client data should only be viewed on a need to know basis. There are a number of things your software can do to allow you to enforce confidentiality restrictions.
- Role assignments could be used to restrict users from certain portions of the application. For example, billers shouldn’t have any need to see charting information and so they should be assigned to a role that prevents them from viewing the charting screens.
- Program assignments could be used to group your clients into separate categories. Your employees could then be assigned to the programs for which they need access to. For example, if you have a nurse that deals strictly with maternal child health, they should have no need to view records for clients that are being seen for HIV treatment.
- Audit trails could be created for the actions your employees take in the application. With an audit trail you would be able to run a report that gives you insight into the records that a given employee has viewed,
created, modified or deleted. If a client wants to know which of your employees has viewed their record, you would have no trouble getting them this information.
There is one last thing that you can do to ensure your software application is secure. Be informed. Don’t be afraid to ask questions of your software vendor, they should be able to respond to any inquiries regarding the security measures they have in place that makes their application safe and secure.
You’re already taking an important step towards being informed when evaluating software products just by reading this blog. You can never be too safe when looking for a place to store your confidential data.
Posted by
Ben Fyvie on Fri, Feb 10, 2012 @ 04:27 PM
This is the second in a series of 3 blogs on EHR security. The first one covered physical security. Now we'll talk about digital security.
This is the type of security that gets the most attention these days. While there will never be an application that is 100% safe against hackers, there are a number of things you should look for to ensure that your application is only accessed in a secure fashion and by authorized users:
- If your application is accessed via a web browser, the web address should start with https (not http), this ensures that all data is encrypted before it is transmitted across the internet.
- Password requirements. Since
passwords are a major part of accessing any software application it is imperative that measures be taken to ensure the passwords are secure.
- Forgotten passwords should be required to be reset. The application should never remind you of your password via email.
- Passwords should be required to be ‘complex’. Typically this is considered to be at least eight characters in length with a mix of letters, numbers and symbols.
- Passwords should be required to change on a regular basis.
- An account should be locked out after a number of consecutive failed login attempts.
The last blog in this series will post next week and covers confidentiality.
Posted by
Ben Fyvie on Tue, Feb 07, 2012 @ 02:52 PM
Ensuring that a software application is secure is a crucial step before you start sending it any confidential information. There are a few different types of security that you’ll want to be aware of with any software application. The categories we’ll be covering are physical, digital and confidential. This is not an exhaustive list of security measures that should be followed, but it should give you a good place to start. We'll talk about these in 3 blogs, starting with Physical Security.
Whenever you save data in a software application that data is being stored on a physical device until you need to access it again. In the past it was common for this physical device to be the machine at your desk; however, with the advent of multi-user software applications it is almost certain that your data is being saved to a remote server. It could be that this server is in a closet in your office or it could be that the server is in a datacenter halfway across the globe. Either way some basic questions need to be asked.
- Where is the server?
- Who has physical access to the server?
- If the server is behind a locked door, who has a key and is it possible that unauthorized copies of this key have been made?
- What policies are in place to prevent unauthorized accessto the server?
- Are there surveillance cameras in place?
- Is a background check required before access to the server is granted?
Physical security is also a concern at any machine where employees access the data. When an employee goes on break or gets pulled away from their computer and forgets to sign out of the application what is in place to ensure that wandering eyes don’t find themselves onto a vacant computer screen? Things such as computer monitor privacy filters or an auto-logoff can help to minimize the physical risk at the end-user’s workstation.
Posted by
Bev Larson on Thu, Feb 02, 2012 @ 02:14 PM
Public/Community Health and Home Care agencies are being asked to be accountable for Quality Improvement activities on a number of different levels. Some agencies are beginning to prepare for national public health accreditation through the Public Health Accreditation Board. Others have been part of the Multi-State Learning Collaborative that brought state and local health departments together with other stakeholders—including public health institutes, health care providers, and universities—to improve public health services and the health of their community by implementing quality improvement (QI) practices.
Home Care agencies are looking to Quality Improvement to become more efficient and effective with their prospective payment dollars. The governing body of your agency may also be asking for documentation of efforts to improve the quality of your services or to justify their effectiveness/existence in these times of tight budgets.
Quality Improvement, in a nutshell, is improving the effectiveness or efficiency of the work that we do. “But," you say, "I do that all the time! We are always tweaking our work processes and making things better for our staff and clients.” Health care agencies are very good at that. What you may not be so good at is documenting what you do in a standardized way so you get credit for it!
How can an electronic health record (EHR) help in your efforts? By having quantifiable data in a format (standardized categories & codes) that allows an agency to “ask questions of the data”, the agency can use their EHR to do some of the following:
Look for areas or populations that may be underserved – this could be such areas as age groups, diagnostic groups, grant programs, geographical areas or any combinations thereof.- Look for programs that are not serving sufficient populations to warrant their continuance.
- Match program data to Community Health Plans to provide data for Community Report Cards.
- Use time & mileage data by program areas to improve on the best use of staff resources.
- Measure savings in staff efficiency and supply costs by using a paperless (or almost paperless) EHR vs. paper documentation/mailing/filing.
- Look for possible QI projects by comparing yourself to previous years or to similar agencies in your region.
Can you think of more ways to make use of the data in your EHR? Champ Software has a Discussion Board where ideas can be shared with your colleagues. Do you have a great idea for a QI project making use of your Electronic Health Record?
Standardized care plans have been proven to be effective tools for clinicians to provide consistent and quality care to patients. How does an agency determine what standardized care plans they need? Review of case studies could provide that link.
A standardized care plan can be defined as strategies designed to assist clinicians in the care of their clients/patients. They are holistic in nature and are specific to the individual needs of the client. They represent best practices and provide you with consistent reliable data as well as improved outcomes for clients/patients.
If you are determined that standardized care plans are a must have, how do we go about choosing and creating them? Review of case studies can help you determine the populations your agency serve. Once you have identified a population, then further review of that case study can help 
you personalize your care plan based on what your agency standards are. It will guide you in asking what interventions need to be standard. These standards can be based on personal agency goals, specialized grant requirements and/or state guidelines.
In this day and age, management of time and money are key. Standardized care plans allow you to institute best practices for your agency thus ensuring goals are met in the most efficient means possible while maintaining quality and consistent care. Case studies are a vital tool for identifying care plans needed as well as how to personalize them specific to client needs. Can your agency afford not to invest time in your own standardized care plans?
When preparing for training on any new software product, you need a checklist. Each software company will have a unique training program with requirements specific to the training tools they use. However, there are some common requirements to be prepared for with any software implementation. Your checklist should always include key people, important tasks, and a timeline.
Champ Software will provide you with a checklist similar to the one shown below. For other software vendors, you can start with this checklist as a guide and modify it to match your implementation.
Project Lead(s):
- Select dates and times for each training session and fill them in on the Implementation Plan.
- Fill out the User List with first name, last name, email, and job title for each trainee.
- Email your trainer the completed Implementation Plan and User List.
- Email all of your trainees a copy of the Implementation Plan.
- Prepare your training room. If you are using a central conference room for training sessions, make sure to schedule use of that room, have an overhead set up if you'd like, and make sure a hands-free conference phone is available.
IT Department (complete the following for each trainee's computer):
- Install Mozilla FireFox (or for non-Champ Software products, ask in advance what you'll need to install).
- Install/update the most recent version of Adobe Flash Player to run video tutorials.
- Install/update the most recent version of Java, which is used by the virtual classroom software.
- Verify the system requirements for using BlackBoard (or any other virtual classroom software, for non-Champ Software products) are installed. Champ provides you with documented BlackBoard Virtual Training Room Instructions. You can also find these on our website.
If you are prepared going into the training session, you will be able to focus on the content and concepts and eliminate distractions created by technical set up issues. Start your implementation off on the right foot. For more information on Champ's training and implementation process, contact training@champsoftware.com.
Need a more effective way to present new or best practices to your clinicians? Give case studies a try! All the latest research on effective learning practices point to a more "hands-on" approach. Let us show you how the use of case studies in your agency might just be the smartest way to go.
We can all remember the many days we spent in school listening to a teacher/professor lecture to us for hours. New research is proving that this traditional way of learning really was punishment for our brains and in fact discouraged/prohibited real learning.
It has been discovered that people learn best when they are allowed to solve realistic problems. These new principles are all based on brain-based learning concepts. By placing learners in an environment where they are allowed hands on realistic scenarios the brain is able to retain and interpret the new information more effectively.
Most of us might be more familiar with the learning pyramid. The pyramid breaks down the retention rates of various learning styles with "lecture" at the top of the pyramid with a mere 5% retention rate. The highest level of retention occurs when you are "teaching others" with a 90% retention rate.
The use of case studies incorporates "teaching others" by presenting real life scenarios and solutions. Case studies are presented using a short summary of case specifics along with a mock-up of how that summary would be presented using your standardized nursing language and/or electronic health record. Case studies can be used to problem solve or teach a new technique. This approach enables your clinicians to take in information that is familiar, allowing the brain to better retain new information.
Effective learning needs to be hands-on and realistic so that a 90% retention rate can be achieved. Case studies are powerful tools that can easily be part of your agency's arsenal of meaningful teaching techniques.
Check out these case studies for public health, home health and more.
The idea of implementing an electronic health record can strike fear into even the bravest of us, which is why I've composed a list of 5 essential secrets to get you on your way to implementation success! This post is a continuation of my article posted on Tuesday, January 10th, "5 Secrets to Successful Implementation (Part 1)," discussing secrets and lessons learned for successfully implementing your new electronic documentation system!
Secret #4: Practice, Practice, Practice!
Do not overestimate the simplicity of practice! Is it delusional to think that users will be eager and willing to practice their new charting methods? Yes! All staff are busy and are very conscientious about keeping up with their work. They might even feel pressured to maintain their current work load. You need to count on the fact that your agency will experience a decrease in productivity by staff as they learn the new documentation system. It is a fact! Now once you have accepted that, you will need to tell your agency staff to expect it. Devoting significant time for users to practice will dramatically decrease the loss in productivity.
How can you get them to practice? Here are some tips:
- Schedule a weekly time to practice.
- Have supervisors present to monitor practice and provide feedback.
- Conduct weekly or bi-weekly staff meetings to discuss concerns or issues.
- Create a self audit tool for users to complete.
- Complete homework assignments, supervisor reviews and provide feedback.
Many users experience anxiety with new or different procedures. Practicing allows users to become more familiar with this new requirement and hopefully experience less anxiety.
Secret #5: Keep the Learning Active.
Learning doesn't stop after you Go Live. Documentation is a constant and evolving process. Changes will need to be made. Some of the ways you can prepare your agency for the flexibility required include creating a focus group and conducting periodic internal audits.
Creating a focus group that is made up of users is helpful to keep the system in working order. Expect that guidelines you created might not meet documentation and/or program needs. Focus groups are not just for complaining. Ensure the focus groups know that they are solution oriented. Have the focus groups lead yearly or semi-yearly trainings as solutions are created. You might also think of rotating the group every 6 months so that all users (including your lingering resistors) get a chance to come up with solutions rather than just present barriers.
Periodic audits might also prove to be beneficial to make sure users are documenting the data as specified by your agency. Along with audits, it is essential to continue to practice your skills using the Omaha System. Case reviews of real life clients presented at staff meetings are a great tool to continue your mastery of the Omaha System.
There is no such thing as a perfect implementation. It is through failure, hurdles and success that the above tips and recommendations were created. As you embark on this endeavour, remember that you can't do it alone, identify the resistors, make a plan, practice and keep learning. You too can have a successful implementation!
This post is a continuation of my article posted on Tuesday, January 10th, "5 Secrets to Successful Implementation (Part 1)," discussing secrets and lessons learned for successfully implementing your new electronic documentation system!
From state to state and county to county, agencies are complex and dynamic. Agencies are now, more than ever, offering very specialized services to various populations. Documentation systems struggle to keep up with all these specialized programs and offer solutions. If you are lucky, you will find yourself using software that allows you the ability to personalize to your agency needs. What that means is that as your agency changes, YOU control the ability to make those changes when YOU need them. Which brings us to the next secret to a 
successful implementation.
Secret #3: Create a Plan for Your Agency.
You must plan to spend some time looking at your programs to see how you will need to personalize your documentation system to meet their needs. You will also need to make decisions for your agency and programs on the process of implementation itself. Here are some questions you might want to ask:
- Is the data you need captured? Whether you need to report certain data at set intervals or if your data will be audited, you need to review your documentation system to make sure the data you must have is captured. You will also need to communicate this to your users so they are completing the data that needs to be compiled. Forms - Will you need to build custom fields into your documentation system or will you continue with your old forms?
- Will you have all your users trained or will you train-the-trainer?
- How often will your implementation team need to meet? Find out who is monitoring the users and identifying if there are any users that are struggling. It will also be important to know how often the users meet to discuss concerns and problems being encountered, as
well as how their issues will be addressed or cataloged.
- How will you keep your users updated? Create desktop aids and/or Go Live Instructions. Apprehension is minimized if users know what the plan is.
- Will your agency Go Live all together or would it be best split up and/or staggered?
These are only some suggestions of questions that may need to be posed during your implementation planning. If you do your homework at the beginning, create a plan for your agency and communicate your plan with your entire agency, you will find less resistance and fewer resistors. This will help you on your way to implementation success!
Check back later this week for the last of the 5 Secrets to Successful Implementation!