CNEA report questions

Hello again fellow bloggers. Just wanted to post the questions for your reports here in case you need them for reference. We realize that this is not a standard “report” format. For this program, we really want to hone in on a number of detailed issues regarding your EHR journey to date. For these questions, we want you to tap the folks most appropriate for the answers, so please let us know if we need to add someone to the Blog·
We want you to choose 3 out of the first 5 questions below as well as question 6, for a total of 4 questions.
· Please treat each question as a New Blog Post, and label it with the question that you are responding to.
· We appreciate and respect that you are all very busy, please let us know if you will need time beyond the November 15th deadline for posting to the blog.
· Please don’t hesitate to contact me if you have any questions or concerns.

QUESTIONS: (Remember you only have to choose 3 out of the first 5 questions) If you have documents to add to the report or share with your colleagues, please post links to those documents in your blog)

1. How did you plan for and model the loss of staff and provider productivity during the initial implementation period?
a. Did this modeling/planning influence the tactics you employed to rollout the EHR (incremental, big bang or hybrid)?
b. How accurate were your predictions? What positively or negatively influenced the actual results?
c. Can you share a spreadsheet or tool you used for analysis?

2. How have the clinics you support dealt with the hybrid environment of paper and electronic charts?
a. What is your plan for chart retirement?
b. In general, how long does it take before the chart is no longer pulled routinely for the visit? What circumstances cause this to vary (patient type, provider preferences, etc)?

3. Did you establish usage metrics and organizational standards post go-live to monitor how effectively the system is used?
a. Did you establish usage metrics and standards and, if so, what were they? (i.e., encounters will be closed within 48 hours, a Women’s Health template will always be used document annual visits, etc.)
b. Did these metrics influence other aspects or your rollout, particularly speed or sequence of rollout to other sites? Number and type of support staff assigned to clinics?
c. What sort of chart audits or usage audits are conducted on a routine basis to assure that organizational standards are being adhered to? What are you finding as a result of these usage audits?
d. Is there a tool or checklist for this purpose that you can share?

4. If you are a network, do you support your clinics in workflow redesign? If you are a clinic organization, how did workflow redesign play a part in your implementation?
a. What tools or techniques did you use?
b. What were the most challenging aspects of workflow redesign?
c. How did this effort positively or negatively impact your EHR implementation?
d. Are there any tools, templates or approaches to this activity that you can share or recommend?

5. How did you approach and/or support end user training?
a. How was training accomplished for providers? For the care team?
b. Was there any attempt to provide process training (i.e., medication refills) in addition to functional training (i.e., prescription writing)?
c. Did you do a skills assessment prior to implementation? If so, can you share any surveys or assessments you used? What was done to mitigate any skill deficiencies?

Everyone must answer question 6 below:

6. Now that we have an idea of CMS’s thinking about “meaningful use”, based on your experience, can you comment on whether you would have changed your implementation approach because of these incentives? Are they realistic for clinics to achieve?