SELECTING AN EHR FOR A GENERAL SURGERY PRACTICE Suppose you've just been hired as the practice administrator of an eight-physician surgery practice. After several years of contemplation and serious deliberations, the physicians have made the strategic decision to invest in the selection and implementation of a facility wide EHR system. They also want to replace their practice management system (which includes patient scheduling and billing). It's an older system that is rather clunky. Ideally, they'd like to find an integrated practice management system that has an EHR component. Dr. Stephen Strange, the current CEO of the physician organization, has very little knowledge of information systems technology. He has been reluctant to move toward an EHR system for many years, primarily because he heard stories from a few his colleagues in other specialty areas who have implemented EHRs in their practices and have found the systems to be highly cumbersome and disruptive to the patient care process. One of his best friends claims he "spends an extra hour or two a night in the office because of the additional time demands of the EHR. He claims the system never seemed to work right." Dr. Strange is convinced that there are not any great surgery related EHR products on the market, but with value-based payment looming, and the opportunity to improve quality of patient care, he's open to taking another look. In addition, one of their newest partners, Dr. Jean Grey, just finished her residency program where EHRs were an integral part of her training. She is a big champion of the effort to select and implement an EHR. She has offered to help lead the effort. One of the other partners, Indiana Jones, came back from a conference impressed with the vendor presentation from Allscripts and convinced it's the way the practice ought to go. The other physicians are nearing retirement and a little nervous about the possible disruption to the office. Information Systems Challenge Even though the patient records at the surgical practice are paper-based, the practice has been using computerized practice management systems for patient scheduling and billing for years. Six months ago, they started to have a nurse enter physician-dictated notes into the paper record while in the examination room with the patient. The physician then reviews the notes at the end of the visit or day and signs off on them. This is in an effort to decrease the dictation and transcription that the practice had historically done and to get the nurses and physicians ready for the EHR. The expectation is that nurses will do the bulk of the data entry in the exam room while the physicians are seeing the patients. However, the physicians will have to review the documentation and sign off on all entries. The practice currently has approximately four thousand patient visits per month, including 40 percent Medicare and 10 percent Medicaid. Assignment: You are tasked with leading the team charged with the selection of the new practice management system, including EHR, for the practice. 1. You begin by convening a practice management-EHR selection team. Who would serve on the team? Who would serve as executive sponsor? Explain your rationale. 2. How might you conduct an EHR-readiness assessment for this practice? What factors will be important to consider? Why? 2.1.1. Review this Organizational Survey contained in the assigned chapter readings. Select what you consider the 3 most important factors are that would contribute to the success or failure of a new software implementation project. 2.1.2. Explain why you chose each measure and describe how it affects the organization's readiness. What would go wrong if users disagreed with this measure? If there is a strong consensus on this measure how does that impact the project implementation? 3. Create a one page example requirements document for the practice that could be used in the vendor evaluation process. Refer to the EHR Functionality Requirements document in the chapter articles for an example. The example can be on any aspect of the system requirements. 4. Provide a brief overview narrative that addresses the strengths and possible problem areas you might encounter when trying to implement a new system for this group