slfc healthcare apss

Ambulatory Practice Solutions Services Complete IT Services for EHR Implementations The turn key services associated with the implementation of an enterprise Electronic Health Records solution. From needs analysis to vendor selection through to go-live and transition to sustaining support. S L Fritz Healthcare August 2010

2 | P a g e © S L F r i t z H e a l t h c a r e , L L C

Table of Contents Overview ................................................................................................................................................................... 3 Practice Management ................................................................................................................................................ 3 Operational Preparedness .......................................................................................................................................... 3 Go Live ...................................................................................................................................................................... 7 Sustaining Support Model ......................................................................................................................................... 7 Upgrade / Uplift Planning .......................................................................................................................................... 8


Overview

Practice Management 1. Business Model

a. Return on Investment (ROI)

b. Benefits Realization

c. Total Cost of Ownership (TCO)

2. Technology Model

a. Applications Implementation

b. Solution Delivery Implementation

3. Operations Model

a. Workflow Management

b. Practice Business Intelligence

Operational Preparedness 1. Enterprise Preparedness - Practices

a. Module definition

b. Pilot deployment

i. Practice Sample

ii. Lessons learned

iii. Rollout modeling

c. Site Selection

i. Medical Discipline

ii. Geography

iii. Patient and Provider Counts

iv. Practice and subsidiary clinics

v. Technical acumen

vi. Paradigm shift adoption

d. Deployment Calendar

i. Team development

1. Model office – staff utilization

2. Staff augmentation

3. Vendor professional services

4. Project based subject matter experts

5. Project / Program Management Office (PMO)

6. Office of the Chief Information Officer (OCIO)

ii. Champion identification and training

1. Existing staff utilization

iii. Critical path planning

1. Work Breakdown Structures

2. Inter-Dependencies

3. Resource Planning

iv. Communications planning

1. Sponsor communications


2. Stakeholder communications

3. Steering Committee communications

4. End user communications

5. Vendor, subcontractor, temp, communications

6. Statement of Work (SOW)

7. Division of responsibility

2. Application Preparedness

a. Design, Build, Configure

i. Control systems

1. Static databases

a. Departments, Procedures, Dropdowns

2. Dynamic databases

a. Patients, Providers, Insurers

3. Transaction databases

a. Notes, orders, results, images

ii. Application configuration

1. Application selections

2. Scripts, hyperlinks, functions

b. Workflow

i. Screen Flow

c. User access and entitlement

i. Workplace management

ii. Role management

iii. Supervisory Role management

iv. Exceptions management

v. Break Glass management, reporting, and auditing

3. Data Preparedness

a. Data Migration

i. To new application

ii. To replacement application

iii. To upgraded application

b. Data Integration

i. Middleware

ii. Extract Transform and Load (ETL)

c. Data transportation

i. Transaction resiliency

ii. Traffic management

1. Real-time

2. Batch

3. Nightly

4. Periodic

a. Monthly, Quarterly, Yearly, etc.

d. Enterprise Data Modeling

e. Data Warehouse

i. Reports

ii. Mining

1. Scheduled

2. Ad hoc

f. Business Intelligence


i. Dashboard design and deployment

g. Forms and Reports

i. Templates

ii. Reports

iii. Forms

4. Staff Preparedness

a. Roles and responsibility

i. Definitions and access declarations

b. Separation of Duty

i. Daily Operating Procedure

c. Training

i. Champions

ii. General support

iii. Provider

5. Quality Management Preparedness

a. Scenarios

b. Use Cases

c. Test cases

d. Testing and Training database populations

e. Testing

i. Unit

ii. Module

iii. Functional

iv. Enterprise

v. Stress, capacity, performance

vi. User Acceptance Testing

6. Infrastructural Preparedness

a. Computers

i. Image

1. Enterprise desktop management

a. Ghosting

b. Staging

c. Deployment

d. Spares management

2. Provisioning Management

ii. Inventory

1. Computers

a. Exam Room

b. Desktop

c. Laptop

d. Tablet

e. PDA

f. Back office

g. Home office

i. Configuration baseline

2. Printers

a. Document printers

b. Prescription printers

c. Forms printers


d. Admissions ID printers

e. Encounter ID printers

3. Scanners

a. Document

b. Card

i. Driver’s License

ii. Insurance Card

iii. Membership Card

iv. Credit Debit Card

c. Bar code

b. Local Area Network

i. Wired

1. Site floor plan drawings

2. Drop identification

a. Electrical

b. Voice

c. Data

ii. Wireless

1. Transponder positioning

2. Coverage Floor plan management

3. Neighborhood collision/conflict management

iii. Guest portal

1. Patients, visitors, vendors, contractors

iv. Router / Switch allocation and assignment

1. Router inventory management

a. Capacity planning

b. Failover – minimum configuration planning

c. Proximity Interleaved Port assignment planning

c. Communications Providers – Data Pipes

i. Data Pipe provider 1

ii. Data Pipe provider 2

d. Data center

i. Application Service Provider model (ASP)

1. Service Level Agreement

ii. Hosted – internal or outsourced

1. Servers

a. Web servers

i. Load Balancing

b. Application servers

i. Cluster configurations

c. Scanning Servers

d. Training and Testing Servers

e. Virtualization

2. Environment Management

a. Live - Production

b. Development

c. Demo

d. Train

e. Test


3. Network Attached Storage

a. Utilization

i. Mirroring

ii. Stripping

b. Consumption monitoring

c. Cloud storage

4. Performance Monitoring

a. CPU

b. Disk

c. WAN

d. LAN

e. Print Services

Go Live 1. Day before

a. Dry run

b. User login and functionality access test

c. WAN bandwidth capacity test

d. Go-Live team introductions and assignments

e. Go, No Go?

2. Day of

a. On-site support staff

b. Off-site support staff

c. Issue management

d. Helpdesk utilization

e. Subject Matter Expert (SME) utilization

f. Sustaining Support utilization

g. End Of Day (EOD) briefing

i. Workflow – Practice Operations

ii. Technical

1. Infrastructure on site

2. Servers in data center

3. Databases

3. Day after

a. Workflow tuning

b. Continuation of Go-Live command and control center

c. Daily briefing

4. Day 30+

a. Transition to Production

b. Technical Support

c. Provisioning uplift

Sustaining Support Model 1. Responsibility Matrix

a. Call Tree management

2. Help Desk

a. Ticket avoidance


b. Issue Response time

c. Escalation management

d. Known issues communications

3. Level 2 and 3

a. Staff SME’s

b. Contracted SME’s

c. On-demand SME’s

d. Vendor SME’s

4. Failover

a. Down Time Procedures

i. Switch to Paper

ii. Operating Procedures – workflow

iii. Information resynchronization procedures

b. Business Continuity Planning

c. Disaster Recovery Procedures

5. Service Level Agreement

a. Authorship

b. Monitoring and compliance management

6. Steady State Documentations

a. Application Availability Schedule

i. EHR

ii. Enterprise

7. Shutdown procedures

a. Order of execution

b. Validation checkpoint procedures

c. Communication plan execution

8. Data Archiving and long term storage

Upgrade / Uplift Planning 1. Version 1.1 recommendations

2. Application upgrade planning

a. Customizations

b. New Features delta

c. Regression Testing

i. Enterprise regression testing

ii. Data migration and transformation

3. Version 2.x

a. Recommendations and request analysis

b. Prioritization and release planning

c. Design, Build, Test, Deploy

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