9 Implementation – Overall effectiveness, timeliness? 10 Data Migration – Overall effectiveness? What EMR did you migrate from? 11 Performance – Overall effectiveness of system performance (speed)? 12 Quality of EMR product – Overall quality of the EMR application? Is it bug free? 13 Vendor Support – How effective is the vendor in providing support for your questions and problems post Go Live? 14 EMR availability – How available is the EMR? (downtime) 15 Ability to create custom Letters / Forms / Handouts / Favourites? Overall Score: # Workflow 1 to 10 or NA 1 Creation of and monitoring Referrals? 2 Preventative Care Management? 3 Medication Management? (Rx, drug interaction, integration with pharmacies) 4 Encounter Notes? 5 Managing chronic diseases? 6 Teaching Unit Functionality? (support of residents and learners.) 7 Do you have a patient portal? If so, how effective is it? 8 Communication of patient activities through EMR Overall Score: Please review Appendix D for Sample User Scenarios to test prospective vendor products TEST SAMPLE DATA EXTRACTS AND SCENARIOS [In addition to the functional testing activities in the previous section, prepare sample practice scenarios. Use these to gain a better understanding of the prospective EMR products you are considering. A sample scenario is provided below for your reference. VENDOR PROFILE
Hannah’s Family History Father - onset CAD (MI age 45) Meds: Tramadol 1-2 tabs q4-6h prn started by Dr. Jones 2 years ago Allergies: Amoxil Hannah’s screening tests: Most recent was Feb. 2, 2011 Most recent PAP was November 23, 2013 User Scenario: New Patient to the Practice Hannah Lambert has moved to Mississauga to live with her mother, Sarah Lambert. Hannah has been ‘feeling down’ lately and is wondering if an antidepressant medication might help. Sarah’s doctor, Dr. Schwarz, has agreed to take on Hannah as a new patient. Hannah calls Summerville to set up an appointment. The receptionist gathers the minimum information required to open a new record. While creating the new record, the receptionist is notified by the system there is already another Hannah Lambert that is a patient at this practice. The receptionist recognizes that a longer, 30 minute, appointment is needed (the default is a 10 minute appointment slot). Hannah tells the receptionist that she is only available Tuesday morning and Wednesday afternoons. The receptionist finds the next available appointment meeting those criteria and books the patient. When she arrives at the practice, Hannah first at the registration desk where the receptionist asks Hannah for her demographic information. Hannah states she is living with her mother and the receptionist uses the address and home phone from the mother’s chart to populate Hannah’s record. Hannah also provides her work phone and cell phone number as well as a next of kin, her sister Jane. On saving the information, the receptionist receives a reminder that this patient needs to sign a roster form and a consent related to storage and release of information. The patient states that she would like to make sure her ex-boyfriend, Jeff, who is a social worker at another site, CANNOT view her record. The record is locked down so that Jeff cannot access it. The clinic nurse now sees on her schedule that the patient is ready to be brought into the exam room. As this is a new patient, the nurse enters information regarding past medical history, family history, current meds, risk factors and recent screening tests. (See above for detail). She also enters the patient’s vitals into the EMR and puts Hannah into Dr Schwarz’s exam room. Dr. Schwarz opens the patient’s record is notified that the patient is overdue for her mammogram.
Finally, Dr. Schwarz wants to know how she is doing in terms of her mammogram screening rates for her practice. She runs a report to identify all eligible patients who are overdue for their mammograms as she wants to contact these patients to have the test completed. NB: Please see the table below to indicate objectives of each portion and vendor notes. Scenario section Narrative Objectives to Vendors Background Hannah Lambert has to Mississauga to live with her mother, Sarah Lambert. Hannah has been ‘feeling down’ lately and is wondering if an antidepressant medication might help. Sarah’s doctor, Dr. Schwarz, has agreed to take on Hannah as a new patient. See data to support scenario section Opening a new Hannah calls Summerville to set up an appointment. The receptionist gathers the minimum information required to open a new record. While creating the new record, the receptionist is notified by the system there is already another Hannah Lambert that is a patient at this practice. Demonstrate minimum data to open a new record Demonstrate duplicate record checking and notification Booking an appointment The receptionist recognizes that a longer, 30 minute, appointment is needed (the default is a 10 minute appointment slot). Hannah the receptionist that she is only available Tuesday morning and Wednesday afternoons. The receptionist finds the next available appointment meeting those criteria and books the patient. Demonstrate booking a non-default appointment type Demonstrate searching for an appointment that meets specific criteria Vendor may want to indicate if criteria sets can be stored and quickly re-run (find next available evening appointment for a specific provider?)
Arriving a new patient When she arrives at the practice, Hannah first at the registration desk. The health card is swiped and validated. The receptionist asks Hannah for her . Hannah states she is living with her mother and the receptionist uses the address and home phone from the mother’s chart to populate Hannah’s record. Hannah also provides her work phone and cell phone number as well as a next of kin, her sister Jane. She also advises the receptionist that she is POA for her mother and requests that this be added to her mother’s record. Demonstrate use of family member’s info to rapidly populate new patient’s chart Demonstrate of additional demographic info If health card swipe and validation cannot be performed in demo environment then describe the process If the EMR has a special section for advanced directives please highlight this Notification and privacy On saving the information, the receptionist receives a reminder that this patient to sign a roster form and a consent related to storage and release of information. The patient states that she would like to make sure her ex-boyfriend, Jeff, who is a social worker at another site, CANNOT view her record. The record is locked down so that Jeff cannot access it. Demonstrate reminders/alerts for reception on saving registration data Demonstrate process to apply patient privacy requests by individual user Vendor may wish to mention other ways chart may be locked down (by role, by data type, other) Viewing the schedule The clinic nurse now sees on her schedule that the patient is ready to be brought into the exam room Demonstrate how patient is reflected on schedule Vendor may want to indicate all the state changes (booked, arrived, in room, etc….) Populating the CPP As this is a new patient, the nurse enters information regarding past medical history, family history, current meds, risk factors and recent screening tests. (See above for detail). She also enters the patient’s vitals into the EMR and puts Hannah into Dr Schwarz’s exam room. Demonstrate how previous medical, surgical and family hx as well as meds, risk factors and previous preventative care screening maneuvers are entered into the CPP See above for detail regarding values to be loaded Decision support Dr. Schwarz the patient’s record is notified that the patient is overdue for her mammogram. Demonstrate alerts and/or visual indicators on opening a chart
Reporting and patient contact Finally, Dr. Schwarz wants to know how she is doing in terms of her mammogram screening rates for her practice. She runs a report to identify all eligible patients who are overdue for their mammograms as she wants to contact these patients to have the test completed. Demonstrate how to a practice for compliance with a screening test Demonstrate both canned and ad hoc querying if possible Demonstrate or describe what options the system has to contact pts Describe and/or demonstrate if patient portals or secure email can be used for the recall task Other questions you may be asked by users at the demonstration: Demonstrate the level of integration between the clinical management system and office productivity tools (e.g., word processing, spreadsheet accounting, email). For example: Mail merge patient and physician information into a word processing document. (This may have already been demonstrated by the reference or recall letters.) Attach a word processing document within a patient’s electronic medical record. Move accounting information into spreadsheet applications. Demonstrate how the CMS application supports both internal reporting and exporting of data Demonstrate what offerings the vendor has in the way of patient access (e.g. can a patient book their own appointments online? Can they see their lab results?)
SAMPLE 2 Source Source Data Element Destination Target Data Element Transformation/ Cleansing Rules Notes <Source Location (e.g., System/File/ Database Table, etc.> <Source Data Element Identifier (e.g., SSN)> <Target Location (e.g., Database Table)> <Target Data Element Identifier (e.g., Member ID)> <Describe data transformation that is to occur, including any data cleansing.> <Describe any timing constraints or anything unique the Migration.> Note: Screenshots can also be captured within the issue log to illustrate what the errors or challenges are.