Below are a set of electronic health record implementation tools adapted for use by behavioral health providers from the National Learning Consortium (NLC) in partnership with HealthIT.gov. The Toolkit follows the “Six Step Approach to EHR Implementation” provided by the NLC, with resources for each step:
- Assess Your Practice Readiness
- Plan Your Approach
- Select or Upgrade to a Certified EHR
- Conduct Training & Implement an EHR System
- Achieve Meaningful Use
- Continue Quality Improvement
EHR Implementation Step #1: Assess Your Practice Readiness
The first step in EHR implementation is to conduct an assessment of your current practice and its goals, needs, and financial and technical readiness. The following tools can support your practice in this first EHR Implementation Step:
- HealthInfoNet’s Practice Readiness Assessment: A questionnaire to assess the readiness of a Behavioral Practice to adopt an electronic health record.
- Why Implement EHRs?: Guidance from the National Learning Consortium.
EHR Implementation Step #2: Plan Your Approach
The second step in implementing an EHR is to plan your approach. Effective planning in these four areas will reduce a chaotic “go live” on your EHR:
Re-design your Workflow. Change inefficiencies in your practice, even before EHR implementation, through Workflow Re-Design. Read the Workflow Design Templates & Instructions and then use the following workflow redesign templates, adapted for behavioral health providers, to help you map out a desired workflow on your EHR for the following: Client Check-in; Client Check-Out; Intake Visit; Office Visit; e-Prescribing; and Referral. For more information on Workflow Redesign, refer to the Workflow Process Mapping for Electronic Health Record (EHR) Implementation Guide, and for options on ways to transition users, refer to the Health IT Rollout and Transition Strategies.
Create a back-up plan using the Contingency Planning for IT Systems developed by the National Institute of Standards and Technology (NIST), and use the Downtime Documentation Worksheet Tool to collect vital client information when the EHR is down.
Establish a chart abstraction plan to convert information from paper charts to electronic charts. Use the Scanning and Preloading Worksheet to identify specific data elements that will need to be entered into the new EHR. If there are items to be scanned, use the Chart Migration Worksheet to identify which documents, information and format should be available in the new EHR system.
- Protect Privacy and Security by using tools developed by the Office of the National Coordinator for Health Information (ONC) with the National Learning Consortium: the Privacy and Security Guide for an overview of the Privacy and Security Requirements for your practice; the Information Security Policy Template that can be customized to meet the needs of your practice; and the Security Risk Assessment intended to be a starting point for organizations to identify cyber security risks.
EHR Implementation Step #3: Select or Upgrade to a Certified EHR
Selecting an EHR system is a critical decision and a significant planning task. The following tools, available through the National Learning Consortium, can help you develop an initial plan to identify goals, select an EHR system that supports these goals, and then finalize the plan after the selection:
Before interviewing an EHR Vendor, read the guidance from the National Learning Consortium on Selecting an EHR; check the ONC-ATCB Certification Page to verify that it’s a certified product; get References on EHRs (and know what questions to ask); use the Reference Checking Worksheet to organize references and compare vendors; use the EHR Demonstration Scenario, Evaluation and Vendor Questions Document to prepare for a meeting with a prospective EHR vendor; and use the Contracting Guidelines and Checklist for Electronic Health Record (EHR) Vendor Selection to structure and complete EHR implementation contracts with vendors.
For a listing of EHRs used by Behavioral Health Providers in Maine, and Vendor Contact Information, please refer to the guide, EHR Behavioral Health Vendors in the State of Maine.
EHR Implementation Step # 4: Conduct Training & Implement an EHR System
EHR implementation involves the installation of the EHR system and associated activities, such as training, mock “go-live,” and pilot testing. The National Learning Consortium provides a “Go Live” Checklist that can be used to plan for the EHR system go-live event and to identify any issues that need to be addressed before system implementation, and an Electronic Health Record (EHR) System Testing Plan Template that describes the types of tests typically performed on EHRs and HIT.
EHR Implementation Step #5: Achieve Meaningful Use
Meeting Meaningful Use is a challenge for all of our providers in Maine, but especially for our Behavioral Health Care Specialists, who aren’t sure how to meet Meaningful Use Measures that have been developed for the Medical environment.
The “Meaningful Use Guide for Behavioral Health Specialists” provides a reference where Behavioral Health Providers can find all the links, documents and information to help meet every measure, and register and attest for the CMS and the MaineCare EHR Incentive Programs.
EHR Implementation Step #6: Continuous Quality Improvement - Assuring Quality post-EHR implementation:
To assure continued quality-care post the implementation of an EHR, Behavioral Health Providers should complete a follow-up EHR assessment one month after the go-live date. The Follow-up EHR Assessment can help Behavioral Health practices to identify and address problems that arise in the first few weeks after the initial Go-Live date.
Not only do Behavioral Health Practices need to continuously evaluate its processes to ensure that the practice is functioning efficiently, but like Medical Practices, Behavioral Health Practices need to educate to themselves about the Clinical Quality Measures (CQMs) identified by the Federal Government as key measures to provide quality care.
To learn more about the clinical quality measures that’s included in the Federal Meaningful Use standards, please refer to the Clinical Quality Measures Section in the Meaningful Use Guide for Behavioral Health Specialists included in this toolkit.
For more information on Implementing EHRs, Meaningful Use, and Health Information Technology, please visit the National Learning Consortium at HealthIT.gov.