Clinic Assessment Tool – with EHR
(Knowledge-gathering tool for use with current users of EHR systems.)
Clinic Contact Information
Assessment date: / Assessor(s):Clinic name: / PIN and Tax ID:
Affiliation (e.g., IHC, U, AUCH):
Address:
Telephone:
Primary contact:
Direct phone:
E-mail:
Fax:
Physician champion (if not primary contact):
Direct phone:
E-mail:
Fax:
1. Number of locations: ____
May the same patients visit all/both clinics?
r No
r Yes
2. Do you conduct staff meetings?
r No Best time and day for clinic meetings:
r Yes When: ______
STAFF CHARACTERISTICS
3. List provider and IT staff by name. List or just indicate the number of other staff. Note any part-time staff members.
PHYSICIAN Name, UPIN / Specialty (If FP, are they AAFP member?)NON-PHYSICIAN CLINICIAN Name, UPIN / Type (PA, NP, ANP)
RESIDENT (name or number/frequency) / Specialty
CLINICAL SUPPORT STAFF (name or just number) / Type (RN, LPN, MA, Phleb., etc.)
ADMINISTRATION (e.g., office manager, financial officer, etc.) / Duties
RECEPTION STAFF (name or just number)
MEDICAL RECORDS STAFF (name and tasks, e.g., scanning)
IT SUPPORT STAFF Name (note if they are consultants or contractors and not employees) / Duties (e.g., backups, upgrades, hardware repairs)
4. Check any other staff positions:
r Phone bank/call center: ______
r Billing: ______(charge entry/service posting staff, coders)
r Other: ______
PRACTICE CHARACTERISTICS
5. Are there plans for significant changes in the clinic for the next few years (e.g., new providers, retirements, move location or add site, new affiliations, etc.)?
r No
r Yes Please describe:
PATIENT MIX
6. Average number of patient visits per day: ______
7. Estimated number of active patients: ____ (if known)
Are patients distributed evenly among providers?
r No
r Yes
8. What is the estimated percentage of active patients with one or more chronic illness (CAD, diabetes, hypertension, osteoarthritis, heart failure)? ____
9. Approximate percentage of patient visits from each of the following carriers:
Both States / % / Nevada / % / Utah / %Medicare / PacifiCare / Altius
Medicaid / Sierra Health / IHC
BCBS / Culinary Fund / DMBA
UHC / Educators (Teacher’s Trust) / Educators (EMIA)
Other / PEHP
Other
10. Please estimate the percentage of your patients/clients who are minorities?
Minority / %African American
Native American
Hispanic
Asian
Other:
Total
11. Do you collect data on your patients’ ethnicity or race? Are you able produce reports by race from your practice management system or EHR?
PRACTICE MAGEMENT SYSTEM
12. Describe your automated practice management system?
Type: ______ Version: _____
For how long have you used the system?
Does it interface with your EHR?
r No
r Yes
Do you have plans to update the system?
r No
r Yes Why?
EHR SYSTEM
(Selection and Description)
13. Describe your EHR system:
Type: ______ Version: _____
For how long have you used the system?
Do you have plans to update the system?
r No
r Yes Why?
14. Who was your physician champion and what other staff were involved in the decision to purchase the EHR?
15. What goals did you hope to achieve with an EHR?
16. Why did you decide on this system (i.e., what criteria did you use to select the system)?
17. Did you conduct site visits before deciding on a system?
r No
r Yes
IMPLEMENTATION PLANNING/EXECUTION
18. Describe implementation process and why you decided to do it that way:
19. What problems (if any) did you encounter during implementation and how did you resolve them?
20. How did you manage training and staff readiness?
21. How long did it take the physicians to get up to speed (i.e., back to the same patient volume)?
What about the other staff?
22. How did you handle old paper charts (e.g., full or partial scanning, on-site storage, availability during visits, etc.)?
23. What would you have done differently if you could have?
EHR SYSTEM DETAILS
(Hardware, software modules, provider use)24. Describe your hardware/IT infrastructure:
25. Which of the system modules/components are you using (describe if needed)?
r Scheduling / r Automated checksr Problem list / r E-Prescribing
r Medication list / r Track orders/referral/results
r Patient demographics / r Ordering labs, etc.
r Entering notes / r Lab results
r Review reports/notes / r E & M coding
r Messaging system / r Other: ______
26. Do all providers use the system components and are they consistent in using them?
r No
r Yes
27. What types of documentation methods do you use?
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r Pull-downs
r Direct entry
r Import transcription
r Note template
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r Voice
r Other: ______
Explain differences/preferences among providers and how they are accommodated:
28. Please check any external or internal systems that would require linkages (interface):
r Prescription writing
r Laboratories (in-house, local hospital, ARUP, Quest, Labcorp, IHC, Lab One, etc.)
(Estimate clinic’s volume as a percentage with each lab to see where most orders are done)
r Radiology
r Disease Registries
r Hospital: ______
r Other: ______
29. Who currently handles your maintenance needs (e.g., internal, consultant, vendor)?
30. How has your relationship with the vendor worked out?
CARE MANAGEMENT AND DATA SUBMISSION31. Are you currently doing any type of population-based care management (e.g., tracking diabetes visits, identifying patients who are overdue for health maintenance, group visits, etc)?
r No Are your providers interested in starting?
r Yes Do you use the EHR for this? Specifically:
§ Do you have the ability to identify specific populations (diabetics, etc)? ______
§ Do you use a system with reminders and prompts? ______
§ Do you use patient specific care plans? ______
Are you interested in learning more about what other practices are doing?
32. Use the list below to assess the EHR’s ability to capture DOQ-IT measures and to understand providers’ consistency in capturing the required data. Read the main element (e.g., “Disease”) and get a general idea of if and how these data are collected. For example, if labs and tests are scanned in, the EHR captures the data but the data cannot be mined for reports.
Data Element / Does EHR or PMS capture this data element? If so, how? / Do all providers consistently enter these data?Disease (with comorbidity, hospitalization)
E.g., coronary artery disease, hypertension, heart failure, diabetes mellitus
Age range/gender
50-69, >=50, female
Pharmacy therapy
E.g, anti-platelet, lipid-lowering, beta-blocker, ACE inhibitor, warfarin, insulinLabs and tests ordered
E.g., lipids, LDL, LVF assessment, A1cResults
E.g., any or most recent LDL cholesterol < 130 mg/dl, A1c level > 9.0%, no evidence of retinopathy in the prior year, BP> 140/90Outside services
E.g., dilated eye exam or evaluation of retinal photographs by an optometrist or ophthalmologist, mammogram in 24 months, colorectal screeningOffice services
E.g., screenings, vital signs, disease management education, health behavior trends, recorded weight, complete foot exam (visual inspection, sensory exam with monofilament, and pulse exam), tobacco use intervention, vaccinations, care plans for HTN
THE BIG PICTURE
33. On a scale of 1–10, rate your overall satisfaction with your EHR system: ____
34. Do your benefits from the EHR match your projected goals for the system (e.g., ROI)?
35. What problems have you encountered with the system?
36. What has EHR changed most about your practice (e.g., workflow, costs, staffing, etc.)?
37. Biggest lessons learned from the experience:
38. Are there areas where you would like to make improvements with your EHR?
r Workflow/paperwork / r E-laboratory (orders/reports)r Time, keeping on schedule / r Templates (using existing templates from other system users)
r Disease management systems / r Internal communication/messaging
r Health maintenance systems / r Coding
r E-prescribing / r Other: ______
39. Are you willing to participate in DOQ-IT as a “peer leader?” (I.e., willing to have other clinics call or visit you and/or attend our learning sessions)?
r No
r Yes What is the best way for inquiring clinics to contact you?
Next Steps:
How can we help this clinic? (e.g., services we may provide, comments/questions for the vendor.)?
HealthInsight prepared this material under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS). The contents presented do not necessarily reflect CMS policy. PUB# 8SOW-OM-TN-14
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