Toolkit Introduction
Downloadable Toolkit Index and Table of
Contents for Your Practice Office
Index and Table of Contents for Chiropractic Offices
STEP 1: Access 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. With an accurate view of your
level of preparedness, your practice can design an implementation plan that meets the specific needs of your
practice. These are the HIT toolkit documents and templates which will help you through Step 1 of this process.
HIT
Toolkit
Section
Intro
Materials
Toolkit Item
(Document Name)
Using the Toolkit
Step-by-Step
Guide to Using
Toolkit & Where
to Begin
Toolkit Index &
Table of Contents
for Chiropractic
Offices
Downloadable
Toolkit Index and
Table of Contents
for Your Practice
Office
How to Use Toolkit
Section
1.
Assess
Tool Description
(Check Toolkit Menu
Section for Complete
Descriptions)
Narrated overview &
guide to using HIT
Toolkit for any size
office
Table of contents for
using the right tools
within HIT Toolkit
appropriate for your
office size & EHR needs
Download
recommended Toolkit
EHR User Track for your
EHR user needs
Summary geared for
users completing entire
toolkit process
Getting Started - Assessment & Readiness
1.1 The Business Case
Narrated presentation
for EHR and How
highlighting benefits of
Meaningful Use
using EHR and EHR
Fits Into Equation
Meaningful Use
(20 minutes)
Program & Incentives
1.1 Understanding
Complete background to
EHR Incentives
final rule and financial
Final Rule for
incentives for EPs
Eligible Providers
presented by Dr. Paul
Kleeberg, May 2011
1.1 HIT Project
HIT Project Governance
Governance
structure, organization
structure and roles
1.1 Visioning &
3 different file formats
Strategic Planning
for reviewing the
conceptual elements &
1.1 Visioning &
components of EHR.
Strategic Planning
Toolkit Index and Table of Contents - 1
File
Format
Track 1 –
Core
Documents
& Small
Office
EHR User Track
Track 2
Track 3
– Large
–
or Adv
Upgrade
Practice
or
Office
Reselect
Track 4 –
Adv EHR
User or
MU
Incentives
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1.1
Visioning &
Strategic Planning
1.1
Overcoming
Barriers
Myths & Realities
1.1
1.1
Implementing
Systems Overview
1.1
Communication
Plan (Overview)
1.1
Communicating
with Patients
about EHR
1.1
Organizational
Readiness
Assessment
1.1
HIT Attitudes
Assessment
1.1
Financial
Assessment
1.1
Financing
Resources
1.1
IT Staffing
Inventory
1.1
IT System
Inventory
1.1
Application
Interface
Inventory
1.1
HIT Security Risk
Analysis
1.1
Contingency Plan
Assessment
1.1
Computer Skills
Survey
Although geared toward
larger EHR/EMR client
server systems, covers
HIT related terms
Overcoming barriers to
adopting EHR
Addressing the myths &
realities of EHR
Summary & introduction
to the various stages of
EHR implementation
Communications plan &
Template for staff and
patients before, during
& after adoption
Planning message
strategy for
communicating with
patients about EHR
Useful templates for
doing self-assessment or
survey of office, staff
readiness for EHR and
attitudes toward
adoption
Survey & checklist for
assessing staff readiness
and attitudes about
EHR/HIT
Useful template and
self-assessment for
evaluating key factors of
financial readiness for
adopting an EHR
Information to different
types of finance
purchasing options &
resources, including
evaluation checklist
Checklist & template for
office use with on-site IT
staff resources
Checklist & template for
identifying/documenting
existing or needed IT
hardware
Advanced template &
analysis of existing
applications &
interfaces
Advanced template and
considerations in
Security Risk Analysis
Checklist & template for
Contingency Planning
and Disaster Recovery
Survey template &
checklist to determine
staff computer skills
Webinar
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Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 2
STEP 2: Plan Your Approach. Planning draws on the information gathered during the assessment phase, to outline the
practice’s EHR implementation plan.
EHR User Track
HIT
Toolkit
Section
Section
1.
Plan
Toolkit Item
(Document
Name)
Tool Description
(Check Toolkit Menu Section
for Complete Description)
Planning Your Approach
1.2 HIT Steering
Resource and roles for
Committee
starting HIT Steering Teams or
Committees
1.2 HIT Project
Sample meeting agendas,
Documentation minutes and templates
1.2 Clinical IT
Description of leadership
Leadership
roles for HIT or informatics
1.2 Project
Useful overview & resource
Management
material for larger offices
(with staff) on Project
Management description,
roles, & process
1.2 Project
Project manager job
Manager Job
description
Description
1.2 HIT Goal
Guidance & template for
Setting
planning and goal setting
considerations
1.2 SMART Goal
Overview of SMART Goal
Planning
System: Specific, Measurable,
(45 minutes)
Achievable, Realistic & Timely
1.2 Change
Informational resource &
Management
assistance on change
management
1.2 Key Clinical
Templates and guidance for
Process
documenting key clinical
(High-level)
process & functions
1.2 Workflow and
Process
3 different file formats
Redesign
reviewing the conceptual
1.2 Workflow and
elements & components of
Process
workflow process mapping &
Redesign
redesign. Note: Advanced
activity tools & resource
1.2 Workflow and
materials
Process
Redesign
1.2 Chart
Templates, guidance &
Conversion
considerations for managing
Planning
paper chart conversions
1.2 Business Case:
Advanced template &
Total Cost of
worksheet to assist in
Ownership and readiness calculations for
Return on
analyzing costs of technology
Investment
+ benefit of acquiring
technology
File
Format
Word
Doc
Track 1 –
Core
Documents
or Small
Office
Track 2
– Large
or Adv
Practice
Office
Track 3
–
Upgrade
or
Reselect
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Word
Doc
Word
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Track 4 –
Adv EHR
User or
MU
Incentives
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Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 3
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STEP 3: Select or Upgrade to a Certified EHR. There are a number of steps involved in choosing the right EHR system for your
practice. Eligible health care professionals and hospitals must use certified EHR technology in order to achieve meaningful use
incentive payments. Looking to choose the right system for your practice or Incentive Program eligibility? Start here.
HIT
Toolkit
Section
Section
1.
Select
Toolkit Item
(Document
Name)
Tool Description
(Check Toolkit Menu Section
for Complete Descriptions)
File
Format
Track 1 –
Core
Documents
or Small
Office
EHR User Track
Track 2
Track 3
– Large
–
or Adv Upgrade
Practice
or
Office
Reselect
Track 4 –
Adv EHR
User or
MU
Incentives
Overview Documents (before you select)
1.3 HIT Code of
Informational resource to
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Conduct
review prior to engaging EHR
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vendors
1.3 Vendor
Temporary high-level overview Word
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Selection and
document. ***Watch for
Doc
Understanding
future updates & notifications
the
Marketplace
1.3 Vendor
This web link is temporarily
PPT
Selection and
not available***Watch for
Understanding
future updates & notifications
the
Marketplace
Remaining items in Section 1.3 are designed to assist with the preparation and facilitation of a Request for
Proposal (RFP) process. Not all Tracks require a formal RFP process (although RFP recommended when
appropriate, reviewing tools will assist with establishing unique practice criteria & needs)
1.3 Requirements
Temporary high-level overview Word
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Analysis:
document. Note: Functional
Doc
Begin with an
requirements on page 2
Analysis of your
***Watch for future updates
Practice
& notifications
1.3
Request for
Proposal:
Preparing an
RFP
1.3
Key
Differentiators
Defining Key
Criteria
RFP Analysis
1.3
1.3
PMS
Functionality
Differentiating
PMS and EHR
1.3
Input Device
Planning
Hardware/Input
Requirements
CCHITCertification
Commission for
Health
Information
Technology
1.3
General RFP template
including (a) high-level
functional requirements of
certified EHR and (b) questions
& operational considerations
General template examples
and guidance to preparing key
differentiators
Word
Doc
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Doc
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Guide for sending out RFP &
analyzing results
Information & template
differentiating EHR and PMS
functionality. Functional
template specific to PMS as
needed
Planning for hardware and
input device capabilities when
making recommendation or
selecting EHR
Link to check latest
information and ONC-ATCB
certified products
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Doc
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Link
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Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 4
Selecting a Vendor: Tools to help in selection process for your Vendor of Choice
1.3 Vendor of
Guidance & checklist for
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Choice
overall acquisition (Selection)
Doc
Process
1.3 Due Diligence:
Template & checklist to
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Demonstration
arrange product
Doc
Plan
demonstrations
1.3 Due Diligence:
Template & checklist to
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arrange site visit plan
Doc
1.3 Due Diligence:
Template & checklist to
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Reference
conduct reference checks
Doc
Check Plan
1.3 Contract
EHR vendor pre- and postWord
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Checklist
negotiating tasks & tips you
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should be aware of when
negotiating vendor
agreements or contracts
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STEP 4: Conduct Training and Implement an EHR System. EHR implementation involves the install of the EHR system and
associated activities, such as training, go-live and pilot testing.
HIT
Toolkit
Section
Section
2.
Implement
Toolkit Item
(Document
Name)
Tool Description
(Check Toolkit Menu
Section for Complete
Descriptions)
File
Format
Track 1 –
Core
Documents
or Small
Office
EHR User Track
Track 2
Track 3
– Large
–
or Adv
Upgrade
Practice
or
Office
Reselect
Track 4 –
Adv EHR
User or
MU
Incentives
Project Planning & Workflow
2.1 Project
Overview of basic elements
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Planning
of Project Planning using
Doc
Microsoft word.
2.1 Project Plan
Project Plan Template
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2.1 Issues
Guidance & Template for
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Management managing issues before,
Doc
during & after
implementation
2.1 Workflow
Resource for addressing
Word
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and Process
workflow & process
Doc
Improvement changes during
implementation
2.1 Policy and
Checklist & Template
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Procedure
identifying Policy or
Doc
Checklist
Procedures which may need
review or updates
All EHR System vendors will provide some level of implementation guidelines and checklists for use during
Implementation Phase. Remaining tools in Section 2.1 can be used as reference or supplemental (gap)
resources to assist with additional materials or Templates you may need.
2.1 Forms and
Use this tool to determine
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Reports
what data you collect – and
Analysis
by whom – to identify
reports you generate
2.1 System Build
3 different file formats
Word
doc
reviewing tool to help with
Doc
understanding tasks
2.1 System Build
PPT
performed during a system
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ppt
build; geared toward larger
2.1 System Build
Webinar
EHR systems or ClientWebinar
Server based solutions
Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 5
2.1
Space
Planning
2.1
Change
Control
2.1
Security Risk
Analysis and
HITECH
Requirements
Workflow
Breach
Notification
in HIPAA
Covered
Entities
Vocabulary
2.1
2.1
2.1
Incorporating
Clinical
Practice
Guidelines
2.1
Incorporating
Clinical
Decision
Support
2.1
Training Plan
2.1
Testing Plan
2.1
Rollout and
Turnover
Strategies
2.1
Go-Live
Checklist
Planning for space or
physical layout
considerations; including
equipment, security &
practice flow
Overview of Change Control
management process;
geared toward larger staff
or multi-site offices
High-level overview
including links
Word
Doc
Word
Doc
High-level overview of
Breach Notification
workflow
Data related definitions
(e.g. unstructured data,
discrete data)
Resource and Template to
help incorporate needed or
required clinical practice
guidelines into EHR system
functionality
Resource & Checklist of
considerations, factors and
use of CDS alert
notifications in your
practice
Checklist & Template for
additional training
considerations in larger
office or staff environments
Checklist & Template of EHR
tests typically performed
Checklist & Template for
larger or multi-site offices to
consider Implementation or
Go-Live strategies (e.g.,
Phased or all-at-once)
Checklist for Go-Live
planning
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Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 6
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STEP 5: Achieve Meaningful Use. The final phase of EHR implementation is effectively utilizing your EHR system in a
meaningful way, improve quality of care and optimize your practice. For Eligible Professionals participating in EHR Incentive
Program this includes successfully attesting and demonstrating meaningful use of EHR, and reassessing what you have learned
from training and everyday use of the system.
HIT
Toolkit
Section
Section
2.
Achieving
MU
Section
2.
Effective
Use
Toolkit Item
(Document
Name)
Tool Description
(Check Toolkit Menu
Section for Complete
Descriptions)
File
Format
Track 1 –
Core
Documents
or Small
Office
EHR User Track
Track 2
Track 3
– Large
–
or Adv Upgrade
Practic
or
e Office Reselect
Track 4 –
Adv EHR
User or
MU
Incentives
The majority of EHR vendors provide system tools including assessment wizards, dashboards or other reporting
features to capture and monitor Meaningful Use, Quality Measures and other key clinical data/reporting
requirements. Section 2.2 provides additional resources to assist with EHR Incentive Program and Meaningful
Use Attestation process.
2.2 Introduction to
Comprehensive easy-toPDF
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Medicare EHR
navigate Beginner’s Guide
Incentive
to EHR Incentive Program,
Program for
published by CMS
Eligible
Providers
2.2 Quick Guide to
Overview, guide and links
PDF
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the Clinical
to understanding Clinical
Quality
Quality Measures (CQM),
Measures
published by CMS
2.2 Chiropractic MU Eligible Provider
XLS
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and CQM
Meaningful Use Checklist
Requirements & & Exceptions for
Exceptions
Chiropractors **Watch
for Updates**
2.2 Pre-Attestation
Meaningful Use PreWord
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Review
Attestation Review &
Doc
Checklist for EP’s
2.2 Attestation
Checklist of
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Audit Tracking
recommended documents Doc
Tool
to retain for MU Audit
Section 2.3 provides supplemental resources which may be needed or to assist in achieving meaningful use or
support effective utilization of EHR system
2.3 Continuity of
Understanding CCD/CCR
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Care Document (Continuity of Care
Doc
Documents or Records)
Use and Structure
2.3 Optimization
Resource & Checklist for
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Strategies for
making cultural shift from
Doc
Point of Care
paper to electronic
Charting
charting
2.3 Optimization
Resource, Checklist &
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Strategies for
Template for integrating
Doc
CDS (Clinical
effective CDS support in
Decision
your practice
Support)
2.3 Optimization
Advanced Resource &
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Strategies for
Template document
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Registries
understanding &
optimizing registries and
registry functionality
Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 7
2.3
Section
3.
Interoperate
Utilizing EDMS
and Hybrid
Record Risk
Management
Checklist and
Word
As Needed
As
As
considerations
Doc
Needed
Needed
implementing Electronic
Document Management
Systems (EDMS) into EHR
systems
2.3 HIT Upgrades
Upgrade management
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overview & definitions;
Doc
appropriate mainly to
larger, client-server, or
non-hosted systems
2.3 Quality
Guidance, Links &
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Measurement,
Templates for PQRS
Doc
Reporting and
(Physician Quality
Improvement
Reporting System)
Resources in Toolkit Section 3.1 and 3.2 address elements of Health Information Exchange (HIE) and
Interoperability
3.1 HIE Readiness
Resource for
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Understanding HIE, and
Doc
Assessing your Readiness.
Published by MN Dept of
Health but inclusive of
applicable terms & links
3.1 HIE Data
HIE Data Exchange
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Exchange
Worksheet
Doc
Priorities
3.1 HIE Technology Introduction to technology Word
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used in HIE
Doc
3.1 HIE Goals and
Information on various
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Governance
health information
Doc
organizations
3.1 HIE
Health Information
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Interoperability Exchange Guidance for
Minnesota’s Health and
Healthcare Providers –
MDH
3.1 HIE Data
Data stewardship & fair
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Stewardship
health information
Doc
practices
3.1 Personal Health Overview of PHR
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Record
Technology
Doc
Technology
3.1 HIE Policy and
Temporary high-level
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Procedure for
overview document.
Doc
PHR
***Watch for future
updates & notifications
Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 8
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STEP 6: Continue Quality Improvement. This final phase refers to reassessing what you have learned from everyday use of the
system and emphasizes continuous evaluation of your practices goals and needs post-EHR implementation and driving
continual improvement toward improved quality-of-care.
HIT
Toolkit
Section
Section
4.
Continue
Quality
Toolkit Item
(Document
Name)
Tool Description
(Check Toolkit Menu
Section for Complete
Descriptions)
File
Format
Track 1 –
Core
Documents
& Small
Office
EHR User Track
Track 2 – Track 3 –
Large or
Upgrade
Adv
or
Practice
Reselect
Office
Track 4 –
Adv EHR
User or
Incentive
s
Former Section 2.3 documents provides resources to assist with tracking your unique practice goals; including
operational efficiencies, staff-user and patient-user satisfaction for sustainable, effective use of your EHR system
in your practice. Additional materials & guidance will be continually added to this section.
4.1 Monitoring
Template to help measure
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Goal
how/if EHR activities &
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Achievement
adoption goals are being
achieved
4.1 HIT Adoption
Template & Worksheet to
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Milestone
measure HIT Adoption
Results
activities & achievement
4.1 Benefits
Template & Worksheet to
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Realization
calculate non-monetary
benefits of HIT,
operational & process
improvement
4.1 Intervention
Guidance & Workflow
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Strategies
diagram to diagnosing
Doc
problems in achieving
effectiveness or efficiency
from EHR system
4.1 HIT User
Sample EHR User Survey
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Satisfaction
Doc
4.1 HIT Patient
Patient Satisfaction
Word
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Satisfaction
Template & Survey for
Doc
analysis before and after
adoption
4.1 Routine System Guidance & Checklist for
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Maintenance
ongoing IS (information
Doc
Checklist
system) maintenance
Additional notes and recommendations:
 Refer to Support section on Toolkit Menu for support and contact information for assistance with these
tools.
 Continual program updates, modifications to resources and resource documents are part of ongoing
process for quality improvement practices and Toolkit value. We highly recommend chiropractic offices
sign up to Receive Toolkit Updates (also under Support section), bookmark Toolkit Main Page or check
back frequently for most current documents and latest information.
Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 9
Copyright © 2011 Stratis Health. Funded by Chiropractic Care of Minnesota, Inc. (ChiroCare), www.chirocare.com
Adapted from Stratis Health’s Doctor’s Office Quality – Information Technology Toolkit, © 2005, developed by Margret\A Consulting,
LLC. and produced under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of
Health and Human Services.
For support using the toolkit
Stratis Health  Health Information Technology Services
952-854-3306  info@stratishealth.org
www.stratishealth.org
Section 1.1 Adopt – Assess – Toolkit Index and Table of Contents - 10