08- installation and maintenance of health it systems- sunny happy care family practice

Installation and Maintenance of Health IT Systems Sunny Happy Care Family PracticeThis material (Comp8_Sunny Happy Care Family Practice) was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.

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*Health IT Workforce Curriculum Version 3.0/Spring 2012 Installation and Maintenance of Health IT SystemSunny Happy Care Family PracticeSHC Family PracticeLocated in Boca-RatonNine EmployeesTwo Full-time PhysiciansTwo NPsTwo NursesThree Office Staff

Logo by Scott Neal. Used with Permission.

Installation and Maintenance of Health IT SystemSunny Happy Care Family Practice

*Health IT Workforce Curriculum Version 3.0/Spring 2012 SHC Family Practice Why an EHR? Currently using paper records Improved workplace efficiencyCost SavingsThreat of penalties for not transitioning



*Health IT Workforce Curriculum Version 3.0/Spring 2012 SHC Family PracticeWhat are they looking for? Cost savings by increasing productivityQualify for governmental financial incentivesUser-friendliness Photo by Scott NealInstallation and Maintenance of Health IT SystemSunny Happy Care Family Practice


*Health IT Workforce Curriculum Version 3.0/Spring 2012 SHC Family Practice What are they looking for? E-prescribing, including electronic management of refill requestsResult viewing and tracking, including images (i.e. PACS)E-documentationQuality reporting (e.g. "How many of my diabetic patients are at their target hemoglobin A1c and blood pressure?")



*Health IT Workforce Curriculum Version 3.0/Spring 2012 SHC Family Practice What are they looking for? Possibly a new PMS

If a new PMS system is chosen, they would want enhancements to:scheduling of appointmentsbilling



SHC Family Practice(Neal, 2012)*Health IT Workforce Curriculum Version 3.0/Spring 2012 Installation and Maintenance of Health IT SystemSunny Happy Care Family Practice


*Health IT Workforce Curriculum Version 3.0/Spring 2012 Important Notes and ConstraintsSHC is a busy place! Project completion outset approximately 12 -14 months Integrate old paper records



*Health IT Workforce Curriculum Version 3.0/Spring 2012 SHC Family PracticeSummarySmaller practices have different needs than their larger counterparts. Some differences would include financing, workflow, specialized EHR needs Sunny Happy Care represents a typical community clinic.Installation and Maintenance of Health IT SystemSunny Happy Care Family Practice


*Health IT Workforce Curriculum Version 3.0/Spring 2012 References:References were not used for this presentation.

ImagesSlide 2: SHC Logo. Image courtesy of Scott Neal.Slide 4: Stethoscope. Image courtesy of Scott Neal.Slide 7: SHC Floor plan. Image courtesy of Scott Neal.Installation and Maintenance of Health IT SystemSunny Happy Care Family PracticeSHC Family PracticeReference


The SHC (Sunny Happy Care) Family Practice is a small, two-physician,outpatient practice which for many years has used a traditional system of paper records and folders to manage patient information, along with an electronic practice management system for appointments and billing.

*The SHC (Sunny Happy Care) Family Practice, located in Boca-Rotan, Florida , has 9 employees - two physicians, two nurse practitioners (NPs), two nurses, a practice manager, a bookkeeper, and an office clerk.

*For several years, the physicians and NPs and their practice manager have had growing interest in installing an electronic health records (EHR) system. Switching to an EHR system would eliminate the need to store so many paper records on site, increasing much needed work space. Additionally, they suspected it would bring other efficiencies to their practice that would lead ultimately to cost savings, but they have always been too intimidated by the cost and too confused by the complex, changing EHR market to seriously investigate a purchase.

With the advent of federal financial incentives to adopt healthcare information technology (HIT), however - along with the threat of future financial penalties for failing to do so - the SHC staff has decided the time is right to purchase an EHR.

*One of the initial steps the SHC staff take is to create a list of their top HIT goals & priorities. During their pre-planning interview the EHR approval committee indicated they were looking for the following features for their EHR: Cost savings - by increasing productivity, i.e. more operational growth without hiring additional full time employees.The EHR should qualify the practice for governmental financial incentives.The EHR should be user-friendly.

*The EHR should include an E-prescribing module, including electronic management of refill requests.It should allow for result viewing and tracking, including images (i.e. Picture Archiving and Communication System (PACS)) and include E-documentation. The EHR should provide quality reporting (e.g. "How many of my diabetic patients are at their target hemoglobin A1c and blood pressure?)

*They are also looking to update their Practice Management System (PMS) Cost however, is a factor. In order to be compatible with the rest of their new EHR, do they need an upgrade? or should they pursue robust interfaces?

The practice is currently using Sage Intergy PMS software version 5.5 and like it very much. The practice managers are considering integrating it into the new EHR system instead of replacement.

If a new PMS system is chosen, they would want enhancements to:scheduling of appointments, andBilling.

*This blueprint depicts Sunny Happy Care's clinic floor plan including furnishings, computing equipment, and available network ports. Lets look at some specifics in detail:

Network Connectivity: The reception area, records room, the conference room, as well as the physicians offices and nurses stations all have network connectivity using unshielded CAT 6 Ethernet cable. A storage area in the back of the clinic also has network connectivity and there is a Cisco wired 24 port switch installed to handle the traffic generated by the clinic. The patient rooms do not have network ports installed.Hardware: Computers and peripherals are set up in the clinic as follows:Reception Area: 2 Dell Optiplex 380 32 bit computers with 3.0 GHZ Duo core processors and 32GB RAM with 22 inch flat screen monitors. Records Room, Doctors Offices, Nursing Stations, and Storage Room: Each desk in these areas includes Dell Optiplex 380 32 bit computers with 3.0 GHZ Duo core processors and 32GB RAM with 22 inch flat screen monitors.The Nurses Station also comes equipped with two HP Deskjet 6940 printers and two scanners. The Storage room is networked and has a 24 port Cisco catalyst 2960 Series switch which allows the desktops to communicate and a Cable modem connecting to the ISP for Internet access.

*The EHR approval committee also made these comments during the pre planning interview:

SHC is a busy clinic and can only afford minimal downtime periods in order to keep up with patient demand.

The SHC practice would like to have a new EHR system in place in approximately 12 14 months at the outset.

SHC would also like to have the old paper patient records somehow integrated into the new EHR system.

*Smaller practices have different needs and concerns when purchasing and integrating an EHR system. Our fictional version of Sunny Happy Care represents a typical smaller community clinic considering EHR options in todays healthcare setting. Throughout the component, we will use Sunny Happy Care as an example for many of the student activities. Take time throughout the component to compare and contrast the needs of larger institutions with their smaller counterparts.

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08- installation and maintenance of health it systems- sunny happy care family practice

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