We have been involved with EMR/EHR systems from the very beginning when the concept first appeared and slowly gained momentum. We were involved in early proof of concept demonstrations and participated in organizations such as HL7 to help flesh out the meaning and application on both the functional and technical sides. We know EMR: although there are hundreds of EMR vendors, we have worked with all major vendors including Epic, McKesson, Siemens, Cerner, Allscripts/Eclipsys and Meditech; and with many specialty vendors such as GE and COPATH. We have also worked with many custom EMR applications developed in house such as applications for lab equipment and patient scheduling. We have used EMR systems, tested and approved EMR systems, and trained users of EMR systems. We have written EMR software, integrated multiple EMR vendor solutions, and we have deployed, monitored and maintained EMR systems.
We bring to the EMR implementation project a full spectrum of experience not only delivering care in a variety of health and clinical settings, but also our extensive experience with software, hardware and IT systems. We are, for instance, now looking beyond the EMR platform itself toward the wider uses of EMR/EHR once fully operational. Our work includes exchanging data across departments within facilities, facility to facility integration, practice to practice and interstate Health Information Exchange (HIE), internationally as well as nationally. We are now actively involved in projects supporting informatics, analytics, and medical intelligence, disease surveillance and epidemic monitoring and response preparedness and Clinical Decision Support tools.
We offer a full cadre of certified clinicians to support the efforts, doctors, nurses and technicians. These resources can be applied in a variety of capacities and settings as required and scheduled according to plan at key stages throughout the project: planning, training, process engineering/reengineering and workflow analysis. These are expensive resources to maintain full time, but we can schedule and apply them as needed according to plan and, thereby, significantly control cost.
We offer a full cadre of IT professionals as well to supplement the program office and the vendor in such activities as installation, configuration, quality of service, performance and stress testing. Advanced skills in network, system, database and application administration and engineering are key to the successful implementation. As is the case with clinicians, these too are expensive resources, but, if well planned and applied strategically, we can also effectively apply these resources to control cost.
Planning and Management have been main stays of our practice. Our experience is not limited to EMR implementations, but extends to many other aspects of the healthcare industry. We can provide quality reporting, progress reporting, dashboard monitoring and other reporting functions. We are PMP certified and Six Sigma certified, and well versed and practiced in other methodologies and best practices. We maintain a disciplined approach from early planning stages throughout all stages of the process. We also understand budget constraints and the decision process. We can assist in continually assessing the impact of competing interests and concerns on the budget as part of managing the plan.
Meaningful Use is a recent and necessary development requiring that the users of a fully implemented and deployed EMR demonstrate acceptance of the technology into the workflow. The implication is that the vendor provides the capability, but the organization is required to demonstrate complete injection into their workflow as documented through audit. At this juncture, MU is at stage 1. Stages 2 and 3 are still under discussion, and so will be an ongoing activity to support. In the short run, and the long run, demonstration is very important from a cost recovery standpoint.
Security is another crosscutting activity and goes well beyond PII and HIPAA compliance. We understand that security starts with project inception, steps through each implementation phase, and continues through operations and maintenance. We have CISSP certified security professionals on staff to see it all the way through and provide the best assurance for confidentiality, integrity and availability of the system in an ongoing manner. We offer such services as training, verification and validation of threat response.
We offer a full set of Training capabilities. We can supplement vendor supplied training, or, depending on the vendor and the contractual agreement, we can provide a wide range of training services from class based formal training to just-in-time and refresher courses. Often, over the shoulder assistance in operational healthcare settings is the most comfortable and cost effective option given the rapid pace of injection and situational op tempo.
We offer Help Desk support to that can either augment existing help desk/technical support, or the vendor help desk. Help desk support is typically designed as 3 tiers. The first tier usually comprises basic trouble shooting efforts. If the problem is not resolved there, a trouble ticket is opened and a basic problem description is collected. That ticket is forwarded to tier 2, which is more specific than tier 1. Based on the information collected in Tier 1 and depending on the structure of your organizations technical support, tier 2 support usually involves system expertise in a specific area such as hardware, network, or specific application. If the problem canÕt be closed out at tier 2, the problem moves to tier 3, which, if application related, may involve the EMR vendor.
Disaster Recovery (DR) and Continuity of Operations Planning (COOP) is also an important aspect of an implementation plan. As EMR systems become critical to the daily delivery of care, our dependence needs the assurance of reliability not realized before. DR and COOP plans should be drawn up, verified and validated. Once operational, these plans should be periodically revisited and tested.