EHR Preparation - Documents and Resources

Getting Started:

• REQUIRED! EHR Site Survey
  If your site is considering the move to EHR, please complete this survey. You will need to contact your Area CAC for the document. Instructions for submission are included with the survey. This document will help with the self-assessment process, and will provide the EHR Program and your Area Office with valuable information about your facility. Once received by the Program, your Area Office will begin to work with you toward EHR implementation. Submission of this document to the EHR Program is required for entry into the EHR queue.
• REQUIRED! EHR Site Tracking Record
  After you complete and return the Site Survey, use the Tracking Record to track your site's progress through the implementation process. You will need to contact your Area CAC for the document. The EHR Program and/or your Area Office will request periodic updates from your site, in order to be able to coordinate the activities of national staff involved with training, software installation, and other support. Periodic submission of this document to the EHR Program is required for progression along the EHR queue.
  
• EHR Business Process Recommendations [DOC-86KB]
  Suggestions for self-evaluation of organizational business processes, based on assessment of early EHR sites conducted by MITRE Corporation.
• EHR Timeline[DOC-717KB]
  An estimated timeline for the major milestones in the EHR implementation at a site. Please note that every site is unique and will take a different amount of time for some tasks.
• EHR Implementation First Steps Checklist [DOC-35KB]
  Are you not sure how to get started with your EHR implementation? Look at this EHR Implementation First Steps Checklist to get you going in the right direction.
• RPMS Package Optimizations[DOC-37KB]
  Before you can successfully implement EHR at your site, you must make sure that you are optimizing your RPMS packages. This document lists the types of ways that your different RPMS packages should be optimized. This is a key step in the successful (and smooth) implementation of EHR at your facility!

User Guides: These are references used at various EHR-related training sessions.

• EHR CAC Setup Guide v1.1 [DOC-4.7KB]
• EHR Clinicians Guide v1.1 [DOC-3.5KB]
• EHR for HIM Guide [DOC-3.1MB]
• EHR for Inpatient Guide [PDF-3.7MB]
• EHR for Inpatient CAC Setup Guide [PDF-556KB]
• EHR Reminders Guide [DOC-2.4MB]
• EHR Nurses Getting Started Guide v1.1 [DOC-6.6MB]
• EHR Onsite Setup Schedule [DOC-2.5MB]
• EHR Go-Live Schedule [DOC-118KB]

Preparing for Pharmacy 5/7:
You can find the most current Pharmacy 5/7 documents on the Pharmacy FTP site [FTP Link].

• Overview of Pharmacy 5/7 Changes with FAQs [FTP Link]
• Prescription Processing in 5/7 [FTP Link]
• Pharmacy 5 /7 Training Manual [DOC]
• Pharmacy 5 /7 Printers & Labels [FTP Link]
• Pharmacy 5 /7 Interfaces [FTP Link]
• Pharmacy 5 /7 Allergy Tracking [FTP Link]
• Point of Sale [FTP Link]

Patient Information Management System information:

• PIMS Web Page

EHR Clinical Reminders:
Because implementing EHR Clinical Reminders is a difficult process, the OIT Training and Deployment Program has identified some criteria and tools to assist both you (at the site) and us (OIT Training and Deployment Program) with readiness, development, and implementation. See the (a) EHR Reminders Metrics and (b) EHR Site Tracking Record (Reminders) spreadsheets below. EHR must have been implemented at your site for at least six months before utilizing Clinical Reminders.

Implementing Clinical Reminders at your site is an ongoing process. Clinical and management groups need to evaluate the needs of your site. They should review and prioritize the clinical guidelines that need to be implemented.

It is imperative that all EHR patches be installed at your site. In addition, basic Resource Patient Management System (RPMS) infrastructure needs to be in place as Clinical Reminders searches for information relevant to the patient in data created by other RPMS packages. These packages include Lab, Order Entry, Pharmacy, PIMS, Radiology, PCC, Diabetes, and Asthma. The reminders can be displayed using the Indian Health Service RPMS Health Summary or the EHR.

• REQUIRED! EHR Reminders Metrics [XLS-23KB]
• REQUIRED! EHR Site Tracking Record (Reminders) [XLS-19KB]

EHR-related articles and literature:

• The IHS Electronic Health Record Project [PDF]
  This article in the IHS Primary Care Provider (November 2003), although dated, describes the background and history of the IHS Electronic Health Record Program.
• Maintaining a Legally Sound Health Record
  This article from the American Health Information Management Association gives guidance on what you should and shouldn't do with your EHR.
• Development of the Leapfrog methodology for evaluating hospital implemented inpatient computerized physician order entry systems [PDF-109KB]
• Physicians, Patients, and the Electronic Health Record: An Ethnographic Analysis [PDF-114KB]
  Little is known about the effects of the electronic health record (EHR) on physician-patient encounters. The objectives of this study were to identify the factors that influence the manner by which physicians use EHR with their patients. This study identified 14 factors that influenced how EHRs are used and perceived in medical practice today. The study found that the introduction of EHRs into practice influenced multiple cognitive and social dimensions of the clinical encounter.
• Electronic Medical Records and Diabetes Quality of Care: Results From a Sample of Family Medicine Practices [PDF-144KB]
  Care of patients with diabetes requires management of complex clinical information, which may be improved by use of an electronic medical record (EMR). This article assessed the relationship between EMR usage and diabetes care quality in a sample of family medicine practices.

• HIM Documents:
  • AHIMA ICD9CM diagnostic coding guidelines [PDF-290KB]
  • EHR Hybrid White Paper [PDF-220KB]
  • EHR P&P Med Record Review [PDF-42KB]