Section 1.1 Adopt – Assess

Section 1.1 Adopt – Assess – Organizational Readiness Assessment - 1

Organizational Readiness Assessment

Understand your office’s readiness for adopting an electronic health record (EHR) or other health information technology (HIT). Determine how leadership and management approaches may contribute to success.

Instructions for Use

  1. Use the two assessments in this tool—for staff and leadership/management—to help determine your organization’s readiness to adopt HIT.
  2. Identify where your organization needs to spend time to better prepare itself to help ensure successful HIT adoption and effective use.

Tool 1: Staff-Assessment of Leadership/Management

Administer the tool on the following page to your staff, review surveys, and provide feedback to the leadership/ management team. If feasible, conduct this survey prior to the self-assessment and use the results to supplement discussion. When you administer this tool, inform staff that your leadership/management team is undertaking an assessment designed to provide overall office improvement as well as to prepare leadership/management for directing the transformation that HIT will bring about. Couple this assessment with specific feedback and change management activities (1.2 Change Management).

Tool 2: Self-Assessment of Leadership/Management

Use the leadership/management self-assessment that follows, as either a survey instrument or a document for a facilitated discussion. If you believe your leadership/management team may have difficulty responding openly to the items on the tool, use a third party to conduct the survey, tally results, and lead discussion. For a small office, simply discussing the items and reflecting on necessary changes and opportunities for improvement can be effective. An activity like this can be more effective in a retreat-like environment or if the group is already interested in leadership training.

When analyzing the results of the tool, the more statements checked in the first column, the more work your organization needs to do to prepare itself to adopt HIT. The more statements checked in the last column, the more ready your organization is.

Copyright © 2011 Stratis Health. Funded by Chiropractic Care of Minnesota, Inc. (ChiroCare),

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 

Staff Assessment of Leadership/Management

As you know, our office will be adopting a health information technology/electronic health record system in the near future. Such technology is critical to the success of the office. The adoption process requires positive leadership and a management team that is highly supportive and able to help make the necessary changes in the environment to transform our office. Please respond to each statement below by placing an X in the applicable column, then provide a short description of how you think more progress could be made. All responses are anonymous and confidential. Aggregate results will be shared with everyone in the office.

Leadership Characteristics Contributing to Successful EHR Adoption

Office leadership… / Agree / Making Progress / Disagree
1.Maintains a stable purpose by establishing clear goals and expectations.
2.Fosters a respectful and positive culture.
3. Provides recognition that identifies staff as valued members of the team and enhances staff performance.
4. Provides continuing education for all staff to ensure personal and professional growth and development.
5. Supports an interdisciplinary team approach, characterized by trust, collaboration, and appreciation of complementary roles that contribute to a shared purpose.
6. Supports a patient-centered care model, in which caring, listening, educating, and responding to special requests ensure patient needs and smooth service flow.
7. Contributes to the community, as well as draws on resources from the community, to meet patient needs.
8. Supports continual quality improvement in both processes and outcomes, using recognized measures, providing constructive feedback, and celebrating success.
9. Does not fear technology, but uses it to enhance the ways patients have access to information and how staff perform their work, and to contribute to the common body of medical knowledge.
For each of the above statements, share your ideas on how might we make more progress.
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2.
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8.
9.

andrbutes first.ause this one is recommnded many ways. The respectful and positive culuter seem like anding the fundamental com

Section 1.1 Adopt – Assess – Organizational Readiness Assessment - 1

Self-Assessment of Leadership/Management

For each row, check the box in front of the statement that most closely applies to your organization.

Organizational Culture /  EHR is viewed as a requirement by insurance companies, government, or IPA /  EHR is viewed as a technology primarily to solve office efficiency problems /  EHR is viewed primarily as a tool to enable health care quality and achieve strategic business goals
 Chiropractor involvement in EHR discussion has been limited /  One or more chiropractors have attended EHR product demos /  Chiropractors are actively engaged in planning and driving the EHR project
 Office manager is driving the EHR project /  Several staff are involved in organizing the EHR project effort /  Staff are engaged with chiropractors, and all staff input is considered in goal development
 Patient involvement in EHR has not been discussed /  Patient satisfaction surveys have triggered interest in EHR /  Patient experience is one of primary goals of EHR and a plan to communicate with patients about the EHR is under development
 Level of planning required for successful adoption of EHR has not been discussed /  A vendor-supplied project plan is expected to be used for the EHR project /  The organization understands the commitment required to plan for EHR, prior to vendor selection and ongoing
Management and Leadership /  Executive management relies on vendor information to select EHR for the organization /  Executive management delegates EHR planning to a manager or a specific team to select EHR /  Executive management devotes substantial time to planning and developing expectations for EHR
EHR is seen as an expense and not an investment, with no ROI analysis performed / A cost/benefit for an EHR has been conducted but an appropriate financial ROI has not been identified / EHR is seen as an investment where the value proposition incorporates non-quantifiable values (e.g., efficiencies, increase in staff and patient satisfaction, improved recruitment and retention, competitive advantage)
An EHR budget has not been identified or discussed / An EHR budget has been funded using flexible funds / Annual budget addresses capital earmarked for EHR acquisition and ongoing maintenance
The organization is not accustomed to setting specific, measurable goals and being accountable for its achievement / The organization has used broad, general objectives in the past when making major investments / The organization has experience or is willing to work on setting measurable goals for benefits realization
There is no clear understanding of how quality/care management may benefit the organization, or is not the current focus / Quality/care management objectives have been established, but not clearly defined goals /  Quality/care management is a key focus of the organization, with compensation tied to improvement in key clinical measures
Operations / Workflow redesign for an EHR has not been discussed / Areas for potential redesign have been discussed and identified. Some functional requirements for EHR have been identified through thinking about workflow redesign / Some workflow and process mapping has already been started to fix “broken” processes prior to EHR, to enable product evaluation, and to begin the change management process for EHR
There is no standardization in practice, for scheduling, care management, or documentation /  Some standardization, such as in standard order sets, has been successfully introduced into practice / Chiropractors value use of standards for efficiency and quality/care management measurement. Have introduced documentation standards in preparation for chart conversion prior to EHR implementation
Policies, procedures, and job descriptions are generally not documented. Security in any existing information technology application is weak to modest / Plans are in place to formalize policies and procedures. Improvement is recognized as a need for information security / Policies exist for applicable medical record functions, HIPAA privacy rule requirements, and security best practices
There is minimal experience in the office for managing a capital acquisition of the scope of an EHR / We have a general understanding of EHR vendor selection and contract negotiation issues. Publicly available tools have been reviewed / Sufficient experience exists to fully evaluate EHR vendor offerings, or there is willing to seek outside assistance
Introducing previous changes in the office has been difficult / Specific training and communication plans have aided achievement of important changes in the past / The office is characterized by a willingness to make the clinical transformation that is reflected by using an EHR
Technology / The office management system is used only for scheduling and billing / The office management system has been used for productivity reporting and to improve patient access / The office management system is fully optimized and updated. Additional modules that support patient management have been acquired. Reports have been generated on patient populations
Need for new hardware is understood but not evaluated / Some understanding of amount of hardware, upgrades to network, and even physical plant changes have been identified / Analysis of technology requirements has been confirmed by an expert and requirements included in the EHR acquisition strategy
Relies on external resources for all IT hardware and software decision-making, installation, and maintenance / Utilizes external resources to fill gaps in areas not able to be accomplished by staff / Dedicated staff or good relationship with external resources to fill gaps. Effective at issues resolution. “Super users” to consolidate expertise in practice
Minimum computer skills exist in office, with virtually no user skills in chiropractors / A skills inventory has been taken and training identified to build skills / Computer skills are strong throughout office
No EHR experience in office / Young staff have experience using an EHR in training / Non-EHR users are open to EHR use
# statements checked: / # statements checked: / # statements checked:

Section 1.1 Adopt – Assess – Organizational Readiness Assessment - 1