Tuesday, April 20, 2010

Phased Implementation

Phased Implementation

Introduction: Phased implementation is the stepwise introduction of HER functionality though a series of phases, each with its own analysis, training, and go-live schedule

- phased approach spreads the users’ learning over time, producing several manageable peaks in cognitive load.

- The big-bang method vs. Modified implementation plan.

3 phases on implementation:

- Phase 1: Access to test results and transcribed docuemtns.

+ Cart abstraction methods: doctor, nurses, give back to clinician to verify

+ scanning: large volume of clinical relevant docs that would not incorporated electronically (like AE note)

- Phase 2: Electronic results distribution, transacription Authentication and E-Messaging.

+ Test results and transacribed documents are sent to providers’ inbasket’ for review and electronic signature

- Phase 3: Order Entry and Patient-care documentation

+ order entry: one of the first tasks is the creation of customized pick list of Dx, Px, Test and drugs

+ one of the kket to creating effective lists is translating the sometimes consing standard lists into language that is familiar to clinicians

+ documentation: in this phas, user begin to enter the clinical assessements and plan directly into the HER

+ the HER makes it easy to build note templates and importable boilerplate that allow a skilled user to document a typeical office visit by hitting minimal keystrokes and typingseveral sentences

+ developing a tool by collecting samples of the most commonly dictatred or the hardwritten documents from the paper medical records, prioritize note templates and to identify their contexts.


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