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The lean electronic health record : a journey toward optimized care / Ronald G. Bercaw, Kurt A. Knoth, Susan T. Snedaker.

Bercaw, Ronald. (Author). Knoth, Kurt A. (Added Author). Snedaker, Susan. (Added Author).

Summary:

"The Electronic Health Record (EHR) is a reflection of the way your organization conducts business. If you're looking to make lasting improvements in the delivery of care, you must start with looking at the system from your patient's perspective to understand what is of value and what is simply waste."--Back cover.

Record details

ISBN: 9781138626584
ISBN: 1138626589
Physical Description: xxii, 275 pages : illustrations ; 26 cm
Publisher: Boca Raton : CRC Press/Taylor & Francis Group, [2018]

Content descriptions

Bibliography, etc. Note:

Includes index.

Formatted Contents Note:

Always start with the patient -- Take care of ourselves before we take care of others -- Dollars and cents -- What is lean and how does it apply to the EHR -- EHR vendor selection -- Lean project management -- Requirements gathering-a new approach -- Design and build phase -- Testing, user acceptance, and training -- Go Live -- Optimizing the electronic health record -- Optimizing your legacy system-standardize by specialty -- Optimizing your legacy system-create and spread the model.

Search for related items by subject

Subject:

Medical records > Data processing.
Electronic Health Records.
Total Quality Management.
Medical Records Systems, Computerized.

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Kirtland Community College Library

R 864 .B47 2018

30775305548423

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Syndetic Solutions - Table of Contents for ISBN Number 9781138626584

The Lean Electronic Health Record : A Journey Toward Optimized Care

The Lean Electronic Health Record : A Journey Toward Optimized Care

by G. Bercaw, Ronald; Knoth, Kurt A.; Snedaker, MBA, CISM, CPHIMS, C, Susan T.

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Table of Contents

Table of Contents

The Lean Electronic Health Record : A Journey Toward Optimized Care

Section	Section Description	Page Number
	Foreword	p. xiii
	Acknowledgments	p. xvii
	Authors	p. xxi
1	Always Start with the Patient	p. 1
	What's in It for the Patient?	p. 1
	A More Seamless and Safer Experience	p. 3
	Reduce Unnecessary Tests and Procedures	p. 6
	Self-Service Options	p. 7
	Easy Access to Medical Records	p. 8
	Chapter Summary	p. 10
	Further Reading	p. 10
2	Take Care of Ourselves before We Take Care of Others	p. 13
	Provider Burnout Is Exasperated by Today's EHRs	p. 15
	The Promise of a Simplified User Experience Has Not Materialized	p. 17
	Getting a Day's Work Done in a Day	p. 20
	Additional Thoughts	p. 21
	Chapter Summary	p. 21
	Further Reading	p. 22
3	Dollars and Cents	p. 23
	How Much Does This New Electronic Health Record Cost?	p. 23
	Where Are the Benefits of an Electronic Health Record?	p. 26
	Can an EHR Have a Return on Investment?	p. 30
	What Can Be Done to Minimize Expenses?	p. 32
	Chapter Summary	p. 35
	Further Reading	p. 35
4	What Is Lean and How Does It Apply to the EHR?	p. 37
	What Is Lean?	p. 37
	Value Added	p. 38
	Non-Value Added	p. 38
	First Theme of Lean Improvement-Continuous Improvement	p. 41
	Second Theme of Lean Improvement-Respect for All People	p. 43
	Seven Wastes	p. 44
	Overproduction	p. 44
	Waiting	p. 45
	Overprocessing	p. 46
	Inventory	p. 47
	Motion	p. 48
	Defects	p. 49
	Transportation	p. 50
	One Additional Waste: Unused (Wasted) Human Talent	p. 51
	Principles of Improvement	p. 52
	Flow	p. 52
	Pull	p. 54
	Defect-Free	p. 56
	Visual Management	p. 56
	Kaizen	p. 58
	Lean Healthcare Defined	p. 59
	Chapter Summary	p. 61
5	EHR Vendor Selection	p. 63
	Patient Perspective	p. 64
	Organizational Requirements	p. 65
	Assessing Readiness	p. 66
	Who Are the Key Stakeholders and What Are Their Objectives?	p. 66
	Who Will Form the Implementation Team and What Are Their Roles and Responsibilities?	p. 67
	How Will We Include the Patient Perspective?	p. 68
	What Is the Overall State of Our Information Technology (IT) Infrastructure?	p. 69
	Cultural Climate	p. 70
	Clinical and IT Governance Structures	p. 70
	Incorporating SAFER Guidelines	p. 71
	Systems Integration	p. 72
	Interfaces	p. 72
	Up and Downstream Systems Integration	p. 74
	Hardware and Infrastructure Considerations	p. 77
	Organizational Strategies	p. 77
	Risk Assessment	p. 78
	Business Continuity and Disaster Recovery Considerations	p. 80
	Gap Analysis-Current Infrastructure vs. Vendor Requirements	p. 81
	Current State of End-User Devices	p. 82
	State of Organizational Finances	p. 84
	Operational Considerations	p. 86
	Current Staff Capabilities and Limitations	p. 86
	Network Infrastructure (Core, Wired, Wireless)	p. 88
	Telephony, Unified Communications, Audio Visual	p. 88
	Service Desk	p. 89
	Data, Analytics, and Measurement Considerations	p. 89
	Data Needs	p. 90
	Reports	p. 91
	Analytics and Measurement	p. 91
	Population Health Management and Meaningful Use	p. 93
	EHR Funding	p. 93
	EHR Selection-Requirements and Selection Criteria	p. 94
	Pugh Selection Method	p. 96
	Chapter Summary	p. 101
	Further Reading	p. 102
6	Lean Project Management	p. 103
	Deploying the Electronic Health Record as a Project	p. 103
	Key Steps in Lean Project Management	p. 105
	Identify a Representative Sample of the Key Stakeholders Who Will Design, Build, Test, Deploy, and Use the EHR	p. 107
	Assign the End Date for the Project	p. 108
	Define the Key Phases the Project Will Go Through	p. 108
	Develop the Criteria for Passing Each Tollgate and Define the Evidence Needed to Verify the Criteria Has Been Met	p. 109
	Determine the Tasks Needed to Pass the Tollgate	p. 111
	Assign Accountability for the Tasks to Meet Tollgate Criteria and the Timeline	p. 112
	Execute the Tasks Needed to Meet the Tollgate	p. 114
	Hold a Formal Review to Confirm That the Tollgate Criteria Have Been Met	p. 116
	Repeat Steps 7, 8, and 9 for Each Phase of the Project Until the Project is Completed	p. 116
	EHR Deployment Governance	p. 117
	Chapter Summary	p. 117
7	Requirements Gathering-A New Approach	p. 119
	Map Existing State	p. 120
	Patient Appointment Task List	p. 121
	Reengineered Patient Appointment Task List	p. 123
	Identifying Existing Workflows	p. 125
	Developing Requirements from Workflows	p. 127
	Functional Requirements for Patient Appointment	p. 127
	Patient Engagement Requirements	p. 128
	Module Selection	p. 129
	Alerts and Reminders	p. 130
	Reports	p. 130
	Technical Interfaces	p. 131
	Population Health Management and Health Information Exchanges (HIEs)	p. 132
	Data Migration Requirements	p. 133
	Chapter Summary	p. 133
	Further Reading	p. 134
8	Design and Build Phase	p. 135
	Standardize, Standardize, Standardize	p. 135
	Visioning	p. 138
	Chapter Summary	p. 146
9	Testing, User Acceptance, and Training	p. 147
	Overview	p. 147
	Testing Considerations	p. 147
	Unit and Functional Testing	p. 149
	System Testing	p. 151
	Integrated Testing	p. 152
	Performance Testing	p. 153
	Super User Considerations	p. 158
	User Acceptance Criteria	p. 160
	Training Tips	p. 161
	Lean Process and Product Testing	p. 163
	Chapter Summary	p. 166
	Further Reading	p. 167
10	Go Live	p. 169
	Overview	p. 169
	Planning the Go Live	p. 169
	Readiness	p. 170
	Application Readiness	p. 170
	Staff Readiness	p. 172
	Process Readiness	p. 172
	Technology Readiness	p. 174
	Strategy	p. 174
	Data Management during Go Live	p. 175
	Go Live Staffing	p. 176
	Central Command Center	p. 177
	Go Live Statistics	p. 180
	Support "At the Elbow" for Providers	p. 181
	Leveraging Super Users	p. 184
	Triaging Requests for Changes	p. 184
	Validating Critical Issues	p. 185
	Decommissioning Command Center and Go Live Support	p. 188
	Chapter Summary	p. 189
	Further Reading	p. 190
11	Optimizing the Electronic Health Record	p. 191
	What Is Optimization?	p. 191
	Optimization through the First Lens: Keeping the Evidence Current	p. 193
	Physician Change Control	p. 196
	Physician Participation in the Change Control Committee	p. 196
	Physician EHR Advisory Group	p. 197
	Physician Input through Medical Executive Council or Service Line Advisory Groups	p. 197
	Physician Builders	p. 198
	Optimization through the Second Lens: Managing for Daily Improvement	p. 198
	Operationalizing the MDI System	p. 205
	Optimization through the Third Lens: Continuous Improvement	p. 208
	Plan on Changes	p. 210
	Assign an EHR Optimization Resource to the Value Stream Steering Team	p. 212
	Do Not Lead with IT Solutions	p. 214
	Minimize HandOffs before Automating	p. 215
	Why Is Optimization of the EHR so Difficult?	p. 217
	Chapter Summary	p. 218
	Further Reading	p. 219
12	Optimizing Your Legacy System-Standardize by Specialty	p. 221
	Three Steps to Transforming Your Legacy System	p. 222
	Standardize by Clinical Specialty	p. 222
	Standardizing by Subspecialty?	p. 227
	Chapter Summary	p. 228
13	Optimizing Your Legacy System-Create and Spread the Model	p. 229
	What Is a "Model" Area?	p. 229
	Create the Model	p. 230
	Using Rapid Cycle Improvement	p. 231
	Applying the Scientific Method and the A3	p. 232
	Rapid Cycle in Action-A Case Study	p. 233
	Spreading the Model	p. 244
	Yokoten	p. 245
	Chapter Summary	p. 250
	Book Summary	p. 253
	Glossary of Lean EHR Terms	p. 257
	Index	p. 265

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