Evaluation and Program Plan Submission

University of San Diego © 2016. All Rights Reserved.

EHR Implementation at Waverly Clinic
Project Charter Template
A. General Information
Information to be provided in this section is general in nature and provides the necessary information about the
organization of the project and project participants.
Project Sponsor: Professor Tennille Gifford

Project Manager: Amrit Virdee
Prepared by: Amrit Virdee
Date: 06/04/2018
B. Purpose
The Waverly Family Health Services Clinic has decided to migrate from a paper based to an
Electronic Health Records (EHR) system using a web-based EHR provided by Practice Fusion
http://www.practicefusion.com. The goal of the implementation is to ensure the Waverly Clinic
meets Meaningful Use Stage 2 reporting requirements, increase productivity and increase revenue
recovery with the use of ICD-10 billing codes.
C. Constraints and Assumptions
Description
Assumptions - Support help will be available from Practice Fusion during the
install phase
Constraints - Budget is set at $20,0000 for the entire project including ‘unseen’
costs
- Clinic has limited experience with EHR implementation and usage
D. Project Scope Statement

The project scope is to implement the conversion of the current paper based charting system at the
Waverly Clinic to a cloud based EHR using Practice Fusion. The project will take 6 months to
complete at a total budget of $20,0000.
E. Resource Requirements
Resource Description
Hardware - Total of 10 workstations consisting of Dell ‘all-in-one’ desktop
with 8MB of ram, Intel i7 processor with 23 inch screens (1 each
in 4 clinic exam rooms, 1 at the front desk, 1 at the biller, 1 each
at the 2 director’s office, 1 for the Medical Assistant and 1 at the
Nurse Practitioner station)
- 10 articulated wall mounts that hold the screens
- High speed T-line
Financial - $20,000 total budget
People - Mrs. Wright, MSN, NP, nurse practitioner has previous EHR
install experience
- Mr. Lawrence, clinic accounts and billing has IT experience
F. Risks
Positive
All data is securely backed up on Practice Fusion’s servers hence no backup devices required at the
practice
Negative
Practice Fusion does not allow any local back up hence Waverly will have to set up contingency
plans if power or internet access is not available. The following resources should be considered:
 Have a prepaid WiFi hub or other back-up internet system ready to go in the event your
internet is down.
 Use laptops with good batteries and connect computers to surge protectors and battery
back-ups for short term power interruptions.
 Identify a second location that you could use temporarily in the case of a serious, long-term
outage.
The workstation configurations meet the minimum standards for utilizing the web-based EHR and
a Security Risk Assessment(SRA) should be utilized to ensure the systems meet and exceed HIPAA
Security Rule requirements
G. Success Metrics: Criteria for Evaluating Project Success and Milestones
Milestone Description Delivery Date

Charter approved The Business Case has been documented TBD
and approved.
Project Start Date Official first day the project will start (Total TBD
project timeline = 6 months)
Training Staff training completed prior to “Go Live’ TBD
‘Go Live’ Agreed date for ‘Go Live’ TBD
1-week post ‘Go Live’ Meet with all key stakeholders to gauge post TBD
Go Live progress
F. Key Stake Holders
Name Title
Dr Waverly Clinic Owner and Medical Director
Dr Jones Physician and Clinic Partner
Mrs. Jones Clinic Director
F. Executive Summary
The Waverly Clinic has a total of 8 employees with 3 of them being key stakeholders; Dr Waverly
who is the Clinic owner and Medical Director, Dr Jones who is a physician and clinic partner and
Mrs Jones who is the Clinic Director. The Waverly Clinic is implementing a web-based Electronic
Health Record (EHR) system, migrating from a paper based system.
The web-based EHR system that will be used is from PracticeFusion and the Waverly Clinic has a
total budget of $20 000 and a timeline of 6 months. To help better manage the project each
stakeholder has been allocated to a certain task in order to help manage resources effectively. A
schedule Gantt chart has been provided in this document that helps better vizualize how the
resources are allocated. Further more a detailed stakeholder analysis is also provided in this
document.
Work Break Down Structure

Module #3
1.1 Milestones
A milestone is “a major event in the project” and represents the completion of a set of activities.
Examples of milestones include:
 Project Charter approval

 Project Team appointed
 Project Quality and testing plan approved

 Project evaluation plan approved
List and describe the key project milestones within the following table. Examples are
provided that you may utilize:
Milestone Description Delivery Date

Charter approved The Business Case has been documented TBD
and approved.
Implementation Team Team members appointed TBD
appointed
Project Start Date Official first day the project will start (Total TBD
project timeline = 6 months)
Training Staff training completed prior to “Go Live’ TBD
‘Go Live’ Agreed date for ‘Go Live’ TBD
1-week post ‘Go Live’ Meet with all key stakeholders to gauge post TBD
Go Live progress
1.2 Phases
A phase is “a set of activities which will be undertaken to deliver a substantial portion of the overall
project”. Examples include:
 Project Initiation
 Project Planning
 Project Execution
 Project Closure.
List and describe the major project phases within the following table.
Phase Description © Sequence

Project Initiation Defining the project by developing a Project Phase # 1
Charter. Implementation team identified.
Developing a high level schedule as well as
conducting a HIPAA risk assessment.
Project Planning Defines the exact parameters of the project Phase # 2

and ensures all pre-requisites are in place.
Additional team members appointed,
resources identified, Results of HIPAA risk
assessment considered, budget constraints
Project Execution Defines the execution of the project and Phase #3

includes all documentation: testing, training,
risk assessment
Project Closure Defines post implementation report and Phase #4

progress report and recommend additional
implementations from implementation
learnings.

1.3 Activities
An activity is “a set of tasks which are required to be undertaken to complete the project." Examples
include:
 Develop Quality Plan

 Formulate Supplier Contracts
 Perform Project Closure.
List and describe the major project activities within the following table.
Phase Activity Description © Sequence

Project Develop Identify the EHR Implementation team which Initial Step
Initiation Quality will consist of a 1) Lead Physician, 2) Project
Plan Manager and 3) Super User
Project Develop Perform HIPAA privacy assessment, review After the Project Initiation
Planning Quality budget, resources, training requirements, but before the formulation
Plan timeline, identify EHR provider of supplier contracts
Project Formulate Discuss EHR requirements with chosen EHR After Developing a Quality
Planning Supplier provider Plan but before Project
Contracts Closure
Project Perform Perform project closure procedures
Closure Project
Closure
1.4 Tasks
A ‘task’ is simply an item of work to be completed within the project. List all tasks required to
undertake each activity, within the following table:
Phase Activity Task Sequence

Project Develop Create Implementation Team 1st
Planning Quality Plan Conduct HIPAA Privacy 2nd
Assessment
Configure Software 3rd
Identify Hardware Needs 4th
Transfer data 5th
Optimize pre-launch 6th
workflows
Consider room layout 7th
Decide on launch approach 8th
Develop procedures when 9th
EHR is down or offline
Implementation Staff training Initiate training plan 1st
What assistance is required 2nd
from EHR vendor
Site visit to an establishment 3rd
EHR site
Plan on ongoing training 4th
needs, HIPAA compliance
requirements
Project EHR Testing Initiate testing and evaluating 1st
Execution against performance criteria
Document feedback 2nd
Develop plan for any 3rd
recommended changes

Project Closure Post Evaluate post implementation 1st
Implementation metrics with performance
Report criteria
Document feedback 2nd
Develop plan for any 3rd
recommended changes
1.5 Effort
For each task listed above, quantify the likely ‘effort’ required to complete the task.
Task © Effort
Create Implementation Team 5 days
Conduct HIPAA Privacy Assessment 5 days
Configure Software 7 days
Identify Hardware Needs 7 days
Transfer data 5 days
Optimize pre-launch workflows 7 days
Consider room layout 2 days
Decide on launch approach 5 days
Develop procedures when EHR is down or offline 6 days
Initiate training plan 30 days
What assistance is required from EHR vendor 3 days
Site visit to an establishment EHR site 2 days
Plan on ongoing training needs, HIPAA compliance 30 days
requirements
Initiate testing and evaluating against performance criteria 28 days

Document feedback 7 days
Develop plan for any recommended changes 7 days
Evaluate post implementation metrics with performance criteria 28 days

Document feedback 7 days
Develop plan for any recommended changes 7 days

1.6 Resources
For each task identified, list the resources allocated to complete the task.
Task © Resource
Create Implementation Team Dr Jones (Physician Lead)
Dr Waverly (Project Lead)
Mrs Jones (Super User)
Dr Jones
Conduct HIPAA Privacy Assessment Dr Waverly
Configure Software Mrs Wright

Mr Lawrence
Identify Hardware Needs Mrs Wright

Mr Lawrence
Transfer data Dr Waverly

Mrs Jones
Mr Lawrence
Optimize pre-launch workflows Dr Waverly

Dr Jones
Consider room layout Dr Waverly

Ms Smith
Decide on launch approach Dr Jones

Dr Waverly
Mrs Jones
Develop procedures when EHR is down or offline Dr Jones

Dr Waverly
Ms Smith
Initiate training plan Mrs Jones
Ms Smith
Ms Felps
What assistance is required from EHR vendor Dr Waverly
Site visit to an establishment EHR site Dr Waverly
Plan on ongoing training needs, HIPAA compliance Mrs Jones

requirements Ms Smith
Ms Felps
Initiate testing and evaluating against performance criteria Dr Jones

Dr Waverly
Mrs Jones
Document feedback Mrs Jones
Develop plan for any recommended changes Dr Jones

Dr Waverly
Mrs Jones
Evaluate post implementation metrics with performance criteria Dr Jones

Dr Waverly
Mrs Jones
Document feedback Mrs Jones

Develop plan for any recommended changes Dr Jones
Dr Waverly
Mrs Jones
2 Project Plan
2.1 Schedule (Gantt chart)
Provide a summarized schedule for each of the phases and activities within the project you have
identify using the supplied Gantt chart template. The Gantt chart will provide a time sequence for
all your phases and important activities.

Fishbone Diagram: DELAY IN PRESCRIPTION BEING FILLED (CLINIC)
COMMUNICATION STAFF
Lack of accountability
Poor Medical Assistant (MA) to MD
communication
Medical Assistant did not follow through

Inexperience with Rx requirements
Poor Front Desk Assistant to Practice

Manager communication
DELAY IN
PRESCRIPTION BEING
FILLED (CLINIC)
No policy/procedure for MD/MA to
respond to voicemails in a timely manner
No practice policy/procedure on how to

tackle Rx discrepancies prior to the Rx
leaving the clinic Did not pay adequate attention to Rx
requirements
RULES /POLICIES
/PROCEDURES ATTENTION ERROR

Fishbone Diagram: DELAY IN PRESCRIPTION BEING FILLED (PHARMACY)
COMMUNICATION STAFF
Did not pay adequate attention to

Did not inform patient that there was an prescription when it was dropped off
error on the prescription when it was
dropped off.
Did not call the patient to inform them

about the additional delay
DELAY IN
PRESCRIPTION BEING
FILLED (PHARMACY)
No pharmacy procedure to ensure that all

prescriptions are reviewed for accuracy
when they are dropped off
RULES /POLICIES
/PROCEDURES

FMEA Template
This template can be used to document the completed FMEA including follow-up actions
and measures. Revise this template as necessary to meet your needs. Review the
Guidance for Failure Mode and Effects before using this template.
Process analyzed: To understand how the hardware on a clinician’s workstation may fail
during project implementation
Team leader: Dr. Waverly
Team members:
Name Position Name Position
Dr. Jones Physician Lead Ms. Smith Team Member

Mrs. Jones Super User Ms. Felps Team Member
Mrs. Wright Team Member
Mr. Lawrence Team Member
Describe your process steps (flowchart): As per the suggested guidance, you might use
sticky notes on separate papers.
Turn on Turn on Turn on Log into

Router Printer Workstation Workstation
Identify what could go wrong during each step of the process. You might use sticky-
notes indicating what could go wrong for each step. Line these up beneath each process
step.
Process What could go wrong
Turn on - Router does not turn on

Router - Router does not connect to the internet
- Router not configured correctly
Turn on - Printer does not turn on
Printer - Printer does not connect to network
- Printer is broken
Turn on - Workstation does not turn on
Workstation - Workstation does not connect to the network

Log into - End User failure
Workstation - Slow connectivity
For each item identified that could go wrong, rate each for the seriousness of this
outcome (severity) and how often the mistake is likely to occur (probability)
Category Outcome Rating (Severity)
Rating Outcome Category Description

5 Catastrophic Power Outage
4 Major Unable to access cloud-based

EHR at all
3 Moderate Intermittent access to cloud-
based EHR
2 Minor One workstation not operational
1 Near Miss Workstation not plugged into
power outlet
Failure Probability rating scale (Probability)
Rating Outcome Category Definition

5 Very High probability: 1 failure in 1 attempt
failure is most inevitable
4 High: repeated failures 1 failure in 5 attempts

3 Moderate: occasional 1 failure in 10 attempts
failures
2 Low: relatively few 1 failure in 50 attempts
failures
1 Remote: failure is < 1 failure in 100 attempts
unlikely
Review your ratings and decide on your process failures identified as high priority for
corrective actions. List the process failures you will focus on in the table below.
Process What could go wrong Severity Rating Probability

Rating
- Router does not turn - 5 - 1

on - -
Turn
on - Router does not - 4 - 2
Router connect to the internet - -
- Router not configured - 3 - 2
correctly
- Printer does not turn - 5 - 1
on - -
Turn on
Printer - Printer does not - 3 - 2
connect to network - -
- Printer is broken - 3 - 2
- Workstation does not - 5 - 1
Turn on turn on - -
Workst - Workstation does not - 4 - 2
ation
connect to the network
- End User failure - 2 - 2

Log - Slow connectivity - 3 - 2
into
Workst
ation
Describe your corrective actions for process failures identified as high priority:
Before determining your corrective actions for process failures, consider whether you
should conduct a systematic analysis to determine the root cause of each failure chosen
for action. If necessary, use techniques such as the five whys, flowcharting, or the
fishbone diagram to assist in identifying the root causes. Additional tools are available that
guide the use of each of these techniques. It is helpful to keep any of these analyses with
your PIP documentation for future reference. In the table below, describe each root cause
for each process failure, and then enter your specific actions to reduce or eliminate the
failure, your completion timeframe, and the responsible individual or group.
Root Cause of Specific Actions to Completion

Process Responsible
Process Reduce or Eliminate
Failure Individual/Group
Failure the Failure Time Frame
Router Place all connections

7 days IT installation group
unplugged securely out of site
All hardware should be
Router burned
plugged into surge 7 days IT installation group
out
protectors
Turn on Router does
No internet provider,
Router not connect to 1 day IT installation group
contact provider
internet
Router not
Configure router to
configured
EHR system 7 days IT installation group
correctly
specifications
Turn on Printer Place all connections 7 days IT installation group
Printer unplugged securely out of sight
Printer does Hard wire printer Wi-Fi
not connect to access instead of 7 days IT installation group
network wireless
Devise practice protocol
Printer is
for repair and 7 days Key Stakeholders
broken
replacement
Workstation Place all connections
7 days IT installation group
unplugged securely out of sight
Workstation
does not meet Upgrade workstation to
Turn on cloud EHR meet cloud EHR 7 days IT installation group
Workstat minimum minimum specifications
ion requirements
Devise practice offline
Power outage 7 days Key Stakeholders
protocols
Natural Devise natural disaster Key Stakeholders, IT
14 days
Disaster offline protocols installation group
Measures of Success
Measure(s) of Success 
(How we will know if this
action is successful) 
(Consider measures of
Correctiv Reporting Schedule and Individual or
how often the failure is still
e Action
occurring after process Group Responsible for Reviewing Results
changes and the incidence
of adverse events related
to the failure)
Place all
connectio Count the number of
ns accidental equipment
Dr. Waverly, Dr. Jones, Mrs. Jones
securely unplugging events per
out of week
sight
Devise
practice
Have training module that
protocol
all staff need to complete
for repair Mrs. Jones
on a yearly basis –
and
measure completion rate
replacem
ent
Devise Have training module that
practice all staff need to complete
Mrs. Jones
offline on a yearly basis –
protocols measure completion rate
Devise
Have training module that
natural
all staff need to complete
disaster Mrs. Jones
on a yearly basis –
offline
measure completion rate
protocols
Signature of FMEA leader/facilitator__________________________ Date __________
PROJECT STAKEHOLDER ANALYSIS
3 Purpose
The purpose of stakeholder analysis is to inform the Project team who the steak holders are, how
those steak holders should contribute to the project, where barriers might be to project success
(from the stakeholder’s perspective and their potential impact) and the actions that need to be
taken to ensure steak holders needs are met. Depending on your project the steak holder analysis
could be performed informally but more complex projects that involve: multiple departments,
agencies, or disciplines may require an extensive analysis. Keep in mind that stakeholders are not
always obvious and requires interviewing and discovery. Taking time to understand the steak
holders and how they can contribute to the success of the project warrants a formal analysis.
The identification of stakeholders will also assist in determining if an advisory board for the project
is necessary (this is not always the case) and what the concerns of the steak holders is.
CONTENTS
Purpose ....................................................................................................................................... 17
Stakeholder Analysis.................................................................................................................... 17
Stakeholder Interview ............................................................................................................... 18
Influence / Interest Grid ................................................................................................................ 20
Guidance notes ............................................................................... Error! Bookmark not defined.
4 Stakeholder Analysis
Identify the key stakeholders (both internal and external) in your project and determine their
interests or requirements from the project; what the project needs from them, any perceived
attitudes and/or risks the stakeholders may have and the actions to be taken to achieve this.
This may require a series of meetings or workshops in order to complete the Interview Sheet below.
From your list of stakeholders you may determine more easily how they fit into your Project
Organisation. The majority of whom will fit into the Advisory Board or Business Community.

4.1 Stakeholder Interview
Category Name Objectives/Questions

Topics to Cover (adjust as necessary):
 Positive/Negative outcome from adoption
 Influence
 Dependencies
 Critical Timelines / Risks
 Actions required
Non clinical Staff Ms. Felps, front - Will participate as a project team
(could be listed by office clerk member
department or -  Actions required
agency) -  Positive/Negative outcome from
adoption
Mr. Lawrence, clinic - Has prior IT experience so his

accounts and billing experience should be leveraged in
the EHR implementation process
-  Critical Timelines / Risks
-  Influence
-  Actions required
Clinical staff (could Dr. Jones, physician - Identified as one of the champions
be listed by and clinic partner in the EHR implementation process
department or -  Critical Timelines / Risks
agency) -  Actions required
-  Dependencies
-  Influence
- Has prior EHR installation

Mrs. Johnson,
experience and has been identified
physician’s assistant as another key champion
(will function as -  Actions required
project team member) -  Dependencies
Mrs. Wright, MSN, - Important to refine back office

NP, nurse practitioner procedures with the new EHR
implementation hence needs to be
managed closely so that Ms. Smith
is kept in the loop of all
developments
-  Positive/Negative outcome from
Ms. Smith MA, back adoption
office medical
assistant (Project - Will participate as a project team
team member) member
adoption
Admin staff (this Dr. Waverly, clinic - Medical director responsible for
might include your owner and medical motivating team and keeping project
practice manager on time and within budget.
and medical director (*Key Responsible for communicating
director) stakeholder) with Practice Fusion.
-  Influence
-  Dependencies
- Clinic director also responsible for

communicating, motivating and
Mrs. Jones, clinic
keeping the project plan within the
director (*Key
specified timeline and budget.
stakeholder) -  Influence
-  Dependencies
Vendors Practice Fusion - EHR cloud based solution that is

being utilized by Waverly. They
have limited influence but have a
vested interest in ensuring EHR
adoption occurs smoothly as they
would want Waverly to continue
utilizing their services.
Patients - Have limited influence and interest,

their primary concern is timely and
courteous care from their healthcare
team
adoption
Finance Amex - Provides finance has little influence

or interest in this project. Their only
concern is that the member does not
default on the payment schedule.

5 Influence / Interest Grid
Once the key stakeholders are identified, plot their position on the grid below. Please refer to the
‘Guidance Notes’ below for reference.
Dr. Waverly, clinic owner and medical Ms. Smith MA, back office medical
director assistant
Dr. Jones, physician and clinic partner
[CHAMPION]
Mrs. Jones, clinic director
Mrs. Wright, MSN, NP, nurse
practitioner [CHAMPION]
High KEEP SATISFIED MANAGE CLOSELY
INFLUENC
E
Ms. Felps, front office clerk

Amex Mr. Lawrence, clinic accounts and billing
Mrs. Johnson, physician’s assistant
Patients
Practice Fusion
MONITOR KEEP INFORMED

Low
(MINIMUM EFFORT)
Low INTEREST High

EHR IMPLEMENTATION
CHECKLIST
STAFF – DR WAVERLY
8 WEEKS PRIOR
☐ Staff training on new EHR policies and procedures begins

4 WEEKS PRIOR
☐ Staff has completed EHR application training

2 WEEKS PRIOR
☐ On the job EHR training begins at dedicated training workstation
1 WEEK PRIOR
☐ Practice huddle to enforce expectations and answers any questions or concerns
☐ Appointment times/schedules have been modified to allow for the EHR learning curve.
GO LIVE DAY
☐ Staff to arrive 1 hour prior to prepare for patients
☐ Super Users and all trainers scheduled to assist with the implementation
☐ Have signage placed in all prominent areas information patients about the ‘Go Live’
implemenation
HARDWARE – MRS JOHNSON

8 WEEKS PRIOR
☐ All PCs meet EHR cloud integration specifications
4 WEEKS PRIOR
☐ Wireless PCs/connections have been checked and areas without connection or “dead spots”
have been identified
☐ Training workstation(s) setup to allow for On-the-job EHR training
2 WEEKS PRIOR
☐ EHR system interfaces have been tested and are working.
DOWNTIME PROCEDURES – DR WAVERLY & DR JONES

8 WEEKS PRIOR
☐ Policies and Procedures for downtime procedures have been finalized
4 WEEKS PRIOR

☐ Staff have completed downtime training and have signed off on EHR downtime policies and
procedures
2 WEEKS PRIOR
☐ Paper copies of all patient forms and templates have been made available in the event of a system
failure
1 WEEK PRIOR
☐ Practice EHR downtime drill takes place
POST-IMPLEMENTATION REVIEW REPORT
1 INTRODUCTION
 Project Identification
The Waverly Family Health Services Clinic has decided to migrate from a paper based to an
Electronic Health Records (EHR) system using a web-based EHR provided by Practice
Fusion.
 System Proponent
Dr Waverly, Clinic Owner and Medical Director
 History of the System

The Waverly Clinic has been using a paper based system and has now migrated to a web-
based EHR system. They did not have an EHR prior to this implementation.
 EVALUATION SUMMARY
The purpose of this section is to provide a summary of the overall adequacy and acceptance of
the system.
 General Satisfaction with the System

Describe the users’ experience with the implemented system. Comments should address the
following:
The level of user satisfaction

The strengths of the system, including specific areas of success
Any problems
Frequently used features
Infrequently used features
Features not used at all
Suggested improvements
 Needed Changes or Enhancements

Gauge the magnitude of effort needed to change or improve the system. Describe the nature
and priority of the suggested changes~ more detail will be provided in other sections.
Comments should address the following:
The suggested changes

The scope of the changes
The resource requirements to affect the changes
 ANALYSIS AND IMPLEMENTATION

The purpose of this section is to gauge the completeness of the functional requirements and
implementation according to the study.
 Purpose and Objectives

Evaluate the adequacy of the original definition of purpose and objectives presented in the
functional requirements document and if the objectives were achieved during implementation.
Evaluate if any objectives have changed or should have changed. Comments should address
the following:
Has the EHR met the goals and expectations originally set forth? a. In relation to quality of
care b. Patient safety c. Unexpected outcomes d. Other issues
Extent to which objectives were met
Possible changes to the objectives
 Scope
Analyze if proper limits were established in the design of the implementation within your
project plan and if they were maintained during implementation. Comments should address
the following:
Variations from the scope definition as agreed to in the concept development

The extent to which the scope was followed
Any possible future changes to the scope
 Benefits
Analyze if the benefits anticipated by implementing the new HER system are met and if they
are not met how did they miss the metric for measuring success. Detail all benefits,
quantifiable or non-quantifiable, and any quantifiable resources associated with each.
The adequacy of the benefit definition

The level and types of benefits of the EHR system realized
The anticipated benefits that can be realized
 The reason for the variance between planned and realized benefits
 Development Cost
The budgeted development cost is $20,000
 Operating Cost
Determine the difference between budgeted and actual costs and if there is a difference
determine the reasons why
 Training
The implementation timeline for the EHR was 6 months. The training phase was 5 months in
length as per project plan.
Was the training phase length adequate in meeting the demands of EHR implementation.
The adequacy of the training

The appropriateness of the training
Identification of additional training needs by job category
The ability of the personnel to use the training provided
 OUTPUTS
The purpose of this section is to evaluate the adequacy and usefulness of the outputs from the
system. Outputs are defined as the clinical records (data) generated by patient visits and any
associate data such as billing, coding, quality reports/data.
 Usefulness
Conduct an after implementation survey with all users to guage if the EHR matches their
expectations. Usefulness is measured using a 5-point scale where 5 would mean ‘extermely
satisfied’ and 1 would mean ‘Not satisfied at all’.
Using a 5 point scale how satisfied are you with usefulness of the EHR?
How important do you feel the EHR is to you and your job?
 Timeliness
Determine if output production performance meets user needs. Comments should address
the availability of clinical records, clinical data, lab reports, imaging data, previous clinical
visits, and billing data.
 Data Quality
Assess the need to provide for effective use of shared data to enhance performance and
system interoperability. Comments should address data accuracy and data reliability.
 Data Protection
Determine if the security, backup, recovery, and restart capabilities adequately safeguard data.
The adequacy of the security, backup, recovery, and restart procedures

Data and activity meet HIPPA compliance
If data and clinical activity with the EHR does not meet HIPPA/security compliance indicate
what additional steps will be necessary to ensure compliance
 Disaster Recovery
Determine if appropriate clinical files, programs, and procedures are established to enable
recovery from a disaster (unintended down time of EHR) resulting in the potential loss of data
or lack of access to stored data. The following are suggested areas of comments:
Back up and recovery procedures are established

Staff demonstrate ability to perform down time procedures for all clinical activities
Ability to access backup data for downtime procedures
 COMPUTER OPERATIONS
The purpose of this section is to ascertain the current level of operational activities. Although
the user point of view is primary to the Post-Implementation Review Report, the computer
operations view is also important to investigate.

 Control of Work Flow
Evaluate the EHR user interface for collecting clinical data for given workflows. Investigate
issues related to data gathering at given points in work flow. Comments should address the
following:
Any problems in accomplishing clinical work flow processes

The frequency and extent of problems related to clinical data gathering within a work flow
Suggested changes from end users
The effort or barriers required to make changes to the EHR to remediate issues
 Scheduling
Determine the ability of computer operations to schedule according to user needs and to
complete scheduled tasks. Comments should address the following:
Any problems in scheduling patient visits, procedures or follow up

The frequency and extent of the problems
Suggested changes
The effort required to make changes
 EHR User Interface

Analyze the usability of the system. The transaction throughput and error rate are included in
this analysis. Comments should address the following:
Number of patient visits processed (number of transactions)

Number of errors made when carrying out clinical documentation
Frequency of problems with the interface
Suggested changes from users
Effort required to make the changes
 Computer systems
Analyze computer issues and problems. Some areas to review are as follows:
The correct or incorrect use of forms and off line files

The adequacy of instructions for end-users on use of EHR
Downtimes via web access through practice
Downtimes via the EHR company of your systems is web based
software bugs or glitches as described by end users
Hardware issues
 MAINTENANCE ACTIVITIES
The purpose of this section is to evaluate maintenance activity involving the EHR system
software and all hardware components.
 Activity Summary
Provide a summary of maintenance activity to date. Provide type, number of actions, and
scope of changes required. Estimate a projected maintenance workload based on the findings
of the review. Discuss the adequacy of maintenance efforts or if major enhancement/revision
is required.
.
 System Maintenance
Discuss the system maintenance based on the design, types of changes required,
documentation, and knowledge about the system (both user and technical personnel).

Evaluation and Program Plan Submission

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Copyright:

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Evaluation and Program Plan Submission

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Copyright:

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University of San Diego © 2016. All Rights Reserved.

University of San Diego © 2016. All Rights Reserved.

Project Sponsor: Professor Tennille Gifford

C. Constraints and Assumptions

D. Project Scope Statement

Financial - $20,000 total budget

G. Success Metrics: Criteria for Evaluating Project Success and Milestones

Milestone Description Delivery Date

‘Go Live’ Agreed date for ‘Go Live’ TBD

F. Key Stake Holders

Work Break Down Structure

 Project Charter approval

University of San Diego © 2016. All Rights Reserved.

Milestone Description Delivery Date

‘Go Live’ Agreed date for ‘Go Live’ TBD

Phase Description © Sequence

Project Planning Defines the exact parameters of the project Phase # 2

Project Execution Defines the execution of the project and Phase #3

Project Closure Defines post implementation report and Phase #4

University of San Diego © 2016. All Rights Reserved.

 Develop Quality Plan

Phase Activity Description © Sequence

Phase Activity Task Sequence

University of San Diego © 2016. All Rights Reserved.

Initiate testing and evaluating against performance criteria 28 days

Evaluate post implementation metrics with performance criteria 28 days

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Configure Software Mrs Wright

Identify Hardware Needs Mrs Wright

Transfer data Dr Waverly

Optimize pre-launch workflows Dr Waverly

Consider room layout Dr Waverly

Decide on launch approach Dr Jones

Develop procedures when EHR is down or offline Dr Jones

What assistance is required from EHR vendor Dr Waverly

Site visit to an establishment EHR site Dr Waverly

Plan on ongoing training needs, HIPAA compliance Mrs Jones

Initiate testing and evaluating against performance criteria Dr Jones

Document feedback Mrs Jones

Develop plan for any recommended changes Dr Jones

Evaluate post implementation metrics with performance criteria Dr Jones

Document feedback Mrs Jones

University of San Diego © 2016. All Rights Reserved.

Medical Assistant did not follow through

Poor Front Desk Assistant to Practice

No practice policy/procedure on how to

University of San Diego © 2016. All Rights Reserved.

Did not pay adequate attention to

Did not call the patient to inform them

No pharmacy procedure to ensure that all

University of San Diego © 2016. All Rights Reserved.

Name Position Name Position

Dr. Jones Physician Lead Ms. Smith Team Member

Turn on Turn on Turn on Log into

Process What could go wrong

Turn on - Router does not turn on

University of San Diego © 2016. All Rights Reserved.

Category Outcome Rating (Severity)

Rating Outcome Category Description

4 Major Unable to access cloud-based

Rating Outcome Category Definition

4 High: repeated failures 1 failure in 5 attempts

Process What could go wrong Severity Rating Probability

Signature of FMEA leader/facilitator________________ Date