Clinical Software Readiness Assessment

Overview

How ready are you to implement new clinical software? Use this tool to ensure the important aspects of implementation are not forgotten when answering this question. With a more accurate portrait of your readiness, you will be more effective in considering your needs.

Note: For brevity’s sake, the term ‘clinical software’ is replaced with EMR (or Electronic Medical Record).

Instructions

The Readiness Assessment can be completed by the leadership team or key staff in the clinic.

Each area is divided into 3 stages of readiness. For each element, identify which best describes your practice’s current status, and record whether you are “red”, “orange” or “green”. An example answer is circled below:

Readiness Component	Not prepared	Moderately prepared	Highly prepared	Score
Staff involvement	Driven by one staff member – office management and clinician leadership	Small committee driving EMR decisions and organizing staff	All staff have a role in the project, and each person’s input is considered in goal development	Orange

There are 4 aspects of the clinic to assess: Organisational Culture, Management & Leadership, Operational and Technical.

Interpret and review results (an interpretation guide is at the end of the document).

Clinical Software Readiness Assessment for [your clinic name]

1. Organisational Culture	Readiness Component	Not prepared	Moderately prepared	Highly prepared	Score
Overall perception of EMR	Viewed merely as a requirement by government or accreditation body.	Seen as a technology to achieve workflow efficiencies	Primarily a technology to enable healthcare quality improvement and strategic business goals
Clinician involvement	Limited clinician involvement in EMR decision-making	Clinic principal(s) approve need for EMR, and will attend product demonstration/s	Clinic principal(s) is/are active in EMR planning and acquisition; clinician “champion” is identified.
Staff involvement	Driven by one staff member – office management and clinician leadership	Small committee driving EMR decisions and organizing staff	All staff have a role in the project, and each person’s input is considered in goal development
Patient involvement	Not discussed	Considered, but there is no documented strategy for improving the patient experience	Clinic includes patient experience as part of primary goals – including patient feedback in planning process (e.g. a survey or focus group)
Project plan	Not established or assigned; not planning to use a project plan	Planning principles are generally understood, and have been developed, prioritised, and assigned; a project plan template will be used	Clinic is committed to completing a project plan template and comprehensively abiding by it. Deviations to the plan will be documented by updating the existing plan.
ORGANISATIONAL CULTURE COMMENTS:

2. Management & Leadership	Readiness Component	Not prepared	Moderately prepared	Highly prepared	Score
The Executive Team	Relies on vendor information for product choice	Planning delegated to managers or a specific team	Sufficient time is allocated to planning for quality improvement using an EMR
The Executive Team	Interested in exploring a new or improved EMR, but having trouble justifying cost and committing to purchase	Studied the cost/benefits of implementing a new or improved EMR and can justify the investment	Leadership links EMR investment to the clinic’s business strategy, mission, and vision and finds ways for the EMR to support them. Leadership believes that an EMR has a positive ROI
Financial	EMR is seen as an expense and not as an investment – ROI not discussed	EMR is believed to be an investment and a positive ROI is expected within an appropriate timeframe.	EMR is an investment and over a longer timeframe, incorporates non-quantifiable returns such as efficiency, increase in staff personal time, and better patient experience
Financial	EMR budget not identified or discussed	EMR budget funded using flexible funds	Annual budget addresses capital earmarked for EMR acquisition and ongoing maintenance
Strategic plan	No specific strategic plan; projects viewed as individual efforts	Strategic planning process separate part of overall clinic planning and has identified need for IT reach goals	Strategic planning process has been an integral part of the organisation and has resulted in a strategic plan that guides EMR procurement
Quality improvement (QI)	No clear objectives and not connected to use of EMR	QI for care management goals established, but not clearly defined	QI documented in the strategic plan and includes measurement of clinical metrics over a defined timeframe
Care Management (CM)	No clear understanding of how CM may benefit clinic or immediate area for focus Clinical practice champion not identified Staff not assigned to QI assurance process	Clinical practice champion identified Incorporation of CM strategies at key meetings (e.g. staff, EMR, QI) viewed as important Identified potential area of focus for initial CM strategies	Identified specific committee/meeting with CM oversight responsibility (includes clinical practice champion)
MANAGEMENT & LEADERSHIP COMMENTS:

3. Operational	Readiness Component	Not prepared	Moderately prepared	Highly prepared	Score
Workflow redesign	Not discussed	Areas for potential redesign discussed and identified	Redesign areas identified and prioritised; “quick win” issues resolved prior to EMR installation; planning process in place for workflow redesign and change management approaches
Workflow redesign	Current and proposed processes not developed	Current and proposed processes generally understood and incorporated into product evaluation	Existing and future processes documented in process maps or procedures manuals and requirements are included in product evaluation process; EMR to complement processes.
Care management	Inventory of current CM tools and strategies not completed Current paper CM processes not identified, minimally effective, or small scale Staff minimally engaged in CM processes	Patient population identified for CM strategy deployment EMR seen as a means to further identify CM strategies Paper CM strategies somewhat effective Staff moderately engaged in CM processes	CM priorities identified and goals set EMR seen as an enabler to more efficient means for providing CM Staff identify their role(s) in improving patient outcomes through CM processes
EMR policies, procedures and protocols	Policies for security and use have been considered but not directly addressed	Policies for security and use addressed; plan in place for development	Developed protocols for security access rights, medical record correction, system downtime and contingency, data ownership, storage requirements, and use
Training plan	Training will be vendor-directed	Gaps in staff skill-set will be included in planning process Staff will discuss training schedule with chosen vendor	Practice-directed EHR implementation and training plan (designed to complement dips in productivity and staff knowledge gaps) developed and placed within contract as addendum Training needs communicated to vendor and built into training plans
OPERATIONAL COMMENTS:

4. Technical	Readiness Component	Not prepared	Moderately prepared	Highly prepared	Score
Use of existing technology	Practice management system (PMS) used only for scheduling and billing	PMS is utilized for general practice management, including productivity reporting and efforts to improve patient access	PMS fully optimized and updated; additional modules and updates that support patient management purchased; reports generated on patient populations; probably converting from previous EMR
Hardware needs assessment	Need for new hardware is understood	Clinic has some idea of the hardware that may need replacing/upgrading	The clinic will not sign a contract without a signed statement from the vendor of the hardware requirements
IT management	Relies heavily on external resources for IT knowledge, planning, decision-making, and implementation of hardware and software	Clinic staff member has informal role to manage IT, but relies on vendors/suppliers to detail the project milestones and tasks There is general computer awareness amongst staff and computer skills assessments are completed for all staff	Clinic has a nominated staff member to undertake IT management, and takes responsibility for implementation planning. IT systems are monitored and a formal process exists for identified flaws to be addressed Developing IT and EMR “super users” to consolidate expertise in the practice
TECHNICAL COMMENTS:

INTERPRETATION AND ANALYSIS	How did your clinic score? Review the number of reds, oranges and greens. A preponderance of reds reduces the likelihood that you would be successful in implementing an EMR (all reds should be addressed before proceeding). On the other hand, a majority of greens indicates you are ready to go ahead. If there is an even balance of orange and green, or a large proportion of oranges, you will need to think carefully about how to proceed. In this case, you will likely need to address a few priority issues. In this space, you may wish to enter a brief report of your findings and analysis.