EMR Assessment & Selection Presentation

1. EMR Assessment & Selection Presentation April 30, 2016

2. Agenda • EMR System Selection Process: • Concepts for System Selection Process • Governance • Committee Roles • Sample Timeline • RFP and Requirements • Evaluation Criteria • Use-Cases • Demonstration Schedule • Demonstration Evaluations • Cost Considerations • Identifying EMR Requirements: • CNYCC/DSRIP Requirements • EMR Solution Pathway: Identifying Your EMR Needs

3. Right-Sizing Your Selection Strategy • Selecting an EMR is one of the most significant financial and operational decisions an organization will make • The selection process should include input from multiple roles including input from clinical, operational, and IT staff • The process described in this presentation is comprehensive and is designed to be highly participative and has multiple steps • Steps can be adjusted to meet the selection needs of the organization • Some organizations may have a short list of candidate vendors and be able to omit some steps • Leadership should make a determination for which steps are important to ensure the process identifies a solution that best meets the needs of the organization

4. EMR Selection ProcessKey Considerations • Multidisciplinary Process – actively engage clinical and operational staff in the process; use for evaluation and feedback during demonstrations • Identify Clinical and Operational Champions – serve as leaders and change agents for the effort • Identify Executive Steering Committee – committee to oversee effort and make final recommendation • Identify System Selection Committee – should be multidisciplinary including representatives for multiple roles within the organization (e.g. nurse, provider, registration staff, lab, billing, etc.) • Focus Groups – use to address specific needs for identified roles or workflows • Plan for Backfill – committee members may spend considerable time on the project; plan for backfill to accommodate their participation during meetings or work sessions • Evaluation – take full advantages of opportunities to evaluate candidate systems (e.g. web demonstrations, on-site demonstrations, hands-on sessions, site visits, reference calls, etc.)

5. Sample System Selection Governance Executive Champion(s) Multi-Disciplinary • Medical Staff • Clinicians • Leadership Physician Focus Groups

6. Committee Roles

7. Sample Timeline Define Strategy Distribute RFP Evaluate RFP Responses Create Demonstration Scenarios Conduct Demos & Workshops Conduct Reference Calls Conduct Site Visits Determine Project Scope and Phasing Conduct Application and Technical Review Develop Total Cost of Ownership Model Vendor of Choice Evaluate Findings

8. Sample RFP Table of Contents Table of Contents • Introduction.………………………………………………………………………………… 3 • Scope of Proposal.………………………………………………………………………… 3 • Current Volumes and Metrics.………………………………………………………..3 • Instructions for Responding…………………………………………………………...4 • Selection Process and Timetable……………………………………………..4 • Proposal Submission………………………………………………………………..5 • Proposal Conditions…………………………………………………………………6 • Communication/Questions & Answers…………………………………….6 • Submission Deadlines………………………………………………………………7 • Proposal Duration…………………………………………………………………….7 • Confidentiality………………………………………………………………………….7 • Notifications…………………………………………………………………………….7 • Evaluation Criteria……………………………………………………………………7 • Webinars………………………………………………………………………………….8 • On-Site Demonstrations…………………………………………………………..9 Sample

9. Sample RFP Table of Contents (Continued) SECTION 2 VENDOR RESPONSE • Requirements……………………………………………………………………………….9 • General Requirements and Vision..………………………………………..9 • Functional Requirements……………………………………………………..10 • Operational Requirements……………………………………………………10 • Technical Requirements.………………….…………………………………..10 • Source of Applications...………………………………………………………………10 • Project Costs...…………………………………………………………….……………….11 • Project Staffing..………………………………………….……………………………….12 • Company Information..………………………….…………………………………….12 • Authorized Signature…..…………..………………………………………………….12 Sample

10. Sample RFP Requirements Review Categories Technical Requirements: 1.    Database & Table Maintenance 2.    Technical Security & Data Display 3.    Mobility/Mobile Computing (kiosk, wall,keypad, tablet, smartphone) 4.    System Monitoring and Maintenance 5.    Storage 6.    Hardware/Desktop/Architecture Functional Requirements: 1.    Analytics / Reporting / Tracking Needs 2.    Providers Requirements 3.    Regulatory / Other Assessment Needs 4.   Health Reform Requirements 5.    HIM / Document Management Needs 6.    Integration/HIE Needs 7.    Medication Needs 8.    Customer Relationship Management 9.    Operations Management 10.  Billing 11.  Referrals/Authorizations 12.  Consents/Acknowledgements and Notices 13.  Client Tracking 14.  Patient Engagement 15. Care Management/Coordination • Operational Requirements: • 1.    Training and Documentation2.    Implementation and Conversion • 3.    System Performance and Support • 4.    System Data and Security • 5.    System Change and Configuration Project Costs: • System Hardware Purchase Cost • System Software Costs • Application Software Costs • Interfaces and Conversions • Implementation and Training Costs • Summary of Costs

11. Sample Evaluation Criteria

12. Identify Key Decision Criteria [Vendor B] [Vendor A] Sample *Tip: Keep to a manageable list of criteria

13. Use-Cases • Use-cases also known as scripts or scenarios are to be used by the vendor during the demonstration sessions. • The purpose of the use-cases: • Provides structure for vendors to follow • Include current pain points and cumbersome workflows • Vendor should show basic functionality in demonstration while addressing the specifics of the use-case • Help identify significant value features and possible gaps • Use-cases will be used for all demonstrations except for the Interactive Workshops • Advisory and Selection Committees will be engaged in the scenario development process. • The number of use-cases can vary by demonstration topic. • Quantitative demonstration evaluation tools are developed directly from the use-cases for each demonstration session.

14. Use-Case Example (Continued) Sample Sample Vendors should follow the appropriate script to ensure solutions will meet organizational requirements and to ensure comparability among vendors Evaluators should use evaluation forms that match scripts to ensure candidate solutions are consistently evaluated during demonstration sessions

15. Sample DemonstrationSample Schedule Vendor 1 Vendor 2 Time Integrated Demonstration (1.5 hrs, 8 – 9:30) 8:00 9:00 10:00 11:00 12:00 1:00 2:00 3:00 4:00 5:00 Data Analytics/BI (1 hr, 8 - 9) Revenue Cycle & Occupational Health Services Billing (4 hours, 8 to 12) Data Analytics/BI (1 hr, 9:45 – 10:45) Clinical Staff (1.5 hrs, 9:15 – 10:45) Integrated Demonstration (1.5 hrs. 11 – 12:30) Clinical Staff (1.5 hrs, 11 -12:30) Revenue Cycle & Occupational Health ServicesBilling Overview (1.5 hrs, 1 – 2:30) Interactive Workshops (2.75 hrs, 1 – 3:45) Revenue Cycle & Occupational Health Services Billing (4 hours, 1 to 5) Revenue Cycle & Occupational Health ServicesBilling Overview (1.5 hrs, 4 – 5:30) Interactive Workshops (2.75 hrs, 2:45 – 5:30) *Sessions are running parallel

16. Demonstration Evaluations Example: Clinical Demonstration Evaluation • Typical 5 point evaluation (Likert) scale: • Exceptional • Exceeds Expectations • Meets Expectations • Needs Improvement • Does not meet Expectations • N/A • Every survey will ask: • For the submitter’s role (ex: nurse, provider, IT , etc.) • “Is the proposed solution an improvement over what I’m using today?” • *Provide an opportunity to submit feedback comments • Concluding survey: • At the end of the entire series of demonstrations, a concluding survey will ask anyone who attended sessions to force rank-order the three candidate vendors

17. All committee members present will receive evaluation forms prior to the demonstrations to record their responses and take notes. An online survey tool can also be used such as SurveyMonkey. The links to each evaluation forms should be email out at the beginning of each. Demonstration Evaluations (Continued)

18. Cost Considerations • Identifying cost includes all aspects of the implementation, not just core vendor costs. • Vendor software and hardware, including licenses, implementation, and support. • Third party software and hardware, like voice recognition, document scanning, clinical content, e-prescribing, drug database, CPT code licenses. • Complete staffing costs, including current staff, incremental staff and consulting resources, and costs for keeping current systems operating during the change. • New system will require x to x new full-time IS staff members • Project team, SME and super-user, and end-user training costs. • Backfill costs for SME involvement in the project and user training. • Archiving of existing data and conversion into the new system. • Electronic interfaces to systems not being replaced. • Additional investments, such as monitor upgrades, mobile devices, patient kiosks, team space and furniture, travel costs. • Offset for decommissioning of current systems.

19. Additional Services

20. CNYCC EMR Requirements

21. CNYCC EMR Requirements • Ability to exchange information with HeC and partner organizations in approved format: • Web services utilized by the IHE (SOAP 1.2) • SAML, required by SHIN-NY • C-CDA document constructs • Direct messaging (SMTP and/or XDR) • x.509 certificate security (encryption and digital signatures) • Meaningful Use Certified (if provider(s) qualifies or plans on participating in MU program). • Reporting and analytic capabilities including patient registries, alerting, decision support, etc. • Support for workflow automation, care planning, and preventive care capabilities • Patient outreach capabilities (patient portals/secure messaging) • Ability to support Patient Centered Medical Home (if provider(s) are participating in the PCMH program). • Implementation schedule aligns with CNYCC milestones (implementation complete by DY 3  2017).

22. EMR Assessment & Selection Questions?