EMR | PM IMPLEMENTATION

Data Migration Plan to AstralJet EMR / Electronic Medical Records

Information is the lifeblood of a practice! When Patient charts, prescriptions, lab reports, x-rays, scans and consults are all readily accessible to a provider and staff for their full utilization, the practice succeeds. Patient care and claim submissions rely on the timeliness and availability of information. However, when the management of this information falters, processes are incomplete, progress slows, compliance issues arise and patient confidence erodes.

How does a Practice Manager or Provider ensure that accurate information flows quickly to staff and patients to ensure that proper measures are taken? Fortunately, complete Electronic Medical Record and Practice Management software exist to integrate the business process workflow and ensure important information is stored, retrieved and utilized. The result is a very efficient information procedure that enhances the process and improves service to patients and payers alike. But a new question arises. After a practice has chosen an EMR, how does one implement this new system without a major disruption to the practice, namely, staff, patients and other external entities with whom you interact on a daily basis? Begin by putting together your Migration Plan. Below is a sample that has proven successful in the implementation of EMR's. It is meant to be used as a guide for your practice and you can accept the recommendations or you can make some changes to suit any unique qualities of your practice.

To begin the implementation of your new EMR/PM you must consider the following:

• Prepare your staff for what is about to happen
• Get the necessary infrastructure in place
• Devise a new workflow for your practice
• Customize the software
• Train your staff
• Providers
• Implement the new workflow - gradually
• Monitor your staff and office and maintain your system

Prepare your staff for what is about to happen:
Your decision to adopt an EMR, is not made in a vacuum; it will have a great impact on your staff. Hold a meeting with them and discuss the project. Emphasize what they, your practice and patients will gain from having an EMR.

• A potential reduction in unbilled encounters. It is estimated that nationally approximately 2-3% of all encounters go unbilled – by utilizing AstralJet integrated EMR/PM software, unbilled encounters will be reduced, your office will be able to easily see all encounters entered and when they were billed.
• In time, all your records will be scanned and available to you and your staff when needed. Your charts are available online, which will change the workflow of the office.
• E-Prescribing will allow for quicker refills at the patient's selected pharmacy.
• Training – each user will be trained to ensure that they achieve a high level of proficiency with the Electronic Medical Records system.
• The readiness of the practice to achieve "Meaningful Use" for ARRA Stimulus payments.

Remind them that participation by everyone helps to ensure success. You are all in this together and will all work with each other to achieve this goal.

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Getting your infrastructure in place:

Internet: As we have stated before, AstralJet v4 is an internet based software. In order for your practice to get optimum speed and response from The AstralJet Electronic Medical Records / Practice Management software, a business level internet access is required. The AstralJet Systems Requirements Document outlines the necessary speed your internet service provider will need to supply.

Hardware: Your hardware needs can be determined by your sales representative or by an IT Contractor. Most practices will need a laptop for each provider, and a desktop for each user or group of users such as Front Desk, Medical Assistants, Check Out, Billing and the Office Manager. Your IT Contractor can also establish a wireless network, which will allow you to use your laptops without being tethered by a cable. Printers, scanners and other such devices can be purchased on the advice of your Sales Representative or IT Contractor.

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Devise a new workflow for your practice:
Implementing an EMR into your office will cause some changes to be made to the way your day to day functions are performed. In general terms, you will need to divide your office according to functions quite similar to the way it is currently – Check In, Intake, Exam, Check Out, plus Billing, and Office Manager.

Check In: The Check In clerk will handle all intake for the patient. They will create the patient file when the patient first arrives, confirm demographics, insurance information and perform eligibility if needed. Oftentimes, your Check In clerk will also function as your Check Out clerk as well as scan any incoming documents for the patient.

Intake: Your Medical Assistant will then measure and record Vitals and any other important functions needed at this time – such as blood draws, or medication checks.

Exam: This is where the provider sees the patient, review past visits, record his/her findings, make recommendations, prescriptions, referrals.

Check Out: Once the patient has been seen, they will be sent to the check out desk where payment is collected and recorded, the superbill is generated and printed, the follow‐up appointment is made and any orders, referrals or visit notes are printed for the patient. Oftentimes, your Check Out clerk will also function as your Check In clerk as well as scan any incoming documents for the patient.

Billing: Once the patient has been checked out and the note of the visit is finalized, the billing clerk would then be able to process and submit the bill to the insurance payer for payment. Once the claim is accepted and processed by the payer, the payment is sent back to the office, where it is entered into the patients account and settled.

Office Manager: The Office Manager is responsible for customizing the AstralJet v4 Electronic Medical Records / Practice Management software to ensure the smooth running of the practice.

Look for areas where there may be bottlenecks. Once such area may be the scanning of the old records - you may find that it might take too much of your staff's time to scan and index your charts especially for your long established patients. It may be worthwhile to look at outsourcing this function and have your staff only scan new patients plus any incoming results and records for existing patients.

Medical Messenger realizes that while medical practices may be similar, each practice has its own set of qualities that make it unique, and as such, your plan must be customized to meet those needs.

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Customizing your software:
Once you have established your new workflow process, it is important to recognize that AstralJet can be customized to meet the needs of your office. The first step in customizing is creating the user accounts for each of your staff members. Accounts for Providers and the Super Admin are created by the team at Medical Messenger. You will create the account for all other staff and assign their level of access based on your new workflow. Medical Messenger will also provide you with the access credentials for any of our partner company features, such as Dr.First's electronic prescribing and ClaimRemedi's claim submission. The next step is to configure the AstralJet screens. This includes InHouse Tests, Preventive Screen, Condensed Code Lists, Payer List and their payment schedules, Calendar settings etc. While the configuring of AstralJet should take no more than a few days of work on the part of your office manager, as a general rule maintaining your EMR is an ongoing task. It is often necessary to make some changes as your practice uses the software.

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Train your Staff:
In our efforts to minimize any disruption to your practice, Medical Messenger has developed an online course for each member of your staff. Each staff member will be required to register for this course. Our courses are comprehensive learning tools designed, to mimic each user's role. This allows for streamlined training of your staff, and best of all there are short quizzes at the end to ensure that knowledge is retained and learned by the user. Upon successful completion of each course a certificate is issued to the user and the office manager.

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Providers:
Providers using an EMR will need to ensure that the features most important to them are configured in a suitable manner. Configuring external features that enhance the EMR is crucial to success. Be sure that you have "trained" your voice recognition software and/or handwriting recognition on the tablet PC before you begin to document live data. Each provider can also create a favorites list of medications and corresponding dosage frequently prescribed. These small but important preparation steps will allow for a provider to spend more time with a patient and less time, trying to figure out how to enter the notes from the visit.

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Implement your new Workflow:
Now that your staff has been trained and your system configured, it is time to go live with your practice and your new AstralJet EMR/PM software!

At a minimum, enter the next day's patients into AstralJet. This way when your patient arrives, all that needs to be done is confirming the information that was entered and perform any eligibility checks if needed. All patients that are new to your practice will be entered directly into AstralJet, eliminating the need for a paper record altogether.

The patient will then flow through the office following your plan. During the first week of implementation, your practice may choose to reduce your patient load by as much as 50% (or an amount you feel is appropriate depending on the size of your practice). In the following weeks the patient volume can increased to 75%. Remember this will vary for each practice. Once the staff is comfortable with the new process, you would then continue to increase the load, until you have restored your regular schedule.

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Monitor your staff and office – maintain your system
You are now up and running! It is important to look at your process and workflow throughout the implementation of AstralJet. You may find areas that run smoothly and some that need work. Look for the areas in need of adjustment. You can do this by running reports to see productivity in areas such as electronic prescribing, claims submission and reimbursements. You can also look at areas of AstralJet that can be customized to suit your needs – Are all your InHouse tests and commonly performed Procedures listed in the appropriate areas? Does the Dragon voice recognition function as it should? Could it be that not enough time was spent "training" this application?

Creating and following a carefully constructed migration plan will not only ensure your success with Electronic Medical Records Implementation, but will also facilitate your staff's acceptance and participation in such an important time for your practice.

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