Guiding Principles. Mission: Vision: Values: Overarching Principles

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1 Guiding Principles To ensure that the organization effectively achieves these goals and objectives and experiences a uniformly successful implementation, we have developed a series of guiding principles for the EHR implementation. These overarching guiding principles are applicable enterprise-wide and all sites are expected to adhere to them. The Guiding Principles support Tanner Health System s overall Mission, Vision and Values: Mission: The mission of Tanner Health System is to provide a continuum of quality healthcare services within our resource capabilities; to serve as a leader in a collaborative effort with the community to provide health education, support services and care for all our citizens. Vision: Through the caring and dedication of our team of employees and physicians, Tanner Health System will be recognized as The Provider of Choice for quality accessible health care for our patients and our community. Values: Recognition that our CUSTOMERS come first. EDUCATION must be encouraged, supported and made available if we are to fulfill our dreams and reach our potential. We must all be lifetime learners. TEAMWORK is the basis of our organizational structure. Individual and corporate INTEGRITY shall never be compromised. Improving QUALITY must always be our focus. Our relationships with one another shall be founded on mutual RESPECT. The foundation for everything we do is CARING for people. As we subscribe to these values, we shall be Professionals in the Profession of Caring. Overarching Principles Foundation System Standardization: Good for patients. Good for Tanner Health. Represents best practices across all of the EHR s client base Is constantly growing and evolving: Incorporating feedback from customers. Expanding existing build. Implementing new functionality. Handling different application mixes. The EHR vendor will work with Tanner Health System to gather feedback on how to make the Foundation System better.

2 Operational Ownership: Everyone participates. Everyone communicates. Operational teams must own the implementation of the EHR system. Physician engagement will be a critical factor to the success of the HER implementation. Medical staff from a wide range of specialties and groups will be chosen to lead and participate with decision-making in all phases of the implementation, including design, build, testing, and training. Senior operational leaders, department managers and subject matter experts from across the Network should know the system and will play key roles in the success of their departments or specialty areas. Readiness programs will engage operational leaders throughout the project and prepare for ownership at Go-Live. Project Governance: Provide the framework to support decision-making and collaboration. This management framework will make critical project decisions, address risks and issues and ensure the project is kept on-track. Governing groups will be created to oversee critical project areas (e.g. physicians, clinical, revenue cycle, technical). Each governing group will have specific membership and responsibilities to provide effective leadership for the duration of the EHR project. Continuous Progress: Perfect is the enemy when great is good enough. Scope will be defined early to avoid scope creep. Workflows and system build will be standardized whenever possible. Patient Focus: When making decisions, we must all be the patient. While many perspectives go into the design and build, the perspective that may not be represented at the table is that of the patient. We must make decisions not just in the best interest of the patient, but as if we ARE the patient. Accountability: On time. On target. On budget. Any initiative as significant as the EHR Implementation, careful attention must be placed on keeping the project within pre-established guidelines. These include project timelines, financial goals and scoping considerations. Universal Adoption: When everyone is on board, no one gets left behind. Our new electronic medical record system will positively impact everyone at Tanner Health System and others throughout the region. Each of us will play an important role to help ensure that the EHR implementation is successful and that everyone adopts the new system. Physician leaders will act as champions for the EHR implementation, providing content feedback, expertise, and enthusiasm for the project to their colleagues and associates.

3 Supporting Principles Application Design The EHR Foundation System with its associated content and workflows will be leveraged to: Promote best practices. Increase operational efficiencies. Increase the quality of patient care. Reduce unnecessary variation. Meet all regulatory and Meaningful Use/Merit-Based Incentive Payment System (MIPS) requirements. Modification of the Foundation System will not occur except when necessary to address significant patient safety risks and regulatory requirements. Promote a paperless environment. Application design and build will favor enterprise-wide decisions when possible, while accounting for regulatory guidelines (e.g. rural health requirements). While there are operational differences across various clinics, system design and build decisions will be driven by consensus across the entire Network. Entity, specialty, and physician-specific requirements will be addressed through preference lists. Tanner Health System s facility time zones will be taken into account when designing and building the system. Tanner Health System will use the EHR validation sessions to confirm the system build and determine the potential impacts of the Foundation System on the operational workflows that the system supports. Given that the Foundation System is based on the EHR vendor s determination of the optimum practice content and workflows based on its many years of system design and implementation, it is the goal of the Tanner EHR project teams to realign workflows where necessary to align with the Foundation System, not vice versa. Patient demographic, clinical and financial information will be captured once electronically and shared across the enterprise wherever and whenever possible. Patient data will be entered into the EHR: By the person who captures that information so as to minimize transcribing errors. At the earliest possible point in the care process so as to minimize unnecessary delays and other impacts on the patient and on other users. The EHR software application code will not be modified in any situation unless authorized by the appropriate governance body. Clinical Design and Use All employed and affiliated physicians caring for patients in a Tanner Health System facility will use the EHR for: Medication, ancillary and patient care orders Clinical documentation Documentation and billing of services provided for all patient care in our facilities

4 All data necessary to meet Meaningful Use/MIPS and other regulatory reporting requirements will be captured electronically in the EHR. Minimizing or eliminating patient safety risks will always override other design and/or build considerations. Where appropriate, we will leverage the documentation templates and other clinical content provided by the EHR Foundation System. Any necessary additions or modifications to that content will be based on published, evidence-based care guidelines where available. We will work to ensure that build decisions, where configurable, minimize impact on clinician workflow (where not driven by patient safety issues, clinical best-practice or regulatory requirements). The project team will work with the appropriate clinical governing bodies to achieve the optimal balance for decision support, between system alerting and clinician annoyance and workflow disruption. Revenue Cycle Design and Use System build will incorporate known requirements to address regulatory compliance, payer reimbursement and accurate documentation of charges. Point-of-care tools will assist caregivers in selecting the most appropriate service codes. Subsequent review by coding and compliance staff of claims records before they are submitted will validate physician compliance, provide continuous education and minimize claims and compliance risks. Third party systems will be standardized across all facilities. Charge Description Master File (CDM) will be standardized across all facilities, with the understanding that different locations may have different fee schedules. System Access and Security Employee access to the EHR will be determined by a user s role and be configured so that they may function to the top of their licensure. Exceptions to the Tanner end user security criteria must be approved by the appropriate governance committee, in conjunction with the Tanner Health System Compliance Officer or department. System training and competency must be demonstrated in order to receive system access. Routine and random security audits will be conducted by Tanner Health System s Compliance department. Inappropriate access by employees to patient information or inappropriate disclosure of patient information obtained from the EHR system will be considered a violation of Tanner Health System s employee policies and will be addressed accordingly. A robust failover strategy is being developed to assure maximum system availability. Training EHR system training will consist of e-learning preparation, classroom-based training, scenario-based practice modules and other reference materials, developed and delivered by the Tanner EHR project team in advance of go-live. Effort will be made to accommodate users schedules, learning styles, end-user role and past

5 EHR experience, though all users will be expected to attend the full complement of classroom training and complete all of the independent practice modules associated with their scope of practice, unless they are able to demonstrate system proficiency. All users must be trained and pass a proficiency test. Users will not be granted access to the live EHR database until training has been completed and competent use of the system for a user s scope of practice has been demonstrated. Integration Like-for-Like Interfaces Systems that are interfaced to the legacy system today will be interfaced with the EHR upon go-live unless the functionality for the legacy system can be directly accommodated within the EHR suite of products installed. In general, systems that are not interfaced with the legacy system today will be considered in the Optimization phase post EHR go-live. These systems will be evaluated during scoping. Evaluation for these systems including; cost, resources, and timeframe can be completed upon submission of a scope change request. Legacy applications not being replaced by an equivalent EHR module will continue to be supported by IT. Integration with non-ehr Tanner applications will be built and supported provided that the benefits of that integration (i.e., reduced costs from duplicate data entry or improved patient safety) can be demonstrated and the integration does not impact the project s timeline, resources or budget. Integration will not take precedence over functionality Similarly, integration with applications outside of Tanner will be built and supported based on the associated benefits as well as the volume of patient data associated with each application, the extent to which the application leverages interface standards (typically HL7) and the readiness of the transmitting organization to accommodate the interface. Bio-medical device integration will be used to capture specified data points and assist care providers with intensive documentation needs. As noted with interfaces above, a like for like strategy will be followed for device integration as well. End-User Devices Device needs (including desktop PCs, laptops, tablets, handheld devices and wall-mount units, etc.) will be based off best practices by role and setting, and will be determined in advance of the go-live. System compatibility, usability and cost are also considerations for any new hardware deployed. Any currently installed devices that do not meet minimum EHR system standards will need to be replaced before the go-live dates. System Performance and Downtime The system will be available to users 24 x 7 x 365 except during scheduled periods of downtime.

6 The planned downtime schedule will be published to all users well in advance. If possible, Tanner Health System Information Systems (IS) will notify users of any unplanned downtime as soon as it is known. IS will also keep users informed regarding when the EHR is expected to come back online. All reports of poor application performance, system unavailability, application design concerns and requests for enhancement will be routed through the IT Help Desk so as to: Ensure prompt resolution leveraging the most appropriate resources. Identify, track and address performance issues, particularly those that may be impacting a wide user base. Evaluate, prioritize and implement system improvements that are deemed most critical to the organization s strategic priorities.