DRAFT STAKEHOLDER INTERVIEW GUIDE

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					Appendix B
Initial Stakeholder
Consultation Questionnaire
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative


        Phase I: Initial Stakeholder Consultation Questionnaire

Introduction
On behalf of Health Canada, Greymartin Consulting has been contracted to develop and
disseminate a Toolkit to support the implementation of Electronic Medical Records in multi-
disciplinary primary health care settings across Canada. The project is starting with a
consultation phase to identify stakeholder needs and preferences -- we would appreciate your
assistance in ensuring that the Toolkit will be comprehensive and useful. Your comments are
extremely valuable to this process and we greatly appreciate your taking the time to complete this
survey.
The survey takes approximately 30-40 minutes to complete. If you would prefer to set up a
telephone interview, please let us know by phone at: 250-920-3560, or email:
emrtoolkit@greymartin.com.

For more information please refer to the project website at: www.greymartin.com/emrtoolkit.

Part A: Identification of EMR implementation needs
We have identified a number of areas in which we think there are needs that should be addressed
by the toolkit. In order to prioritize these, and to identify any additional priorities, you will find
below a list of statements regarding the items we think should be included in the toolkit.

Using a scale of 1 to 4, where 1 = Strongly Disagree, and 4 = Strongly Agree, please mark
the response that best describes how you feel about each statement. For the purpose of
these statements the word “support” includes providing guidance, resources, policies,
procedures, templates or checklists as appropriate.
                                          Scale: 1 = Strongly Disagree; 2 = Disagree; 3 = Agree; 4 = Strongly Agree
Change Management – Integrating an EMR into daily practice
General Change Management

The Toolkit should support a primary health care clinic to:
A1  Identify reasons for wanting to use an EMR. E.g., Why implement an                                   1234
    EMR? How will the primary health care practice benefit? What needs
    and objectives will the EMR help the clinic to meet?
A2 Assess readiness for change. E.g., How prepared is the primary health                                 1234
    care practice for this change?
A3 Identify and manage changes in office processes and procedures to                                     1234
    support the use of the EMR. E.g. ―Process change management‖— what
    must be done differently, and by whom, when moving from paper-
    based to electronic appointment scheduling and clinical charting?
A4 Engage in personnel change management. E.g., what new                                                 1234
    work/staff/training is required to effectively use an EMR?
A5 Educate and support the clinic’s patients through the transition to an                                1234
    EMR. E.g., Sample posters, handouts etc..
Change Management Related to Workflow
A6 The toolkit should include support for work assignment. E.g., Allocation                              1234
    of work among all staff members.



Appendix B – Initial Stakeholder Consultation Questionnaire                                                      2
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative


A7  The toolkit should include support for workflow. E.g., How work flows                               1234
    between staff members.
A8 The toolkit should include workspace redesign. E.g., How the office &                                1234
    exam rooms may need to be laid out to fully support EMR use.
Change Management Related to Implementation
A9 The toolkit should include details of effective implementation planning                              1234
    techniques. E.g., phased, vs. big bang.
A10 The toolkit should include details of training models and training                                  1234
    requirements. E.g., Cross-over training vs. role based training
A11 The toolkit should contain optimization processes for quality and                                   1234
    continuity of care. E.g., performance measurement, evidence-based
    outcomes management for target populations.
A12 The toolkit should contain optimization processes for planning and                                  1234
    accountability. E.g., clinical governance.
A13 The toolkit should contain optimization processes for clinical decision                             1234
    support. E.g., contraindications, recall and follow-up reminders.
A14 The toolkit should contain optimization processes for management and                                1234
    sharing of information. E.g., internal messaging.
A15 The toolkit should contain optimization processes for ensuring data                                 1234
    quality. E.g., data coding and quality standards.
                                          Scale: 1 = Strongly Disagree; 2 = Disagree; 3 = Agree 4 = Strongly Agree
EMR Selection & Procurement – Choosing hardware, software, and a vendor

The Toolkit should provide support for selecting a system that:
A16 Meets the clinic’s needs and objectives. E.g., Identifies common                                    1234
     requirements and objectives, and helps the clinic to define their own
     needs and objectives.
A17 Can be customized to meet their local needs and to support successful                               1234
     implementation. E.g., Provision of templates and protocols.
A18 Can support the clinic’s growth over time.                                                          1234
A19 Helps the clinic to apply clinical coding standards. E.g., provides                                 1234
     information to improve data quality and standards for coding clinical
     problems, encounters & episodes of care (e.g., ICD, SNOMED) in
     addition to Billing codes.
A20 Helps the clinic to apply best practices of care. E.g., the EMR includes                            1234
     alerts/recalls/reminders to support care delivery – i.e. allergy warnings,
     drug contraindications, identification of patients recommended for
     recall for flu vaccination, pap tests, etc..
A21 Provides clinical reference tools. E.g., drug formulary information,                                1234
     clinical guideline lookups, common calculations (e.g. cardiac risk
     assessment tools)
A22 Helps a clinic to communicate electronically with other health care                                 1234
     providers and organizations. E.g., securely obtaining and sharing
     patient information for direct patient care, referrals, or patient transfers.

The Toolkit should contain recommendations, guides, and checklists for:
A23 Evaluating vendor software, proposal responses and price quotes. E.g.,                              1234
     assessing the EMR product against the clinic’s needs; assessing the
     vendor company’s stability and support capabilities.


Appendix B – Initial Stakeholder Consultation Questionnaire                                                     3
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative


A24 Contracts and contract negotiating. E.g., Standard contract terms,                                  1234
    conditions, key issues and potential areas of concern.
A25 Interoperability standards / industry standards. E.g. How to identify                               1234
    relevant standards, and assess EMR vendor compatibility/compliance
    with provincial and territorial standards.
A26 Entering into a service level agreement (SLA) with the vendor. E.g.,                                1234
    What services will the vendor provide as part of their contract with the
    clinic, with respect to support, maintenance, and upgrades of the
    software, hardware and network? What obligations does the clinic have,
    and what obligations does the vendor have? What is the process and
    timeframe for obtaining support, and resolving problems?
                                          Scale: 1 = Strongly Disagree; 2 = Disagree; 3 = Agree 4 = Strongly Agree
EMR Implementation Aids – Technical / Procedural aspects of implementing EMRs

The Toolkit should contain recommendations, guides, checklists, sample policies and
procedures for:
A27 Planning and coordinating each step of the implementation.               1234
A28 Privacy and security                                                     1234
A29 Patient consent                                                          1234
A30 Data backup and archiving                                                1234
A31 Document retention                                                       1234
A32 Legacy (paper) data migration requirements                               1234
A33 Calculating space, network, and electronic storage requirements          1234
                                          Scale: 1 = Strongly Disagree; 2 = Disagree; 3 = Agree 4 = Strongly Agree
EMR Post-Implementation
A34 The toolkit should contain support for evaluating the effectiveness of                             1234
    the EMR after implementation. E.g., Helping to assess whether or not
    the EMR is helping to meet the clinic’s implementation goals and
    objectives, and whether or not the clinic is making the most of the
    capabilities of the EMR.

A35     Please list and rank any additional areas that you would like to see included
        regarding:
         Change Management;
         EMR Selection & Procurement; and
         EMR Implementation & Post-Implementation supports




Appendix B – Initial Stakeholder Consultation Questionnaire                                                     4
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative


Part B: Identification of existing EMR implementation and
        change management projects and supports
Thank you for completing Part A. Part B asks questions about projects you and your
organization are aware of, or have been involved in, regarding EMR implementation in primary
health care. We are interested in identifying and collecting information on projects and
resources that are underway or are already developed.

                                                                        Please circle the appropriate response
Are you aware of any resources related to:
B1     Identifying needs and issues associated with EMR implementation?                         Yes     No
B2     Supporting EMR selection and procurement?                                                Yes     No
B3     Supporting EMR implementation?                                                           Yes     No
B4     Supporting change management (e.g., “Practice redesign” or “Office                       Yes     No
       redesign”) for integrating EMRs into primary health care practice?
B5     Recommendations, requirements, models or standards for privacy,                          Yes     No
       security, document retention or patient consent?

B6      If you answered yes to any of the above questions please provide more details –
        What are the resources? What do you like/dislike about them? Who would we
        contact to obtain more information (contact details?)?




Appendix B – Initial Stakeholder Consultation Questionnaire                                                 5
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative




B7      Are you aware of any other projects, programs, resources or EMR
        implementation supports which may be helpful in the development of the
        toolkit? For instance, we are aware of, or have copies of materials prepared by
        Alberta’s POSP, the OntarioMD Transition Support Project, the CMA’s online
        Privacy Toolkit, and the American Academy of Family Physicians Center for
        Health Information Technology. What other projects or resources can you
        identify? Can you provide us with a brief description and contact information?




B8      What other materials (e.g. people, literature, resources, toolkits, or websites) can
        you point us to?




Appendix B – Initial Stakeholder Consultation Questionnaire                                              6
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative



Part C: Identification of Canadian EMR-related Success Stories
Thank you for completing parts A and B. We are now interested in finding specific examples
of successes related to implementing EMRs in multidisciplinary primary health care
settings. What initiative(s) are you aware of, or have you been involved in, which have been
successful? Why are they successful? What lessons can be learned which should be incorporated
into similar projects across Canada?

If you are not directly involved with one of these Success Stories, who should we contact for more
information about the Success Story/ies?
         Project Name: ____________________________________________
                          ____________________________________________
         Contact:         ____________________________________________
                          ____________________________________________

If you can provide more information on Canadian Success Stories, please complete the
questions below. Otherwise, skip to section D.

C1      What is the name of the EMR related initiative and in what setting was it
        implemented (i.e. PHC model, funding and remuneration mechanism,
        governance structure)?




C2      Please provide a brief description of the project.




C3      Why do you consider this project a success? Are there any results available
        which demonstrate clinical effectiveness, health outcomes, improved provider
        satisfaction or other benefits?




Appendix B – Initial Stakeholder Consultation Questionnaire                                              7
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative



C4      How is the EMR used to support primary health care practice? Does it involve
        multi-disciplinary teams? If so, how?




C5      How is/was change management addressed?




C6      What do you think are the lessons that can be/have been learned from this
        initiative?




C7      What do you think the major issues are/have been in this initiative?




C8      What are the next steps for this initiative?




Appendix B – Initial Stakeholder Consultation Questionnaire                                              8
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative


Part D: Toolkit project planning, development and
        implementation
Please help us to identify gaps, redundancies, or missed opportunities related to the project.

D1      Are you interested in participating in one or more of the following special
        interest working groups that will be established as a part of this Project?

        1. Change management – human, process, technology                           Yes                 No
        2. EMR selection & procurement                                              Yes                 No
        3. EMR implementation/post-implementation support                           Yes                 No

D2      Who do you think are the key target audiences are for the toolkit? (please list)




                                          Scale: 1 = Strongly Disagree; 2 = Disagree; 3 = Agree; 4 = Strongly Agree
How do you think the Toolkit should be disseminated to the target audience(s)?
D3 Via a website                                                                                         1234
D4 In paper form                                                                                         1234
D5 On CD-ROM                                                                                             1234
D6 Through provincial/regional workshops                                                                 1234
D7 Others? (please list)




D8      How do you think the toolkit should be evaluated?




Appendix B – Initial Stakeholder Consultation Questionnaire                                                      9
Supporting Implementation of Electronic Medical Records in Multi-disciplinary Primary Health Care Settings
               A Health Canada sponsored Primary Health Care Transition Fund Initiative



D9      Please feel free to make any additional comments here regarding any aspect of
        the toolkit development, dissemination or evaluation.




D10     Please provide your name and contact information:

Name:
Title:
Organization:
Address:
City/Province:
Postal Code:
Tel:
Fax:
Email:


THANK YOU
Thank you for your time. We greatly appreciate your taking the time from your busy
schedule to assist us. Please return your completed survey by email, to
emrtoolkit@greymartin.com, or by fax to 250-920-5771. We will be in touch by phone or
email to arrange a brief follow-up discussion about your survey response.

If you would prefer to respond through a phone interview, please call (250-920-3560) or
email (emrtoolkit@greymartin.com) to schedule a time.

For further information on the development of the Health Canada EMR Toolkit please
visit the project website at: www.greymartin.com/emrtoolkit. More information will be
made available at this site as the project develops.



Appendix B – Initial Stakeholder Consultation Questionnaire                                             10