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					                                         Viewer




1=Below expectations (did not meet minimum requirements; not easy, very difficult)
2=Expected (met minimum requirements; moderately easy, minimal difficulty)
3=Above expected(met and exceeded requirements; very easy, not difficult)




Note: The three encounters have panes frozen. To see background material unfreeze panes
                                       Vendor
Vendors should be able to walk through these scenarios and demonstrate the extent
to which their system can execute with a minimum of "workarounds"


                                         Viewer

Rating Instructions: Note difficulties or ease in performing the all tasks, as well as
comments and/or questions that arise during the demonstration and score each task
using the following:

1=Below expectations (did not meet minimum requirements; not easy, very difficult)
2=Expected (met minimum requirements; moderately easy, minimal difficulty)
3=Above expected(met and exceeded requirements; very easy, not difficult)
Make sure to pay attention to the number of mouse clicks and screen changes it takes
to complete one task and check for visibility of key information and the intuitiveness of
the interface.


Note: The three encounters have panes frozen. To see background material unfreeze panes.
           Reviewer                    John Smith                                                     Department
           Position/Function           Physician                                                       Weighting



           Goals:                      Tailorability of First View                               Pre Conditions
                                       Test Clinical Protocols                                      Disposition
                                       Visit History                                                    Age/Sex
                                       Outstanding Test Review                                        Diagnosis
                                                                                                 Secondary Dx
                                                                                                       HPI Brief

                                                                                                       Allergies
                                                                                                Lab Test Status
                                                                                                   # Prev Evals

                                                                                                           Article




Sequence             Guideline                      Scenario                            Expected EHR


                                                      Event                              Performance
                                                                              EMR notifies clinician at least 48
                                       Clinician must note that upcoming      hours in advance that upcoming
                                       evaluation is for a XXXX               evaluation is for a XXXX
1          Pre-visit procedural prep   evaluation prior to the actual date.   evaluation.
                                       Clinician calls and instructs          EMR prompts nurse to call and
                                       residence/caregiver to bring typical   instruct residence/caregiver to
                                       lunch/snack and specific food /        bring typical lunch/snack and
                                       liquid consistencies the patient       specific food / liquid consistencies
                                       would usually eat 24-48 hours          the patient would usually eat 24-48
2                                      ahead                                  hours ahead
                                       Scheduler tells caregiver to bring     EMR prompts nurse to call
                                       in guardian to do consent if first     caregiver to bring in guardian to
3          Pre-visit admin prep        time visit                             do consent if first time visit
                                       Clinician ensures there is an MR
                                       and/or prescription present for        EMR displays scanned MR and/or
4          Pre-visit clinical prep     evaluation                             prescription for the evaluation
                                                                              EMR pushes prior medical or
                                       Clinician reviews prior evals if       other evals to us or we can pull
5                                      available                              them e.g., OT from the EMR
                                       Make sure we have various              EMR would remind nurses or
                                       adaptive utensils/equipment and        clinician that morning to do this
6          Additional clinical prep    kits available prior to eval           with a checklist
                       Pt arrives and we wait for front
                       desk to page us that pt is there.
                       We have to call back front desk      Computer "Pings", informing us
7    Patient arrival   until we reach them.                 that a pt has "arrived"


                                                            EMR pushes prior history from last
                                                            eval or other disciplines/areas into
                                                            historical sections of this exam;
                                                            clinician reviews pushed data with
                                                            caregiver. EMR allows clinician to
                       Do assessment: Get hx usually        add additional information from
8    Session           from accompanying caregiver          case history to report, if needed.


                       Proceed with testing of XXXX,       EMR prompts testing of xxxx eval
                       eval and write data: motor,         and allows clinicain to fill in data:
                       awareness/                          motor, awareness/control,
                       communication/cognition,            communication/cognition,
9                      evaluation                          evaluation
                                                           EMR prompts you to document
                                                           your review with pt/family about
10                     Speak with pt/family about findings findings
Walk in?(unnannounced)
Wheelchair bound
45 year old male
Bi Polar Disorder
Mild-Moderate Dysphagia Suspected
CP
Considering Increasing Medications
Possible Adverse Reaction to Lithium
Had Lithium Lab Test Last Visit?
?
Request medical Assistant?
28



                                                                         SCENARIO


                                            Importance       Demo Performance Rating


      Function Getting Tested              1-5 (5 highest)   1 = below, 2 = expected, 3 = above
 Alerts/Information Presentation     
Documentation                        
Consent Tracking & Management       
Patient look-up                                  4                          1


Patient Instructions
Documentation

                                                 5                          2
 Alerts/Information Presentation    
Documentation                       
Consent Tracking & Management                    5                          3
 Reminders
 Alerts
 Order and Results functioning                  4                          _
 Reminders
 Alerts
 Evaluation Template functioning                4                          _
Reminders
Alerts
 Protocol Prompts                               4                          _
 Check-in function
 Check-in notification
                                         3   _


 Evaluation Template populates with
date from previous evaluations and
other disciplines into HX sections for
this exam
 Reporting
 Case History
                                         4   _




 Evaluation Template
 Documentation flow
 Protocol for evaluation alert          4   _


 Documentation prompts/alerts           3   _
O

                      Weighted     Ease of Use      Task                                       Intuitiveness of
    Below Expected
    Expected         Performance           Time            Visibility of        Workflow                                  Systems
    Above Expected      Score           Navigation       Key Info        (   Compatability 2   Interface    3
                                     1,2,3, Scale -->      1 = below,          = expected         = above )
                                                                                                                  E-PMS




         1               4                  1                    1                 1                  1




         2               10



         3               15


         _           #VALUE!



         _           #VALUE!


         _           #VALUE!
_   #VALUE!




_   #VALUE!




_   #VALUE!


_   #VALUE!
Systems                     Workflow Elements


  EHR     BHIS   Decision     Form   Data/Info   Thought   Importance
        Generalized System Selection Criteria (Helps us:)




1. Streamline Workflow




2. Reduce Duplication of Effort



3. Consolidate data and data sources


4. Embraces rules, protocols, best practices



5. Improve data quality, information quality, decision quality


6. Convert and standardize human expert systems and avoid dilution of expertise
7. Unify approach to Article 28 & 16 Primary Care and Behavioral Health




8. Supply business intelligence, analytics and reporting




9. Support Organizational growth


10 The system has the capacity to "grow with us"
           Reviewer
           Position/Function



           Goals:




Sequence                        How Should EHR



                      Event    Manage These Tasks   Function Getting Tested
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
    Department
     Weighting


Language
Pre Conditions
Disposition
Age/Sex
Diagnosis
Secondary Dx
HPI Brief
Plan
Allergies
Lab Test Status
# Prev Evals

Article       28 & 16
Equipmnt need


                                             SCENARIO


                                                                   Below Expected
                                                                   Expected
  Importance            Demo Performance Rating
                                                                   Above Expected


1-5 (5 highest)         1 = below, 2 = expected, 3 = above


                                                                                    0
                                                                                    0
                                      N/A                    N/A
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
0
0
0
0
0
           Ease of Use                                       Intuitiveness
            Task Time        Visibility of     Workflow            of                Systems                     Workflow El
             Navigation        Key Info      Compatability     Interface
          1,2,3, Scale -->   ( 1 = below     2 = expected     3 = above )

 Score                                                                       E-PMS     EHR     BHIS   Decision
   0
   0
   0
#VALUE!
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
0
0
0
0
0
Workflow Elements



  Form   Data/Info   Thought   Importance
                         Generalized System Selection Criteria (Helps us:)
1. Streamline Workflow
2. Reduce Duplication of Effort
3. Consolidate data and data sources
4. Embraces rules, protocols, best practices
5. Improve data quality, information quality, decision quality
6. Convert and standardize human expert systems and avoid dilution of expertise
7. Unify approach to Article 28 & 16 Primary Care and Behavioral Health
8. Supply business intelligence, analytics and reporting
9. Support Organizational growth
10 The system has the capacity to "grow with us"
           Reviewer
           Position/Function



           Goals:




Sequence                        How Should EHR



                      Event    Manage These Tasks   Function Getting Tested
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
    Department
     Weighting


Language
Pre Conditions
Disposition
Age/Sex
Diagnosis
Secondary Dx
HPI Brief
Plan
Allergies
Lab Test Status
# Prev Evals

Article       28 & 16
Equipmnt need


                                             SCENARIO


                                                                   Below Expected
                                                                   Expected
  Importance            Demo Performance Rating
                                                                   Above Expected


1-5 (5 highest)         1 = below, 2 = expected, 3 = above


                                                                                    0
                                                                                    0
                                      N/A                    N/A
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
                                                                                    0
0
0
0
0
0
           Ease of Use                                       Intuitiveness
            Task Time        Visibility of     Workflow            of                Systems                     Workflow El
             Navigation        Key Info      Compatability     Interface
          1,2,3, Scale -->   ( 1 = below     2 = expected     3 = above )

 Score                                                                       E-PMS     EHR     BHIS   Decision
   0
   0
   0
#VALUE!
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
   0
0
0
0
0
0
Workflow Elements



  Form   Data/Info   Thought   Importance
                         Generalized System Selection Criteria (Helps us:)
1. Streamline Workflow
2. Reduce Duplication of Effort
3. Consolidate data and data sources
4. Embraces rules, protocols, best practices
5. Improve data quality, information quality, decision quality
6. Convert and standardize human expert systems and avoid dilution of expertise
7. Unify approach to Article 28 & 16 Primary Care and Behavioral Health
8. Supply business intelligence, analytics and reporting
9. Support Organizational growth
10 The system has the capacity to "grow with us"
Question #                                         Questions
             How does the system separate article 28 & article 16 activities and data for;
    Q1       Audits/Auditors; Statistical Purposes; Reporting…
    Q2       Explain depths and ranges of eligibility checking:
                                Is it native to the system or does it require additional software?
                                                                            Is it real time-on-line?

              If yes which payers can it accommodate? Which exchange or submit digital data
    Q3       How does system collect data in a pre-registration pre-tx mode
             What are the capabilities for real time bi-directional interfaces to local databases
   Q4        as well as to top 20 behavioral health systems
   Q5        How do you handle database conversions from local databases to EHR
   Q6        Provide a complete explanation of full breadth of referral management
   Q7        How does system handle incident reporting?
   Q8        How is weight management handled? (needs more definition)
   Q9        How does the EHR trigger protocols?
   Q10       How is ordering, OT and PT recertification with dates accomplished?
   Q11       How does the EHR construct manage and execute business rules?
   Q12       Demonstrate the handling and functions associated with user defined fields
   Q13       Capabilities to maintain and manage waiting lists for residencies/services
             How does EMR absorb functions of RFS and referral tracking form so that
             record of registration and referral status may be maintained within the EMR. PSS
             staff must be able to pull up referrals based on status for each service and also
   Q14       tie all requests to the patient record.
             How does system accommodate & implement regulations/accommodate
   Q15       ongoing changes in regulations
   Q16       How do requests for services,Rx and orders get handled in system?
             How is Care and Treatment Management handled? By Add-on Module
   Q17       (e.g.Kryptique) or in native system functions?
   Q18       Chart Number/MPI/Unique Identifier reconciliation. How is this handled?
   Q19       Is clinical decision support integrated? How does it function?
   Q20       How does the system assist with "screening" patients (e.g. mental health)
   Q21       Can system handle group services? How?
   Q22       How are notes and superbill connected?
   Q23       What are the time controlled elements in system/signatures/tx plans…etc.
   Q24       What do the audits audit, how are they reported, and impact on system?
   Q25       How is system used to assist with compliance audits? Who's done it?
   Q26       What are levels of relationship to patient the system can accommodate?
   Q27       What are the internal resources required to manage and run the system?
   Q28       What levels of effort are required for data integrity and data quality?
   Q29       How would it track activities in our residential business?
   Q30       What are the controls on source and target of alerts, reminders & triggers
   Q31       Explain your template indexing/accessing scheme
   Q32       Explain your scanning indexing/accessing/conversion to data scheme
   Q33       How does the system help evaluate, analyze and manage patient cycle time
   Q34       How do you show us how the system "grows with us"?
       Rating           Category       Comments

Critical             Demo Needed
Highly Important     Demo Needed
Important            No Demo Needed
Important            No Demo Needed

Highly Important     No Demo Needed
Important            Demo Needed

Highly Important     Research Needed
Highly Important     Research Needed
Important            Demo Needed
Somewhat Important   Research Needed
Important            Demo Needed
Highly Important     Demo Needed
Important            Demo Needed
Important            Demo Needed
Important            Demo Needed
Important            Demo Needed



Highly Important     Demo Needed

Important            Research Needed
Highly Important     Demo Needed

Highly Important     Demo Needed
Critical             No Demo Needed
Highly Important     Demo Needed
Important            Demo Needed
Important            Demo Needed
Important            Research Needed
Somewhat Important   Research Needed
Somewhat Important   Demo Needed
Important            Research Needed
Somewhat Important   Research Needed
Important            Research Needed
Important            Research Needed
Somewhat Important   Research Needed
Important            Demo Needed
Important            Research Needed
Somewhat Important   Demo Needed
Important            Research Needed
Somewhat Important   Research Needed
     Term or Abbreviation
Article 16



Article 28
NYSDOH
MRDD
OMRDD
PSD
PSS




Triage Team




WF
                                      Definition
Public Health Law providing guidelines for MRDD services
Public Health Law that provides guidelines for the certification of clinics and the basis of
payment based upon the "threshold visit". Guidelines include; basis of
payment;documentation of services; scope of services; reports of services
State Department of Health
Mental Retardation Developmental Disabilities
Office of MRDD
Patient Services Department
Patient Services Specialist
combination of patient services and clinicians that determines eligibility and makes
requests for services
General activities of triage team
  The triage team: updates the Referral Tracking Form, changing the status and
 disposition of the service as appropriate.
  Enters comments in a text box on the Referral tracking form to reflect
 communication with person requesting the service, clarify determinations, etc.
  Enters comments into General Comments text box in E-PMS alerting anyone
 scheduling to certain information (e.g., this patient needs sign language interpreter,
 this patient has been discharged).
  Referral is forwarded to assigned for f/u
Workflow
                                       Questions

      · What is the system's ability to manage medications administered
Q1    and produce a medication administration record (MAR)
      ·    What is the system's ability to capture unique demographic, contact
      and consent information. For example, many individuals served are
      unable to provide informed consent and rely on others e.g., family
      members, advocates, guardians, etc. or are members of a court defined
      “class” and therefore, have external representation by parties
Q2    established by the court.

      ·      What is the system's ability to create a “ready to go” package of
Q3    information for accompanying any emergency hospital visit
Q4    ·      What is the system's ability to print the entire medical record
      ·      What is the system's ability to record and monitor Activities of
Q5    Daily Living (ADL)
Q6    ·      What is the system's ability to operate as a legal document

Q7    ·     How does the system customize workflow and manage workflow
      ·     What are the Behavioral Healthcare features including features for
Q8    developmental disabilities care and MR care

Q9    ·     How does the system accomocate Long Term Care Functions
               How does the system accomocate patient health history
      information including the exact nature of the “developmental disability”
Q10   and/or other chronic medical conditions
      ·       What is the system's ability to create an overall health care plan
      that addresses all current medical and/health conditions with associated
Q11   treatment plans and records of treatments
      ·       What is the system's ability to create a list of all of the patient’s
Q12   current health care providers
      ·       What is the system's ability to accommodate a file system for
Q13   referral documents with a built-in tracking system for follow up.
      ·        What is the system's ability to maintain all laboratory and
Q14   diagnostic testing data and current medications
      ·      Please describe how your solution or suite of solutions addresses
      the unique needs of my practice. Specifically, how does your solution
      accommodate both long-term care/in-patient, MRDD and ambulatory
Q15   care treatment and service requirements?
      ·     What is the number of client installations in practices similar in size,
Q16   specialty, etc. to my practices using your proposed system?
      ·     Please provide a complete client list of practices similar in size and
      general profile to our practice currently operational on the proposed
      EMR and PMS. Provide names of individuals who will have sufficient
      experience to speak knowledgeably concerning such issues as the
      implementation process, product functionality, response time, vendor
Q17   support, and documentation and training?
Q18   ·     Interface Capabilities
      a.     What types of interfaces are currently available? Please list the
      systems and/or products to which you currently have operating
      interfaces.
      b.     Describe the process of creating new interfaces.
      c.    Describe your overall approach to developing, testing,
      implementing, and upgrading system interfaces to other third-party
      systems.

      d.      Discuss any limitations/issues regarding your willingness or ability
      to interface/integrate your product with the systems that send us data.
      e.      Does your product accommodate an interface engine? If so please
      explain?
Q19   ·      Report Generation and Tools
      a.      What is your system's ad-hoc report writing utility with access to all
      databases?
                           i.    Is this a third-party package?
                          ii.    Is the same report writer used for all applications?
      If not, indicate the differences.
                          iii.     Are all data elements (including user-defined
      fields) available for report writing?
                            iv.      Is a data defintion library included? Is it
      comprehensive?
      b.      How can third-party report writing software be used to access
      information within your system? How and which packages are
      supported?
      c.      Please describe your reporting capabilities. How much technical
      knowledge is required for a general user responsible for analytical
      reporting?
      d.     Ad-hoc Reporting
                i.     How can your clients perform ad hoc reporting without
      vendor assistance?
                ii.   How can non-IT users use the ad hoc reporting tool?
                 iii.   What type of special training is needed for your report
      writing tool?
Q20        ·        How does it force completion of notes
          ·     How does it pre-populate pt info into every document, form, request,
Q21       etc. we work on
          ·    How does it hanlde permissions to allow work to proceed
Q22       without prerequisites met (Rx for the service; txmt plan)

          ·    How does it assess Quality at the individual level – follow individual pt
Q23       parameters over time to analyze indiv pt trends and spot outliers
          ·   How does the system aggregate QA/UR (and dump results
Q24       automatically into reports we format)
          · How does the system: enable mgrs to easily formulate QA
Q25       questions and run searches themselves
             · Put in the parameters, have a “random search capacity” to
             sample charts
             · Once we see a report, to be able to drill down from that back
             to the individual level (e.g. report on outliers, want to drill back
             and look at some of the outliers’ charts)
          ·    How does the system accommodate work from the field (nutrition, OT,
          PT, SP) PDA? Tablet? Laptop? Wireless? What manner of
Q25       Datadump/Synchronization does the system use?
      ·    What is the systems's ability to replicate CMS data-mining protocols
Q26   proactively

      ·      Recognizing that EMR doesn’t prevent us from breaking regs
      (treatment proceeds without a svc Rx, a treatment plan, or a PPD). –
      what do users of the system do in the compliance dept assigned to
Q27   ensuring EMR does all we need from a compliance standpoint?
      ·      How does vendor guide users in having backup plans ready
Q28   for when the system crashes

      ·       How does the system navigate the different rules correctly as
      we move between Art 16 and 28 (some clinicians are both) – How
Q29   can it do different sets of rules for diff clinics, diff disciplines?

      ·      How does the system accomodate clinicians from one clinic to
      easily access info from another clinic without a lot of steps (psych –
Q30   MH; nutrition – medicine; obesity clinic providers)
      ·      How does the system assist Helping technologically-struggling
Q31   providers
Q32   ·      Ease of modifying discipline templates: initially, later on
      ·      how does the system accommodate multiple simultaneous
Q33   customers of the same view
Q34
Q35
Q36
Q37
Q38
Q39
Q40

				
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