product evaluation his

Purchasing ‘HIS/HMS integrated with EHR’ can revolutionize your healthcare facility, Improve revenue across the facility and drive real results in revenue, brand building and customer loyalty. But how do you find where to start?

Hospital Information System

Evaluation Checklist

w w w . l i f e t r e n z . c o m

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Table of Contents

Introduction 2

Chapter 1 - Self-Assessment 2

Chapter 2 - Goals & Planning 4

Chapter 4 - Vendor Evaluation 5

Chapter 5 - Product Evaluation 6

Who we are & What we do 10

His Evaluation Checklist1

Self assessment


Chapter 1

“Purchasing ‘HIS/HMIS integrated with EHR’ can revolutionize your healthcare facility, Improve revenue across Facility, and drive real results in revenue, build brand and customer loyalty. But how do you know where to start?”

Choosing a HIS/HMS solution is an important decision: not only is it a significant investment in time and resources, the system you choose will have an enormous impact on the daily activities of both your clinical and non-clinical teams. So it’s important to conduct the proper research and go into the process with the right questions in hand.

The following three chapters will help you build a framework for evaluating vendors, figure out questions to ask each, and find your perfect solution — in three steps:

Self-AssessmentGoals & PlanningVendor / Product Evaluation

You’ll start by evaluating your own business strategy to determine your particular needs and priorities, then take a closer look at the many features of HIS/HMS and EHR, and what specific attributes

to look for in each.The questions provided can help you to identify the factors that truly differentiate one vendor from another, and determine how to choose the product that most closely aligns with your needs

“Analysing the processes you currently have in place will help you pinpoint areas that can be improved with an EHR solution.”

84% of top performers are “using” or “planning to use” EHR Solutions from 2012 to 2015. (HIMSS, September 2012)

Introduction


Answer the following questions about your current processes and strategy to help you identify areas that can be optimized:

What are your current strategy to build your brand and create customer Loyalty? (Your Patient portal, Patient Mobile app, Interoperable Patient EHR records, Patient Lifecycle management and tracking, Patient engagement with Lifecycle communication)

What are your current strategy, for Avoiding Clinical Errors and managing Medico Legal Cases? (Clinical decision support Systems, Clinical Pathways with Defined Clinical Protocols &Order sets, Electronic Clinical records & Notes accessible & available anytime anywhere)

What are your strategy to ensure Quality of Healthcare delivery, high turnaround of clinical support staff lowering cost of clinical staff? (Clinical decision support Systems, Clinical Pathways with Defined Clinical Protocols & Order sets)

What are you strategy to comply with the Government of India regulation on the EHR Standards to be Used? (Procure a HIS with Integrated EHR, Upgrade my Current HIS)

How do you intend to improve your Efficiency and Revenues? (Automated Patient Centric Cross department workflow, Use smart EHR to Measure& monitor Clinical, Financial & Operational Efficiency)


In order to properly prepare for the search phase,it’s important to discuss EHR initiative with all departments that will be affected and define the specific requirements of each. Use the following questions to plan how both Clinical & Non Clinical departments will use EHR Solutions and reap the benefits:

Who are the people in your company that can be part of a core team, to take respective department ownership for the EHR implementation and adoption?

Who in your organization can be champion for Clinical and non-Clinical processes? The Operation Head for non- clinical and the senior-most Physician for Clinical would be the right choice from experience.

Who in your organization can be responsible to define Order Sets /Clinical protocols? Normally these is a team of Physicians managing Quality.

Goals & PlanningChapter 2 “Once you’ve outlined your current processes, it’s time to

define what you hope to achieve with implementation and plan out your strategy.”


Who can define the List of ‘Patient life Cycle’ for conditions your facility specialize in, and further define the Milestones, Patient activities &communication to the patient?

What are your current KPIs, and how can you show each department’s value?

What are the Short term goals that can be achieved with an EHR integrated HIS?

What are the long term goals that can be achieved with an EHR integrated HIS?

Vendor EvaluationChapter 3

“After you’ve done a little preliminary research, it’s time to sign up for some product demos to learn about the features and capabilities of each EHR platform.”

Comparing features across various solutions can help you understand what you’ll be able to achieve with each platform, and how these capabilities align with your goals. Here are a few questions to keep in mind as a sales rep demonstrates his or her product:

Is the demo live?A live demo can tell you about more than just the product’s capabilities— it can show you the pace at which the product will function. If a sales rep shows you screenshots of what can be done instead of demonstrating the capabilities him or herself, it could be a sign that they’re concerned the product will freeze up or not perform accurately in the demo.


Does it cover the basics?You’ll begin to notice differences between platforms as you continue to explore your options, but all EHR platforms should include some basic capabilities.

What are the Delivery Mechanism available with the Vendor?While ‘On Premise’ installed solutions were the most popular till sometime back, most new age solutions also offer more modern delivery options such as Public Cloud and Private Cloud environments, which can give you considerable saving on capital Investment and ongoing cost in managing servers. Look for a vendor who provide all the above 3 option to ensure you can make the choice suitable to you.

While traditionally payments for such solutions have been a one-time License Fee with an annual AMC, new age solutions can also offer you monthly subscription model or even a transactions (# of OP / IP /Pharmacy Bills) based billing model. This can bring down you CAPEX to zero and a variable OPEX linked to your operations and revenue, which will reduce your investment risk. Again look for vendors who offer all 3 models, so that you can choose between what is best for you.

Download : ROI of EHR Integrated HIS

Product EvaluationChapter 4

Does the EHR incorporate all the Essential Features?

In each demo, look for these essential features of a complete EHR Platform:

• Integrated HIS with EHR• Patient centric Workflows• Clinical Decision Support System• Integrated Drug Information Framework & Drug database• e-Prescription Capability• Immunisation Management• Clinical Care Pathways• Clinical Documentation• Patient Lifecycle management• Patient Portal• Interoperable & EHR standards compliant Patient Health

Records• Dashboards for Financial, Operational & Clinical Efficiency

Use the questions on the following pages as you walk through these features to help you start conversations and find out what you need to know about each.

Remember: based on your needs, a sales rep may not show every feature — if you aren’t sure, just ask!

http://www.lifetrenz.com/roi_of_ehr_integrated_his.html


Questions to Judge the Capability of each Feature

Integrated HIS with EHR1. What is the vendor offering – is it an EHR or an EMR? (Remember

what you are looking for is an EHR - Download the paper on differences between an EHR & EMR here)

2. Is the EHR integrated seamlessly with the HIS? Demonstrate that a Lab order made by a physician in the EHR going through to billing, sample collection, reporting at lab and the result being made available to the ordering physician online.

3. Incase of an existing HIS, can the EHR integrate with it? Briefly describe how this integration can be achieved. (Support for messaging standards like HL7 can make this possible. Read more about integration of healthcare systems using HL7 here)

Patient Centric Workflows1. Does the EHR system follow the patient, as the patient goes through

an OP or IP visit? Demonstrate by registering a patient for OP visit, appointment fixing, billing for consultation, physician consult, physician orders – minimum of Med and Lab orders, payment & execution of orders, order results to physician, follow up visit appointment fixing and patient check out.

2. Can the system auto generate the IP bill items fully based on various clinical actions such as administration of a medication dose or based on collection of samples for a lab test or a consultant’s visit to the patient?

3. Can the system completely eliminate the need for maintaining a paper based activity chart for each IP patient?

Clinical Decision Support System1. Does the system provide alerts for the following, as the orders

happen? Please demonstrate:• drug-drug contra indication• drug-allergy contra indication

• drug-disease contra indication• drug-food contra indication• pregnancy contra indication• lactation contra indication• duplicate therapy alert

2. Does the system auto calculate paediatric dose-range of medications? Please demonstrate.

3. Does the system support renal and hepatic precautions while med ordering? Please demonstrate.

4. Does the system capture and maintain, as discrete data, the reason for variation from rule based clinical messages, for clinical audit? (Whenever a physician is overriding a CDSS alert, the system should ask for a mandatory reason and date/time stamp and user details should be captured).

Integrated Drug Information Framework & Drug Database1. Does the system have an integrated Drug Information

Framework that organises drug hierarchy information from ingredients to generics to routed generics to dose form generics to dispensable generics and link it to packaged/ branded drugs?

2. Is the CDSS(Clinical Decision Support System) deriving the alerts automatically from data built into the integrated Drug Information Framework?

3. Do the database cover all generics as per Indian Pharmacopeia? Does it allow the addition of new generics and combinations?

4. What is the coverage of built in Indian branded drugs database? (As there are more than 150,000 packaged drugs sold in India, a minimum coverage of at least 75,000 is essential for a smooth operation of the EHR). How is this being maintained and updated?


5. Does the drug database allow searches based on the following from the physician consulting window? - Generics, Branded Drugs, Systems & Therapeutic Groups, Indications

6. Does the drug database allow finding replacement drugs based on Generics and Therapeutic Groups?

7. Does the system allow ordering meds from the drug database even if they are not available in the hospital pharmcy?

e-Prescription Capability1. Does the system provide the ability for clinicians to write all

patient care orders electronically? nursing care, medications/ IV/immunizations, diagnostic testing, procedures, diet orders, physical therapy orders, referral orders, admit orders etc?

2. Does the system auto build a physician level favourite list based on system usage? Can all orders be made this list? Can this list be pre-built at physician level to improve adoption during implementation?

3. Can physicians use order sets while ordering and e-prescribing using minimal clicks?

Immunisation Management1. Does the system have built in immunization auto-planner as

per IAP Immunization Schedule?2. Does the system auto generate immunisation schedule

based on DOB and make necessary adjustments in follow up schedule based on actual date a particular immunisation was administered?

3. Does your system send alerts/reminders to people when immunisations fall due?

Clinical Care Pathways1. Does the system support creation of evidence based clinical care

pathways and protocols both at Hospital level and individual physician level?

2. Does the system have the ability to create ailment specific protocols/ order sets and map them to diagnosis out of ICD 10 standard?

3. Does the System allow the user to edit the Order Set at the patient level before prescribing/ordering?

Clinical Documentation1. Check how easy is it to input clinical data in the user interface,

especially in OP Physician consult module, as the physicians are expected to see large number of patients every day in OP?

2. Does the system support work flow of a nurse or junior physician capturing patient history and other details prior to consultation by a senior physician in OP and present data to the senior physician? (Improves productivity of senior consulting physicians)

3. Does your system auto generate after visit summary for an OP visit based on clinical actions?

4. Does your system auto generate discharge summary based on clinical actions?

5. Does it follow the standard format? Is it ready to be printed out with minimal manual data entry?

6. Is the format of OP visit summary and IP Discharge summary configurable? Can the hospital have more than one templates with the freedom to use any based on need?

7. Does the system support making clinical notes non-editable through signing and finalisation by physicians? Does it allow addition of addendums to finalized notes?


8. Does the system display summary of all past encounters (OP/ ER/ IP) visit wise?

9. Does the system automatically maintain an updated patient level clinical summary derived out of his/her life time clinical records?

10. Does your system support exporting or importing patient clinical records in CCR/ CCD/ CDA format?

Patient Lifecycle Management1. Does the system enable Patient Lifecylce Management to

improve patient engagement and revenues?2. Can the system manage multiple lifecycles and link them to a

diagnosis/condition?3. Can actions such as reminders/alerts and EHR tasks be initiated

automatically based on lifecycle triggers?4. Does the system provide tools to design lifecycles, their

milestones and set triggers as required?

Patient Portal1. Is a patient portal available? Is it integrated with the EHR? Can

the portal be customised to the hospital’s branding?2. Can people update their demographic details on the portal?

Does that reflect in the EHR automatically?3. Can patients seek & manage appointments on the portal?4. Can Patients view their EHR, OP visit summaries, Lab/

Radiology reports, Discharge Summaries and bills online?5. Does the portal support patient education and have relevant

content for patient education?

Dashboards for Financial, Operational & Clinical Efficiency1. Does the application have dynamic management dashboards

on Financial, Operations and Clinical performances? Are they visually presented using graphics and charts?

2. Can these dashboards consolidate data from multiple hospitals? Can these reports be drilled down from group to individual hospital level?

3. Can you compare performance and view trends using multiple parameters?

Interoperable & EHR standards compliant Patient Health Records1. Does your HIS comply with the Healthcare IT standards

approved by Government of India?2. Does your EHR comply with the Government of India

approved EHR standards? Most importantly Download our EHR Compliance Checklist to verify if it meets the Government of India regulation on EHR standards. Also Download the GOI EHR Standards Document.


Who we are What we do

We are an organization of Healthcare IT Domain Experts with a collective experience of more than 100 man years in the areas of Hospital Software Development with expertise in Cloud Engineering, Analytics and Big Data,Mobility solutions. We operate with dedicated focus on EHR Technology Framework with experience in developing and deploying products in highly competitive International Markets and we strive to support our customers with best practices in Healthcare Management through our domain expertise and End-to-End mature Hospital Software Solutions.

The world is in the threshold of an impending paradigm shift in the way healthcare is delivered and individual health records managed. With the accelerating adoption of EHR standards, we, at Lifetrenz, are positioned appropriately to ride ahead and become torchbearers of IT enabling this revolution.

We builds innovative IT Solutions to power global healthcare providers. Our products are built on modern technology, comply with International EHR (Electronic Health Records) standards and are intuitive to use. Our Solutions combine the power of Cloud with the rich user experience of a desktop application in its Smart Client Web Application delivered as a service from a cloud infrastructure or onsite. We are an innovative company finding success and satisfaction in being able to work closely with our clients in areas that are critical to their success. Our solutions focus patient and customer satisfaction. We are nimble footed when it comes to speed of implementation and we take great pride in being a thinking organization. We see each engagement as an opportunity to collaborate with our clients and ensure maximum return on their investment.

We build IT solutions that enable healthcare providers deliver safer healthcare, economically, so as to make quality healthcare more affordable for people across all socio-economic strata. The service delivered as pay-per-use SAAS (Software As A Service) from our public cloud enables healthcare providers of all sizes and segments to consume these services as they need. Our service sits on top of an extensive and evolving knowledge base of information and tools that enable the users of the service to improve the safety, quality and speed of their work. Any professional person or organization in Healthcare wishing to streamline their practice and align their work to International standards and best practices will find that Lifetrenz makes this a smooth journey. Though there are many local and regional players in this segment, it is largely fragmented and looked at more from an operations perspective and not so much from clinical information side. Lifetrenz turns the table around to look at the whole solution from a patient centric perspective with the capture and storage of patient clinical data using EHR standards.

The EHR Technology Framework of Lifetrenz is built on Open Source Technologies incorporating features like scalability, all round security and minimal set-up and go-live requirements, blending best of functionality with user-friendliness. The EHR Product is completely engineered in house by Lifetrenz, taking into account the Domain Expertise to provide an up-to-date Technology to Hospital software customers.

All our Hospital Management Software products like Lifetrenz Hospital, Lifetrenz EHR and Lifetrenz Polyclinic are engineered to be interoperable, based on International and Indian EHR Standards. The products are highly reliable, scalable and patient-centric for Healthcare Workflows across product verticals/providers for a comprehensive, holistic Healthcare ecosystem founded on knowledge framework with features to provide modular up gradation and enable Continuity of Care.

HIS ProductsEvaluation Checklist

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