synapse (sin'aps)medactivus.com/medactivus_whitepaper.pdf · computer system characteristics...

1 | N u r s i n g 7 8 1 : P r o p o s a l

Synapse, established in 2011, is an informatics consulting fimanaged by advancedinformation systems to the team provides expertise in system analysis and solution development. Synapse is prepared to design or implement an information pathway to improve your healthcare system. Our services aim to optimize your organizations efficiency, quality, and safety of healthcare delivery.

Services Offered

• SYSTEM ANALYSIS

• SOLUTION DEVELOPMENT

• COST-BENEFIT ANALYSIS

• RISK ASSESSMENT

• APPLICATION EDUCATION

Synapse

T h e p o i n t o f c o n t a c t b e t w e e n h e a l t h c a r e a n d t h e i n f o r m a t i o n h i g h w a y

N u r s i n g 7 8 1 : P r o p o s a l

Synapse, established in 2011, is an informatics consulting fimanaged by advanced practice nurses. We specialize in connecting information systems to the healthcare environment. Our consulting team provides expertise in system analysis and solution development. Synapse is prepared to design or implement an information pathway to improve your healthcare system. Our services aim to optimize your

ons efficiency, quality, and safety of healthcare delivery.

YSTEM ANALYSIS

OLUTION DEVELOPMENT

BENEFIT ANALYSIS

ISK ASSESSMENT

PPLICATION EDUCATION

Synapse (sin'aps)

T h e p o i n t o f c o n t a c t b e t w e e n h e a l t h c a r e a n d t h e i n f o r m a t i o n h i g h w a y

Synapse, established in 2011, is an informatics consulting firm s. We specialize in connecting

healthcare environment. Our consulting team provides expertise in system analysis and solution development. Synapse is prepared to design or implement an information pathway to improve your healthcare system. Our services aim to optimize your

ons efficiency, quality, and safety of healthcare delivery.

T h e p o i n t o f c o n t a c t b e t w e e n h e a l t h c a r e a n d


Analysis

Description of Problem The practice of healthcare is not

rendered. With a nearly 30% Medicare reimbursement cut anticipated by January 2012, missed and inaccurate billing charges(Deshchenko, 2011). There are over 780represent 17% of the state (kff.org, 2011). A decline in reimbursement from this population puts healthcare practices in jeopardy of closing their doors forever. It has now become imperative that charges forensure accuracy and completeness. Charge capture at the point of care has the potential to increase quality of care, billing process transparency and revenue, while decreasing charge lag and demonstrating com

The South Carolina Heart Centercare and services within the dynamic inpatient setting Columbia, SC. Submitting accurate and complete billing informatienvironment has been an ongoing challenge through the currentLast minute consultations, bedside procedures, and often been overlooked when the workday is completed. 15% of charges never get billed in the hospital setting (Adkison, 2011). do not have support persons such as nurses and medical assistants in the inpatient setting to ensure billing is completed. As a result of the often chmany providers are delaying billing at the time of care as the excessive paperwork can become tedious and overwhelming. Documentation is often donerelying on memory and notes scribbles on paperthroughout the day. When charges are submitted by providers, they are often sketchy, handwritten, illegible notes.

Description of Problem

• Revenue loss from missing charges• Lack of billing process transparency• Compliance audits • Poor staff/provider workflow


tice of healthcare is not sustainable without reimbursement for services

rendered. With a nearly 30% Medicare reimbursement cut anticipated by January 2012, missed and inaccurate billing charges decrease revenue required to sustain practices(Deshchenko, 2011). There are over 780,000 Medicare patients in South Carolina which represent 17% of the state (kff.org, 2011). A decline in reimbursement from this population puts healthcare practices in jeopardy of closing their doors forever. It has now become imperative that charges for services be completed at the point-of-ensure accuracy and completeness. Charge capture at the point of care has the potential to increase quality of care, billing process transparency and revenue, while decreasing charge lag and demonstrating compliance during audits.

The South Carolina Heart Center (SCHC) provides both scheduled and emergentwithin the dynamic inpatient setting on a daily basis at two hospitals in

Columbia, SC. Submitting accurate and complete billing information in this dynamichas been an ongoing challenge through the current paper-based system.

Last minute consultations, bedside procedures, and unexpected admission charges have overlooked when the workday is completed. Studies have shown that up to

15% of charges never get billed in the hospital setting (Adkison, 2011). Providers often do not have support persons such as nurses and medical assistants in the inpatient setting to ensure billing is completed. As a result of the often chaotic inpatient routine,

billing at the time of care as the excessive paperwork can become tedious and overwhelming. Documentation is often done later in the day

and notes scribbles on paper after having seen numerous patients When charges are submitted by providers, they are often sketchy,

Description of Problem

Revenue loss from missing charges • Elongated charge lag Lack of billing process transparency

Poor staff/provider workflow

• Lost charges/ Inaccurate billing• No patient record for “on call”

providers • Poor communication

sustainable without reimbursement for services rendered. With a nearly 30% Medicare reimbursement cut anticipated by January 2012,

decrease revenue required to sustain practices ,000 Medicare patients in South Carolina which

represent 17% of the state (kff.org, 2011). A decline in reimbursement from this population puts healthcare practices in jeopardy of closing their doors forever. It has

-care to ensure accuracy and completeness. Charge capture at the point of care has the potential to increase quality of care, billing process transparency and revenue, while decreasing

provides both scheduled and emergent on a daily basis at two hospitals in

on in this dynamic based system.

unexpected admission charges have own that up to

Providers often do not have support persons such as nurses and medical assistants in the inpatient

aotic inpatient routine, billing at the time of care as the excessive paperwork can

later in the day by en numerous patients

When charges are submitted by providers, they are often sketchy,

Lost charges/ Inaccurate billing No patient record for “on call”


Paper charges are frequently submitted days to weeks later, which makes verification of correct documentation and billing impossible. This has opened an unending cycle of lost charges, an inaccurate reflection of services, and decreased financial reimbursement for patient services.

The SCHC has requested that Synapse help develop a solution to ensure that billing is done routinely on every patient and procedure and that the billing reflects the accuracy of the encounter.

System Analysis

The Gassert Model for Defining Nursing Information System Requirements (MDNISR) served as a framework to conduct a system analysis of SCHC to better define a proposed information solution. The MDNISR is a graphic representation of the process of identifying nursing information system requirements and to assess the capability and comprehensiveness of potential systems. The model can be easily adapted and applied towards other health related information systems.

The strengths of the MDNISR include:

1. Analyzes the needs of the end user and their respective function in the clinic environment.

2. Defines how information is utilized by end users, what systems are currently operating in the environment, the interface capability, and additional hardware and software needs.

3. Guides the consulting team in determining if the proposed solution meets the needs and goals of the end users and is ultimately beneficial to the overall functioning of the health system.

The weaknesses of utilizing the MDNISR include:

1. It is heavily focused on nursing information systems.

2. It does not include an element that specifically addresses the barriers to implementing a particular solution, which will be addressed at the conclusion of the system analysis.

The MDNISR is a pentagonal shaped model with five elements that are interrelated (See Appendix A). The five elements are as follows; nurse users, information processing, nursing information systems, nursing information, and nursing-system goals. Within each of the five elements, inputs, processes, and constraints have an impact on


each element. Based on the impact, each element produces a different output. The five outputs define the above elements and are all interrelated (Gassert, 1991b).

Element one, “nurse users element” addresses nursing functions, practice responsibilities, and information handling needs. Nursing functions include all the activities performed by nurses in their respective role. Practice responsibilities are the role of nurses within an environment and the activities performed in that particular role. The information handling needs is the data that is read, recorded, or utilized by nurses when performing nursing tasks. The output of element one is nursing information functions as it relates to the activities performed by nurses in their respective role (Gassert, 1989). A survey of the current environment at the SCHC reveals a fast paced clinical environment with multiple providers and support staff. The goals of the practice are to remain fiscally sound, organized, and efficient, while delivering high quality patient care. The functions performed by physicians, nurse practitioners, and physician assistants include diagnosis and treatment of presenting healthcare issues in the office setting and hospital setting. The nurses in the office manage clinical work flow, physician schedules, and patient education. The business office manages insurance referrals, billing, and account receivables. The information handled by the registered nurses (RN) includes patient records, laboratory reports, radiology reports, prescriptions, and billing route slips. The output from element one for the current hospital setting includes the ability to document accurate and current patient care, coordination of discharge and follow-up care, and patient education. In addition, capturing charges at the time care is delivered in the hospital will avoid lost charges, improve accuracy of billing, and increase revenue. The current billing process within the hospital involves the provider recording a visit or procedure charge on paper and placing in a designated box. The charges are then picked up by a courier and taken to the business office at SCHC for submission (See Appendix B).

Element two, “information processing element”, integrates nursing information functions and practice responsibilities, to further define information processing requirements. The information processing requirements are the processes that the end user feels the system must have to provide pertinent and useful information. Examples include treatment plans, reminder systems of missing data, and staff scheduling (Gassert, 1989).

In review of the current environment at SCHC, the following information processing requirements representing output from element two were as follows:

• Access to selected patient information


o Date of Birth, age, name, medical record number: Used to search for patient in database

o Diagnosis: Tagged to billing for audit compliance

• Treatment plans

• Alert systems regarding allergies

• Advanced directives

• Access to appropriate billing codes

• Hospital rounding list

• Patient procedure schedules.

Element three “nursing information system element” describes the processing requirements necessary to analyze data and information, the characteristics of the computer system needed and the computer systems that are currently in the environment. Computer system characteristics of the current system are:

Computer System Characteristics

• 10 desktops in Pods A-E (2 per unit) • Microsoft Works • Internet Explorer • Electronic Medical Record: NextGen • Touch Chart (repository for scanned documents)

The current patient information system is protected by bank level encryption. The providers have smart phones, iPads, and laptops for accessing current information.

Current System Outputs

• Paper provider Schedules • Fax Machine • Telephone • Cell Phone: text, SMS • Paper billing: Office and Hospital • Tasking through electronic medical record (EMR) • Patient visit note through EMR • Digital images via echocardiogram, catherization, radiology


The output from element three identified the following areas necessary to improve productivity, efficiency and ultimately revenue:

1. A system that interacts with the current information systems within the clinic environment

2. A system that provides real time access to patient information, which necessitates the need to internet access.

3. The need for providers to have real time access to hospital rounds and procedure schedules.

4. A system that allows for billing at the point of care to improve accuracy and timeliness of patient billing will improve practice revenue.

Element four, “nursing information element”, is the synthesis of the outputs noted above and available patient data (Gassert, 1989). Examples of available patient data are the patient’s past medical and surgical history, social history, demographic data, and previous patient encounters. In the current environment, available patient data is accessed by the Electronic Medical Record (EMR) and printed past office visit notes. Data requirements are the information that must be included for providers and support staff to perform their respective function. Examples of data requirements include medical diagnoses, treatment plans, patient outcomes, and standards of care. At SCHC, the data requirements are available through the EMR requiring a computer with internet access that has the EMR (NextGen) loaded.

Element five, “nursing system goals element,” compares data requirements, system outputs, and goals to define system benefits (Gassert, 1989). The system goals describe the desired end-point of the ideal information system. The system goals at SCHC are:

1. To improve communication between providers and support staff

2. Improve clinic efficiency

3. Improve documentation of patient care

4. Provide real time access to patient records

5. To capture patient charges at the point of care

The nursing system benefits are statements that describe the advantages and outcomes of implementing a new information system. At SCHC, the advantages of using an information system that address the goals noted above include:


1. Improved patient outcomes

2. Improved clinical decision making

3. Up-to-date medical records

4. Increased revenue

5. Improved organization

6. Use of longitudinal data to review patient care trends and billing patterns

7. Decreased charting time

Environmental Analysis

The 7S Model has been used in internal environment analysis. It evaluates:

1. Strategy

2. Structure

3. Style

4. Staff

5. Skills

6. Systems

7. Shared values

http://www.business-plan.co.za/the-internal-environment-analysis.html

The SCHC strategy takes into account long term, medium and short term goals which help to ensure the company is progressive and continually improving quality of care and productivity. SCHC has a formal organizational structure in place which includes a Chief Operations Officer (COO), Chief Nursing Officer (CNO), and Chief Information Officer (CIO), of which the latter two are registered nurses. This hierarchy is utilized to ensure clear lines of communication between levels. All leaders are approachable and


well-liked by staff. They welcome feedback from staff. The leadership style within SCHC is predominantly autocratic with all major decisions made by physician leaders and the COO/CNO. This is beneficial in that it allows company members to focus on specific tasks and patient care without having to make major decisions. The downside of this style in SCHC is that there is little input from company members on major decisions. This can hinder buy-in from the group as a whole when implementing a new application. The staff at SCHC is competent, skilled, and experienced. There are several employees who have experience in multiple areas. Daily communication is sent out every morning by the CNO to ensure company members are in the correct location and aware of responsibilities for the day. Most employees work from 8am to 5pm with 1 hour for lunch from Monday to Friday. Physicians/ Nurse Practitioners/ Physician Assistants work varying days/hours based on company needs. Staff retention has been fluctuant over the last several years which may be a reflection of the autocratic leadership style.

Turnover rates for 2010 were:

Employee Turnover Rate

Physicians 22%

Nurse Practitioner and Physician Assistants 55%

Registered Nurses and Medical Assistants 40%

The high turnover rate at SCHC is well above the desired <5% in the top 25% of employees (Sullivan, 2011). It is important that new employees be able to learn a new application easily and quickly, especially providers in the hospital environment. All SCHC members possess a varying combination of leadership, technical, management and inter-/intrapersonal skills. The members are usually eager to learn and able to adapt to change reasonably well. SCHC implemented an EMR 4 years ago and all members were able to adjust well to this change with their specific combination of skills.

There are a number of systems in place at SCHC:

§ Performance management system

§ Financial management system

§ Management information system

§ Accounting information system

§ Quality control system

§ Health and safety


§ Accounting system

§ Production related systems

All of the above attributes help describe the shared values of SCHC and its members which include providing quality care in a timely, efficient, and effective manner.

A SWOT analysis (strengths, weaknesses, opportunities, threats) was completed to identify areas vital to the successful implementation of an application designed to improve accuracy and consistency of billed services. The Gassert Model was utilized in the system analysis to assure the needs of the endusers were addressed early in the process in order to promote early adoption. Through this process, multiple barriers were identified that have the potential to impact a successful implementation of an information solution. The table below demonstrates the identified areas that can impact implementation of a new application:

Internal and External Threats

Strengths Weaknesses Opportunities Threats

• Tech-savvy end users that like new technology

• Competent and skilled staff

• Providers already using smart phones

• Little time available for training

• No input from staff on decision may lead to resistance

• Ability to organize patient info

• Increased revenue • Decreased paper trail

increases efficiency • Compliance with

audits • Transparent billing

service

• May not interface with existing software

• Increased cost for clients • Frustration from staff

The SWOT analysis demonstrates a competent staff that will very likely acquire information for new technology easily. Since there may be resistance to new technology at first, it will be important to stress the goal of the project which is to increase revenue at the bottom line. This will help ensure SCHC will keep a steady cash flow which is vital to operation, thus ensuring salaries for an adequate staffing level. It will be important to choose an application that will not require a great deal of training time, since resources are limited and time is of the essence. There were many opportunities identified that will work nicely with the long-term goal of SCHC. The application chosen could help keep SCHC in the mainstream of technology by decreasing a paper trail, providing transparent auditing, and increased compliance. The listed threats demonstrate the need for an


application that is already compatible with the current system, is cost-friendly, and user-friendly as well.

Software Solution MedActivus

MedActivus has developed innovative workflow management solutions for medical practices. This is a privately owned corporation located in Columbia, South Carolina. MedMobile and MedForte are two products developed by MedActivus being proposed as information system solutions for South Carolina Heart Center. MedMobile and MedForte are integrated management tools that address practice organization, hospital workflow and charge capture at the point of care.

MedMobile

The primary goal of MedMobile is to eliminate lost charges by capturing charges when care is delivered. MedMobile allows clinicians to document patient encounters from mobile devices at the time care is delivered. The benefit is the elimination of lost or missed charges that occur when clinicians neglect to complete the proper paper documentation required by the business office. The benefit to the practice is increased accuracy and number of charges, thus increased revenue (MedActivus, 2010). The use of mobile devices for charge capture in the clinical setting provides the opportunity to increase revenue, often by 20%, or up to $20,000 per provider, per year (Adkison, 2011).

MedMobile is accessed through the provider’s mobile device. Patients entered into the MedActivus system have an electronic file that allows clinicians the ability to view and enter patient information from virtually anywhere using a mobile device. The ability to access the patient record away from the clinical setting allows the provider on call the ability to make appropriate decisions concerning patient care and for prompt billing of services provided outside of normal office hours (MedActivus, 2010).

Patient rounding and practice schedules are easily accessed. Patient data is added and managed, including illnesses, informed consent, and pre-procedure checklists. Alerts systems are also incorporated. Patient charges are billed at the time of care. ICD-9 and CPT codes are included within the program. Charges are easily accessible and able to be reviewed with ease. MedForte has the ability to track patients enrolled in clinical trials.


MedMobile promotes improved communication with colleagues and support staff by allowing voice, text, fax and images to be submitted and received through a provider’s mobile device. Providers can send messages to office staff regarding patient needs for follow-up care or to clinical partners regarding consultations. The ability to receive faxes on the mobile device eliminates the need to locate a fax machine while out of the office. Messages and faxes are documented in a central location allowing easy retrieval (MedActivus, 2010).

The following devices support MedMobile: Android, iPhone, Blackberry and the web (all browsers). MedMobile also integrates with MedForte allowing access to patient data, patient rounding list, practitioner’s schedules, and ICD-9 and CPT codes. Patient charges are captured at the point of care and the data is synced automatically (MedActivus, 2010).

MedForte

This is a web based application accessible from any computer with internet connection. The program is intended to allow practitioners and support staff the ability to manage the needs of the practice from any location (MedActivus, 2010).

The program incorporates work-flow data integration by addressing the day to day work-flow of the practice. MedForte tracks daily schedules, paid time off, holidays, vacation, and continuing education for clinicians. Patient procedures are built in the system and contain information including diagnoses and diagnosis codes (ICD-9). Important patient information such as “no code”, allergies, device implantation, “no blood products” and comfort care measure are also built into the system. The program has the ability to decrease lost charges and provide easy access to charge records by having CPT codes and modifiers available as needed (MedActivus, 2010). Cost-Benefit Analysis

A cost-benefit analysis is a process that determines both the tangible and non-tangible value of a solution and subtracts the costs of implementing a solution (Cost/benefit analysis, 2011). The implementation of MedActivus products, MedForte and MedMobile will require minimal start-up costs. The initial start-up costs primarily involve the cost of new iPhones, at approximately $99.00 each. With 20 providers, the cost approximates to $2,000.00. In addition, the training of providers, support staff, and super-users will initially be required. The cost of training super-users is approximated at $1,520.00. The cost of training support staff is approximated at $618.00. The cost of training providers is approximated at $2,582.00. Flexible costs include refreshments during training sessions: estimated at $950.00. The total startup cost for implementing


MedActivus is $7,670.00. In addition to the initial start-up costs, there will be monthly reoccurring costs to the practice to maintain MedMobile and MedForte. Monthly phone service for 20 providers equates to $4,000.00 per month. The monthly service charge to maintain MedActivus is $200.00 per provider, which equates to $48,000 annually.

The financial benefit for implementing MedActivus products is to recapture revenue in lost charges. If 1% of lost charges were recaptured, approximately $2,151,980 could be regained in revenue. If 5% of lost charges were recaptured, approximately $11,076,980 could be regained, and 10% would equate to an increase in revenue of $21,833,230 over one year. Intangible benefits include those benefits that may not have a monetary value, but overtime lead to increased revenue (Cost/benefit analysis, 2011). The intangible benefits associated with MedMobile and MedForte includes improved efficiency, organization, and communication. In conclusion, with the implementation of MedForte and MedMobile, SCHC can anticipate a significant gain in revenue, an efficiently run clinic, and improved employee satisfaction. Evidence of a gain in revenue can be seen with periodic auditing (See Appendix C).

Potential Issues

• Privacy, Confidentiality, and Security: Privacy refers to the information that a person wishes or does not wish to disclose. Confidentiality refers to the information that has been disclosed and should not be shared unless given permission by the person who disclosed the information. Security is the measures organizations take to secure health related information and protect a patient’s privacy and confidentiality. The greatest risk to security is the persons interacting within the system (Englebardt & Nelson, 2002).

Health Insurance Portability and Accountability Act (HIPPA) of 1996, addresses the “specific requirement for maintaining a secure environment for electronic storage and transmission of patient data” (Englebardt & Nelson, 2002). MedActivus ensures confidentiality and privacy, by using the same 128-bit encryption and physical security that is utilized by banks (MedActivus, 2010). All MedActivus applications are HIPPA compliant. Data transfer is over Secure Sockets Layer (SSL) and encrypted. The data centers are fire walled and completely secure (MedActivus, 2010). Both MedForte and MedMobile can only be accessed by using a secure online login and entering approved identifiers and passwords. All users will be required to enter log in name and password. Security upgrades are included in the pricing.

Ergonomics

Ergonomics refers to the design of equipment, tools and machines in relation to the human body (Englebardt & Nelson, 2002). MedActivus offers web-based applications that are accessed through a mobile phone or desk top computer. MedForte and MedMobile address both the physical and psychological dimensions of ergonomics. The


physical dimensions look at the interaction between technology, the work station and the human being (Ergonomic Workstations, 2011). The psychological dimensions look at the interface between the user of the program and the program itself (Institute of Ergonomics and Human Factors, 2011).

• Physical Ergonomics

MedForte is a web based application that is accessed through a computer. End-user’s will be provided guidelines that address the physical dimensions of ergonomics such as: maintaining a viewing distance from computer screen of 18-24 inches, a chair that provides lumbar support, a chair height that positions the body in 90 degree angles at the elbow, hip and knee. Wrists should be straight and in the neutral position. Feet should be flat on the floor. Lightening should be sufficient, but to the end user’s preference (Ergonomics Workstations, 2011).

• Psychological Ergonomics

MedForte’s home page is organized into four sections. Subject tabs link you internally to pages within a particular section, by clicking the tab one time. The particular subject is listed in text below the tab, helping the user to become familiar with each tab. On each tab there is graphic art associated with each subject. After linking to a new page, the user will notice the subject tabs are listed again in the tool bar region (MedActivus, 2010).

The user is able to operate the program independently, creating one’s own navigational path throughout the application. The program acknowledges input from the user, and provides feedback if additional information is needed. For example, when creating a new patient, a certain amount of data is required. If the required data is not entered, the program will create an alert that information is missing and will identify what information is missing. The data can also be easily edited after information is saved.

Invalid commands are handled constructively. The program tolerates some variations in command formats such as upper or lower case when entering patient names for example. The program will notify and coach the user if invalid commands need to be adjusted such as entering the birthday in the appropriate format. There is a help button that links you to several topics. In addition, there is also electronic contact information for support and an email to send questions.

MedMobile can be readily accessed if you have an iPhone or Android mobile device. The language is familiar if you have experience working in the


health care industry. The graphics are consistent and coordinate with terminology. The tabs including graphics on MedMobile are the same on MedForte providing consistency from one application to the other. The language within the program is clear if the user has experience working in a clinic or hospital setting.

New patients can be added into the application. A picture of the patient can be included. Documents can be

Communication with colleagues and officeor fax is another feature of MedMobile. There is also an alert system that can alert the clinician by either sound or vibration. Notes in the patient’s file can also be verbally recorded. There is a help button that linksThere is also electronic contact information for support and an email to send questions.

System Requirements

MedMobile is fully functional anywhere, even when you are offline (MedActivus, 2011). MedForte require access to the inteMedActivus. The practice does not need to install software, manage updatesmaintain hardware. This is all included with a MedActivus subscription. applications utilize 128-bit encryption and data is (MedActivus, 2011).

Hardware Components

Features

(Apple Inc., 2011)

Product type Apple iPhone 3GS

MSRP $99.99

Color and Capacity Black/ 8GB

Cellular and Wireless •

•

•

Location •

•


health care industry. The graphics are consistent and coordinate with terminology. The tabs including graphics on MedMobile are the same on MedForte providing consistency from one application to the other. The language

is clear if the user has experience working in a clinic or

New patients can be added into the application. A picture of the patient can be included. Documents can be uploaded to the patient’s file.

Communication with colleagues and office personnel via voice, text, image or fax is another feature of MedMobile. There is also an alert system that can alert the clinician by either sound or vibration. Notes in the patient’s file can also be verbally recorded. There is a help button that links you to several topics. There is also electronic contact information for support and an email to send

is fully functional anywhere, even when you are offline (MedActivus, MedForte require access to the internet. The server is maintained by

MedActivus. The practice does not need to install software, manage updates, or This is all included with a MedActivus subscription. The MedActivus

bit encryption and data is stored in secured data centers

(Apple Inc., 2011)

Apple iPhone 3GS

Black/ 8GB

UMTS/HSDPA (850, 1900, 2100 MHz)

GSM/EDGE (850, 900, 1800, 1900 MHz)

802.11b/g Wi-Fi Bluetooth 2.1 + EDR wireless technology

Assisted GPS

Digital compass

terminology. The tabs including graphics on MedMobile are the same on MedForte providing consistency from one application to the other. The language

is clear if the user has experience working in a clinic or

New patients can be added into the application. A picture of the patient

personnel via voice, text, image or fax is another feature of MedMobile. There is also an alert system that can alert the clinician by either sound or vibration. Notes in the patient’s file can also

you to several topics. There is also electronic contact information for support and an email to send

is fully functional anywhere, even when you are offline (MedActivus,

or The MedActivus

stored in secured data centers


•

•

Display •

•

•

•

Camera, photos, and video

•

•

•

•

•

External buttons and connectors

External Buttons and Controls

Connectors and Input/Output

Power and battery •

•

•

•

•


Wi-Fi Cellular

3.5-inch (diagonal) widescreen Multi-Touch display

480-by-320-pixel resolution at 163 ppi

Fingerprint-resistant oleophobic coating Support for display of multiple languages and characters

simultaneously

Video recording, VGA up to 30 frames per second with audio

3-megapixel still camera

Autofocus

Tap to focus Photo and video geotagging

External Buttons and Controls

http://www.apple.com/iphone/iphone-3gs/specs.html

Connectors and Input/Output


Built-in rechargeable lithium-ion battery

Charging via USB to computer system or power adapter

Talk time: Up to 5 hours on 3G, up to 12 hours on 2G

Standby time: Up to 300 hours

Internet use: Up to 5 hours on 3G, up to 9 hours on Wi

Touch display

Support for display of multiple languages and characters

Video recording, VGA up to 30 frames per second with audio

3gs/specs.html

3gs/specs.html

Charging via USB to computer system or power adapter

Talk time: Up to 5 hours on 3G, up to 12 hours on 2G

Internet use: Up to 5 hours on 3G, up to 9 hours on Wi-Fi


• Video playback: Up to 10 hours • Audio playback: Up to 30 hours

Audio playback • Frequency response: 20Hz to 20,000Hz

• Audio formats supported: AAC (8 to 320 Kbps), Protected AAC

(from iTunes Store), HE-AAC, MP3 (8 to 320 Kbps), MP3 VBR,

Audible (formats 2, 3, 4, Audible Enhanced Audio, AAX, and

AAX+), Apple Lossless, AIFF, and WAV • User-configurable maximum volume limit

Mail attachment support

Viewable Document Types: Viewable Document Types: Viewable Document Types: Viewable Document Types: jpg, .tiff, .gif (images); .doc and .docx (Microsoft Word); .htm and .html (web pages); .key (Keynote); .numbers (Numbers); .pages (Pages); .pdf (Preview and Adobe Acrobat); .ppt and .pptx (Microsoft PowerPoint); .txt (text); .rtf (rich text format); .vcf (contact information); .xls and .xlsx (Microsoft Excel)

Headphones


• Apple Earphones with Remote and Mic

• Frequency response: 20Hz to 20,000Hz

• Impedance: 32 ohms

System requirements • Apple ID (required for some features)

• Internet access4

• Syncing with iTunes on a Mac or PC requires:

o Mac: OS X v10.5.8 or later o PC: Windows 7; Windows Vista; or Windows XP Home or

Professional with Service Pack 3 or later

In the box

• iPhone 3GS

• Apple Earphones with Remote and Mic

• Dock Connector to USB Cable

• USB Power Adapter

• Documentation

All providers will require a mobile smart phone in order to use the MedMobile application for submitting charges at the point of care. The Apple iPhone 3GS was selected for its versatility, ease of use, and competitive price. Since this mobile device will be required, it will likely replace the current mobile devices utilized by providers. The Apple iPhone 3GS has a digital

http://docs.info.apple.com/article.html?artnum=303414


key pad for text messaging which will replace the need for beepers and pagers as well. The long battery life will ensure no charging is required during the work day. This mobile device also interfaces with Microsoft Outlook which is used at SCHC. The current device used by SCHC, the Motorola Droid X, does not support this application.


Design and Development

Education Plan

MedActivus will provide onsite subscription. Training will take place at Street, Columbia, SC 29204. It will occur in the format of a “lunch and learn” session for providers. This will be provided for physicians/NP/PAs in week 13session will include hands on training with mobile devices disThe session will last approximately one hour. It will be followed by a brief evaluation.

The training for support staff and business office will be provided prior to clinic hours between 7am-8am. Support staff will be compensated for the additional hour of work. These training sessions will be provided for support staff in weeks 10 and 12. Evaluation of support staff will be done in week 1

Training sessions will be provided for business staff in weeks 11 and 13. The training for support staff and the business office will include hands on training with laptop computers. Evaluation of knowledge retention and education presentation will be completed in week 13 for the bus

Resources Required

• Presenter:

o Laptop, projector, and laser pointer

• Participants:

o 12 training laptops from IT departmentmobile devices, pen, and paper

o IT staff available for assistance

• Training manual for participants

• Education conference room on 1

o Coffee, juice, breakfast pastries, fruit tray

• Executive conference room on 3

o Lunch Provided


and Development

MedActivus will provide onsite training which is included in the monthly raining will take place at the South Carolina Heart Center, 2001 Laurel

will occur in the format of a “lunch and learn” session for be provided for physicians/NP/PAs in week 13 (see Timeline). This

will include hands on training with mobile devices distributed in weeks 8 and 9. last approximately one hour. It will be followed by a brief evaluation.

The training for support staff and business office will be provided prior to clinic 8am. Support staff will be compensated for the additional hour of

raining sessions will be provided for support staff in weeks 10 and 12. Evaluation of support staff will be done in week 12 following the education session.

Training sessions will be provided for business staff in weeks 11 and 13. The ort staff and the business office will include hands on training with

laptop computers. Evaluation of knowledge retention and education presentation will be completed in week 13 for the business office staff.

ctor, and laser pointer

12 training laptops from IT department with wireless internet access, mobile devices, pen, and paper

IT staff available for assistance

Training manual for participants

Education conference room on 1st floor for support staff and business office

Coffee, juice, breakfast pastries, fruit tray

Executive conference room on 3rd floor for providers

the monthly 2001 Laurel

will occur in the format of a “lunch and learn” session for (see Timeline). This

tributed in weeks 8 and 9. last approximately one hour. It will be followed by a brief evaluation.

The training for support staff and business office will be provided prior to clinic 8am. Support staff will be compensated for the additional hour of

raining sessions will be provided for support staff in weeks 10 and 12. education session.

Training sessions will be provided for business staff in weeks 11 and 13. The ort staff and the business office will include hands on training with

laptop computers. Evaluation of knowledge retention and education presentation will be

net access,

port staff and business office


o IT staff available for assistance

Learning Objectives

Audience By the end of session participant’s should :

Providers • Be competent in the utilization of MedMobile • Be able to access MedMobile from a mobile phone • View provider schedules • View rounding schedules • Access patient records from mobile device • Document patient encounters • Enter billing charges • Listen to voice messages • View text messages, faxes and images via mobile device

Support staff • Be competent in the utilization of MedForte in the clinic setting • Be able to access MedForte from a computer • View and edit provider schedules • View and edit rounding schedules • Search ICD-9 codes and CPT codes • Enter, view and edit patient data • Enter, view and edit alert system • Identify and track patients who are involved in clinical trial • Be familiar with the management tool MedMobile • Send voice messages, text messages, faxes and images via

MedForte to provider’s mobile device Business office • Be competent in the utilization of MedForte in the clinic setting

• Be able to access MedForte from a computer • View provider schedules • View rounding schedules • Search ICD-9 codes and CPT codes • Enter, view and edit patient data • Enter, view, track and edit patient charges • Identify and track patients who are involved in clinical trial • Be familiar with the management tool MedMobile • Send voice messages, text messages, faxes and images via

MedForte to provider’s mobile device

Supplemental Education

• Webinars available online


• Support Email from MedActivus

• Training over the phone from MedActivus

• Superusers within organization for support during training and Go-Live

Devices

Computers

Apple iPhone

Number of Devices

12

20

Location

2 in Pods A-D

1 in Pod E

3 in business office

With provider

Rationale

Use of MedForte

Bedside charge capture

The SCHC will not require any additional computers or upgrades for implementation of MedActivus. The current 12 computers are already in use. All upgrades of the application are performed by MedActivus and included in subscription price. This helps ensure a low startup and maintenance cost. Twenty Apple iPhone mobile devices will be required for use MedMobile by all providers. Fax machines will not be required for use with this program, but the provider can have faxes sent directly to the mobile device if needed.


ImplementationTimetable

Timeline: 16 Week Implementation

1. Communication Plan

- Identify project manager

- Select application task force

- Review & Choose application (MedActivus) - Announce decision to SCHC end users - Contact Verizon for samples

- Select hardware (iPhone)

- Submit cost of iPhone devices to COO - Purchase iPhones (20)

2. Training/Implementation

- Contact trainer from MedActivus

- Obtain training materials

- Post training materials online for easy reference - Reserve conference room for training dates - Identify superusers

- Obtain username and passwords for all end users - Train superusers to use MedActivus

- Assign staff to meeting dates/times

- Train nurses on MedForte

- Train providers on MedMobile

- Train business office on MedForte

- Evaluate knowledge retention

3. Command center plan

- Ensure computers working

- Disperse mobile devices

4. Go-live plan

- Begin to input patient data and procedures - Review Go-Live plan

- Reconcile hospital census

- email day/time to staged go-live

- Begin Go-live in Pods

- Cease paper billing if appropriate

- Evaluate implementation


Implementation

1 2 3 4 5 6 7 8 9 10 11 12 13

13 14 15 16

A,B C,D E


Use of a timeline is imperative to ensure that implementation of MedActivus stays on course to completion. The Synapse team divided up the task into 4 categories:

1. Communication plan: This plan describes how the project team will choose an application and market to endusers (Englebardt & Nelson, 2002). It takes place during weeks 1-6. An application task force is developed and comprised of key members from each area of impact (physicians (MD), nurse practitioners (NP), physician assistant (PA), registered nurses (RN), business office, and information technology (IT). This team selects the software application and hardware. This project team notifies the organization of the pending application implementation by email and unit flyers. The Apple iPhone vendor is contacted to bring in products for review by this team. The Apple iPhone 3GS is selected and 20 are ordered for the providers. The cost of this is submitted to the Chief Operations Officer (COO) for review prior.

2. Training and Documentation Plan: This plan takes place during week 4-13. Once the application is selected, training must be planned. Since MedActivus provides educational support to its users, they are contacted to get assistance from a trainer and any additional materials required (reference manual, FAQ sheets, handouts, competency tests, “quick help” documents). Once the materials are received, they are posted online at the SCHC intranet for easy future reference. To ensure there is sufficient support throughout the process, superusers are identified from each group (MD, PA, NP, RN, business and IT staff member) for more intense initial training by MedActivus support personnel. Once this step is complete, MedActivus support personnel and superusers work together to train physicians, NP/PA’s, RNs, IT, and business office staff over a 4 week period. Englebardt and Nelson (2002) recommend training initiation no more than 4-6 weeks prior to Go-live. After evaluations are completed in the 4th week of training (week 13) Synapse moves on to Step 3.

3. Command Center Plan: This step ensures that the organization has the requirements for a usable command center (Englebardt & Nelson, 2002). This includes weeks 4-9. Once the system requirements are identified, IT begins checking all workstations (computers) for issues that may impede implementation. Once the Apple iPhones arrive, they are set up, loaded with MedMobile, and distributed to all providers (physicians/NPs/PA).

4. Go-Live Plan: This step officially begins in week 9 and continues through to implementation of MedMobile. In week 9, the plan is first reviewed by key members of implementation team (MD, PA, NP, RN, business and IT staff member superusers) and Chief Executive Officer (CEO), COO and Chief Information Officer (CIO). Englebardt and Nelson (2002) recommend that this group meet at least 3 times before the Go-live date to ensure that expectations are clear and preparation is complete.


Committees

Project Manager: This is an individual or group that is “organized and capable of planning at every level” of MedActivus implementation (Englebardt & Nelson, 2002, p. 184). This would be assigned by a member of senior management (CEO, COO, or CIO). The project manager drives the entire process of implementation by:

• Helping identify an IT vision

• Logically integrating new technology and information

• Describe necessary features, resources, skill sets, and financial estimates needed to accomplish plan (Englebardt & Nelson, 2002, p. 183).

Application Task Force: This group is comprised of a physician, NP, PA, RN, business and IT staff member. Their primary responsibility is to select the application (MedActivus) needed to solve the identified problem (lost revenue). This team is assembled early in the process (week 1 and 2) to expedite project goals.

Superusers: This group is comprised of a MD, PA, NP, RN, business and IT staff member. These members are identified early in the process (week 5) as “unit-based professionals who assist with training and/or end user support for their units during implementation” (Englebardt & Nelson, 2002, p. 200). Mastrian (2011) noted that superusers might be identified by characteristics seen in early adopters such as: experimenters, socially connected, intrinsically motivated, confident, embrace change, attracted to technology and those that think outside the box. These users also assist in education of other users prior to implementation and throughout the process. They are trained early on by the MedActivus vendor to assist in acceleration of implementation.

Revised Process

Following implementation of MedActivus at SCHC, the billing process will become more streamlined, accurate, and increased turnaround of revenue. The paper billing will be replaced with MedMobile and MedForte, thus eliminating the need for leaving collection of paper charges by a courier, instead sending charges directly to billing office staff personnel for review (See Appendix D).


EvaluatioOverview of Evaluation Plan and Methods

The quality of training is vital toabout the system and will affect succesEvaluation will determine the degree to which training has supported organization goals (CDC, 2011). Riley & Smith (1997) observed how insufficient training could contribute to users 'resistance to change' and noted that superior training is core to succtechnological change. A consequence of failing to review a finished project is that actions or decisions that caused problems and errors may be repeated in subsequent projects (Disterer, 2002).

Synapse will utilize the CDC Model for training evalua4-level evaluation model builds on successive levels to measure performance by analyzing (CDC, 2011):

1. Reactions 2. Learning 3. Knowledge Transfer 4. Results

Reaction

‘Staff reaction’ questions participants’ reaction to the they like it and was it relevant to their job function. This can be assessed by participant feedback questionnaires, informal comments from participants and focus group sessions with participants (cdc.gov).

Learning

Learning is the advancement of knowledge, skills, and attitudes towards what is being communicated in the training program. Extent of learning can be measured by preand post-test scores, on-the-job assessments and supervisor reports (cdc.gov).

Knowledge Transfer

Knowledge transfer is defined by the CDC (2011) as the measure of change in behavior due to a training program. people's heads then being exchanged with others. process by which documents, data, or other types of resources is captured and stored in formats and media that allows for retrieval by others when needed (toolbox.com). Knowledge and experience gained from ITas team members become available for subsequent projects (Disterer, 2002). Knowledge


Evaluation Overview of Evaluation Plan and Methods

The quality of training is vital to project success. It is the primary way users learn and will affect successful use of the system and attitudes towards it.

Evaluation will determine the degree to which training has supported organization goals Riley & Smith (1997) observed how insufficient training could contribute to

users 'resistance to change' and noted that superior training is core to successful technological change. A consequence of failing to review a finished project is that actions or decisions that caused problems and errors may be repeated in subsequent projects

Synapse will utilize the CDC Model for training evaluation (See Appendix Elevel evaluation model builds on successive levels to measure performance by

‘Staff reaction’ questions participants’ reaction to the training program, i.e. did they like it and was it relevant to their job function. This can be assessed by participant feedback questionnaires, informal comments from participants and focus group sessions

the advancement of knowledge, skills, and attitudes towards what is being communicated in the training program. Extent of learning can be measured by pre

job assessments and supervisor reports (cdc.gov).

Knowledge transfer is defined by the CDC (2011) as the measure of change in behavior due to a training program. It is considered as informal or "invisible" - lying in people's heads then being exchanged with others. Formal knowledge transfer is the

by which documents, data, or other types of resources is captured and stored in formats and media that allows for retrieval by others when needed (toolbox.com).

ained from IT projects are a great resource for an institution am members become available for subsequent projects (Disterer, 2002). Knowledge

way users learn attitudes towards it.

Evaluation will determine the degree to which training has supported organization goals Riley & Smith (1997) observed how insufficient training could contribute to

essful technological change. A consequence of failing to review a finished project is that actions or decisions that caused problems and errors may be repeated in subsequent projects

(See Appendix E). This level evaluation model builds on successive levels to measure performance by

training program, i.e. did they like it and was it relevant to their job function. This can be assessed by participant feedback questionnaires, informal comments from participants and focus group sessions

the advancement of knowledge, skills, and attitudes towards what is being communicated in the training program. Extent of learning can be measured by pre-

Knowledge transfer is defined by the CDC (2011) as the measure of change in lying in

knowledge transfer is the by which documents, data, or other types of resources is captured and stored in

formats and media that allows for retrieval by others when needed (toolbox.com). projects are a great resource for an institution

am members become available for subsequent projects (Disterer, 2002). Knowledge


transfer is accomplished by the learning process and through the vendors training courses and materials (Disterer, 2002) and can be measured through self-assessment questionnaires, on-the-job observation and/or reports from customers, peers and company managers (cdc.gov). An assessment of knowledge transfer should indicate if the knowledge and skills gained during the training program are being used by the trainee (cdc.gov). Company employees can enhance knowledge transfer through the use of webinars, training of ‘superusers’, and the compilation of vendor training materials for easy access during future projects.

Results

It is important to assess outcomes and results post implementation to determine if the software is positively impacting the initial problem. Management understands increased productivity, decreased costs and improved quality (cdc.gov, 2011). These attributes can be documented by measuring revenue and/or the number of lost charges post-implementation via financial reports, quality inspections and/or interviews with financial managers (cdc.gov).

Evaluation Methods

Attribute

Method

Reaction A comprehensive survey will be administered post-implementation to participants to assess reactions to training (See Appendix F).

Learning Learning for SCHC will be assessed using a post-test upon completion of software installation and training (See Appendix G).

Knowledge Transfer Focus groups of the different classifications of employees will be convened to assess knowledge transfer in a “lessons learn” format (See Appendix H)

Results An audit tool will be used to measure lost charges pre and post implementation; comparison of revenue for the 6 months prior to and after implementation (See Appendix C).


References

Adkison, P. (2011). Revolutionizing the coding and billing cycle with intelligent mobile technology. Retrieved on November 10, 2011 from http://www.healthmgttech.com/index.php/solutions/payers/revolutionizing-the-coding-and-billing-cycle-with-intelligent-mobile-technology.html

Apple Inc. (2011). iPhone 3G tech specs. Retrieved on November 23, 2011 from http://www.apple.com/iphone/iphone-3gs/specs.html

Business-plan.co.za (2011). The internal environment analysis. Retrieved on November 11, 2011 from http://www.business-plan.co.za/the-internal-environment-analysis.html

Center for Disease Control and Prevention (CDC). (2011). Training planning. Retrieved on November 1, 2011 from http://www2.cdc.gov/cdcup/library/pmg/development/tp_description.htm

Cost-benefit/Analysis. (2011). Retrieved on November 24, 2011 from http://www.mindtools.com/pages/article/newTED_08.htm

Deshchenko, O. (2011). CMS: Medicare reimbursement to decrease by nearly 30 percent in 2012. Retrieved on November 10, 2011 from http://www.dotmed.com/news/story/15541

Disterer, G. (2002). Management of project knowledge and experiences. Journal of Knowledge Management, 6(5), 512-520.

Eppler, M. J., & Sukowski, O. (2000).Managing team knowledge: Core processes, tools and enabling factors. European Management Journal, 18(3), 334-341.

Ergonomics-info.com. (2011). Ergonomic workstations. (Retrieved on November 22, 2011 from http://www.ergonomics-info.com/ergonomic-workstations.html

Institute of Ergonomics and Human Factors. (2011). Retrieved on November 17, 2011 from http://www.ergonomics.org.uk

Kaiser Family Foundation (kff.org). (2011). South Carolina: Medicare enrollment. Retrieved on November 10, 2011 from http://www.statehealthfacts.org/profileind.jsp?cat=6&sub=74&rgn=42

Knowledge Transfer. (2008). Retrieved on November 11, 2011 from http://it.toolbox.com/wiki/index.php/Knowledge_Transfer

Mastrian, K. (2011.) Integrating technology in nursing education: tools for the knowledge era. Retrieved on November 11, 2011 from http://books.google.com/books?id=rhIPAtCW_4cC&pg=PA49&lpg=PA49&dq=early+adopters+to+change+in+nursing&source=bl&ots=n7dbLiKBg1&sig=TXxg8yfkzruzQD7uZJ_ieyBes8I&hl=en&ei=ef_CTpKFOsHYtweElr2sDg&sa=X&oi=book_result&c

http://www.healthmgttech.com/index.php/solutions/payers/revolutionizing-the-coding-and-billing-cycle-with-intelligent-mobile-technology.html

http://www.healthmgttech.com/index.php/solutions/payers/revolutionizing-the-coding-and-billing-cycle-with-intelligent-mobile-technology.html



http://www2.cdc.gov/cdcup/library/pmg/development/tp_description.htm

http://www.dotmed.com/news/story/15541

http://www.ergonomics.org.uk/

http://www.statehealthfacts.org/profileind.jsp?cat=6&sub=74&rgn=42

http://it.toolbox.com/wiki/index.php/Knowledge_Transfer


t=result&resnum=2&ved=0CCsQ6AEwAQ#v=onepage&q=early%20adopters%20to%20change%20in%20nursing&f=false

Nicoletti, B., Dera, J. D., Valancy, J., Beeson, S., Edsall, R. L., Paladine, H. L., . . . Welby, M. (2009). Chart audit: Is your practice billing what it should? Family Practice Management, 16(2), 15-19.

Riley, L., & Smith, G. (1997). Developing and implementing IS: a case study analysis in social services, Journal of Information Technology, 12, 305-321.

Sullivan, J. (2011). The ideal turnover rate. Retrieved on November 19, 2011 from http://hiring.monster.ca/hr/hr-best-practices/recruiting-hiring-advice/strategic-workforce-planning/employee-turnover-rate-canada.aspx



Appendix A

The Gassert Model


Figure 1: Current paper billing process at SCHC; (International Classification of Diseases)


Appendix B

Current Process

Figure 1: Current paper billing process at SCHC; CPT (Current Procedural Terminology), ICD(International Classification of Diseases)

(Current Procedural Terminology), ICD-9


Appendix C

Chart Audit Tool Screen Shot


Figure 2: Improved paperless billing process


Appendix D

Proposed Solution

billing process


Appendix E

CDC Five-phased Instructional System Design


Appendix F

Reaction Assessment Tool


Synapse Reaction Assessment Tool

The following survey was designed to assess client satisfaction and to gain feedback regarding your general satisfaction with the training process for your IS implementation.

Synapse takes great pride in providing the best possible customer service, thusis very important in assessing the degree to which we successfully met your training needs. Please read through the survey and answer each question accurately.

Thank you in advance for your time.

Synapse – Informatics Implementation Team

What did we do well on the project training?

What can we do better next time?

What do you feel were the main risks with training and how well were they managed?


Reaction Assessment Tool


takes great pride in providing the best possible customer service, thus this survey is very important in assessing the degree to which we successfully met your training needs. Please read through the survey and answer each question accurately.

Thank you in advance for your time.

Informatics Implementation Team

What did we do well on the project training?

What can we do better next time?



this survey is very important in assessing the degree to which we successfully met your training



Instructions

Use the scale below to rate your degree of satisfaction with each item presented. As indicated, a higher score indicates a greater degree of satisfaction. For any item with a rating of 2 or below, please provide a written explanation in the comments section.

1 2 3 4 5

Extremely Satisfied Satisfied Extremely dissatisfied

_______Overall

_______Facilities

_______Time allotted

_______Thoroughness of training plans and curriculum

_______Effectiveness of training

Comments


Appendix G

Learning Assessment Tool


Synapse Learning Assessment Tool

Upon completion of training program, following areas as evidenced by a satisfactory (S) return demonstration for the training team:

Providers: (MD/NP/PA)

________Access of MedMobile from a mobile phone

________Viewing of provider schedules

________Viewing of rounding schedules

________Accessing patient records from mobile device

________Documentation of patient encounters

________Entering of billing charges

________Listening to voice messages

________Viewing text messages, faxes and images via

________Overall competence in the utilization of MedMobile

Comments (include any remediation)



Upon completion of training program, participants will demonstrate competence in the following areas as evidenced by a satisfactory (S) return demonstration for the training

________Access of MedMobile from a mobile phone

________Viewing of provider schedules

____Viewing of rounding schedules

________Accessing patient records from mobile device

________Documentation of patient encounters

________Entering of billing charges

________Listening to voice messages

________Viewing text messages, faxes and images via mobile device

________Overall competence in the utilization of MedMobile

(include any remediation)

participants will demonstrate competence in the following areas as evidenced by a satisfactory (S) return demonstration for the training



Upon completion of training program, participants will demonstrate competence in the following areas evidenced by a satisfactory

Support Staff: RN

________Accessing MedForte from a computer

________Viewing and editing provider schedules

________Viewing and editing rounding schedules

________Searching ICD-9 codes and CPT

________Entering, viewing and editing patient data

________Enter, view and edit alert system

________Identifying and tracking patients who are involved in clinical trials

________Familiarity with the management tool MedMobile

________Sending voice & text messages, faxes & images via MedForte to provider’s

mobile device

________Overall competence in the utilization of MedForte in the clinic setting




Upon completion of training program, participants will demonstrate competence in the by a satisfactory (S) return demonstration for training team:

________Accessing MedForte from a computer

________Viewing and editing provider schedules

________Viewing and editing rounding schedules

9 codes and CPT codes


________Enter, view and edit alert system



text messages, faxes & images via MedForte to provider’s



Upon completion of training program, participants will demonstrate competence in the training team:

text messages, faxes & images via MedForte to provider’s



Upon completion of training program, participants will demonstrate competence in the following areas as evidenced by a satisfactory (S) return demonstration for the training team:

Business Office

________Assessing MedForte from a computer

________Viewing provider schedules

________Viewing rounding schedules

________Searching ICD-9 codes and CPT codes


________Entering, viewing, tracking and editing patient charges

________Identifying and tracking patients who are involved in clinical



mobile device





program, participants will demonstrate competence in the following areas as evidenced by a satisfactory (S) return demonstration for the training

________Assessing MedForte from a computer

________Viewing provider schedules

ewing rounding schedules

9 codes and CPT codes


________Entering, viewing, tracking and editing patient charges





ny remediation)

program, participants will demonstrate competence in the following areas as evidenced by a satisfactory (S) return demonstration for the training



Appendix H

Knowledge Transfer Tools


Synapse Knowledge Transfer Assessment

Focus Group Attendees

1. What about the training this week was relevant to your work?

2. What were the training’s strengths?

3. What were the training’s weaknesses

4. How would you change the training to make it more useful to you in your management of patients?

5. Will you be able to implement this training in your management of patients?

6. What challenges might you face?

7. What resources will you need in order to implement what you learned in this training?

8. Would any additional training be helpful to you in the utilization of this software?


Knowledge Transfer Assessment

Occupation

What about the training this week was relevant to your work?

What were the training’s strengths?

What were the training’s weaknesses

How would you change the training to make it more useful to you in your

Will you be able to implement this training in your management of patients?

challenges might you face?

What resources will you need in order to implement what you learned in this

Would any additional training be helpful to you in the utilization of this software?

Will you be able to implement this training in your management of patients?

What resources will you need in order to implement what you learned in this

Would any additional training be helpful to you in the utilization of this software?