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Strategic Planning: Implementation Plan and Operational Plan
Strategic Planning for EMR is the most important step taken towards the implementation and eventual adoption of an EMR system. Strategy Planning differs fundamentally from general planning in that Strategic Planning is a long term plan (measured in years) and takes into account internal and external influences on the clinic. Based on the 3 year OntarioMD funding cycle, the strategic planning proposed here will cover an elapsed time of at least 3 years.
The seven steps to developing a Strategic Plan are given below.
Vision Statement
This is a collective aspiration and seeks to visualize how patient care will improve in three years time in terms of the use of patient information in the form of electronic health and electronic medical records.
Mission Statement
Whereas a Vision Statement is an aspiration, a Mission Statement is a covenant or a pragmatic commitment. The application process for OntarioMD will avail the clinic
of funding that should be used for improving the healthcare service it provides by the use of new or enhanced technology but not at the expense of impeding the
delivery of this service by professionals or a loss of revenue for the clinic. The Mission Statement must launch the EMR project with words that encapsulate the new direction the clinic is determined to take.
Environmental Scan
This is an important step in the planning process as it takes into account all the internal and external entities, in particular the EMR vendor, that impact on the quality and timely delivery of healthcare service. The work flow of all entities that affect the healthcare delivery needs to be documented in order to establish how the EMR will affect the workflow in the future. This will give the participants an chance to question the functionality of the EMR and verify that the software can deliver the same process. The layout of the graphical User interface is important and its user friendliness. Also, reports, referral letters, workflow sheets and established encounter strategy needs to be reviewed against what the software displays.

External influences in the form of billing requirements and the importance of lab reports and diagnostic images needs to be verified. Other technical issues such as the external monitoring of the EMR server also needs to be understood. The OntarioMD funding process is the most important influence in the EMR project. An understanding of the application process and how it will influence the timelines, deadlines and deliverables in the project should be discussed and documented.

Goals and Objectives
As we progress from the Vision Statement to the Environmental scan, our choices in what we can do as a healthcare team narrow and sense of realism, based on the time we have, the funding and people resources at our disposal, influences our choices. We are now better equipped to specific succinct goals that are realistic, measurable and that support the clinic's mission. Typical goals such as the completion the OnatarioMD application process, documenting timelines and milestones for deliverables and allocating resources, upgrading hardware, writing and reviewing a proposal, signing a contract with the EMR Vendor, Training staff etc.
The Objectives for each goal should be clearly stated deliverables for each goal. For the OntarioMD application process for example, the objectives could be to complete and submit the Readiness and Self Assessment grant application, the EMR Funding Agreement Grant forms etc.
Implementation Plan
An implementation Plan requires a high degree of accountability. For example the Performance Grant from OntarioMD requires that 600 Patient records or 2/3 of the clinics current roster (whichever is less) needs to be input into the EMR system.
Who will do this? When will this be done? And will resources be allocated for this task?
For the Goal of receiving the performance grant, the answers to the above questions
become the Implementation Plan for the Performance Grant Goal. For each of the Goals and their objectives, the above questions (Who? When?) must be answered. Moreover,
there should be a tracking process that verifies the timely completion of these tasks.
Since professionals on the team work hard to implement the clinic's goals, it is recommended that a system of rewards or recognition should be established as this acts as an incentive and ensures the co-operation of the team.
Operational Plan
Operation Plans are short term plans and are concerned with the day to day running of the new EMR system. The scope of action is typically three to six months in duration. These are plans to deal with the allocation of resources on short term projects. If the implementation planning is concerned with when and who is going to responsible for this objective, the operational plan focuses on how this objective is going to be achieved. For example, how is the training going to be done?
Webinar based, online courses, self-directed or conventional face-to-face training? Another example could be: How will you deal with legacy patient data when an existing patient returns to the clinic and his/her encounter needs pre-EMR information?
Performance Measurement
Performance measurement asks the question: How well are we doing?
The impact of the EMR will be felt in three areas:
a) Quality of patient care
These can be handled by Web based surveys. It’s important to get a bench mark reference of patient information before the EMR is implemented.
Then repeat the survey every year for the duration of the three year OntarioMD funding cycle.

b) Staff satisfaction with the new tool in terms of workflow execution

c) A review of the clinic's finances to assess if the revenue for the clinic has increased or decreased.

Information in the above three areas must be reviewed every year and corrective action needs to be taken if necessary. This includes a change of plans.
The strategic planning process must be flexible enough to allow for short-comings and failures. Lessons can be learned and positive outcomes can be finally achieved.