EMR Implementation Readiness

Assessment Tool

Revised versions
 I. Summary
Electronic Medical Record (EMR) is a digital version of a medical record. Typically,
it contains everything you’d find in a paper chart, such as medical history,
diagnosis, medications, immunization dates, and others. As with the
implementation of any information technology that automates a workflow process,
readiness for EMR adoption is extremely important. Lack of organization-wide
readiness has been a major contributor to the overwhelmingly high failure rate of
EMR adoptions throughout the healthcare industry. This report summarizes
findings in General organizational capacity and IT infrastructure assessment.
II. Objective

The proposal’s main objective is to conduct Facility leaders and workforces

commitment and Infrastructure readiness assessment at different health facilities.

Specific objectives

• To understand the organizational culture

• To evaluate the commitment of management and leadership
• To assess technical readiness and status of network infrastructure
• To identify the operational readiness of the health facility
• To assess the available IT infrastructure meets the standard to implement
EMR at the health center

III. Methodology

The organization readiness will be conducted on the health facilities’ organizational

alignment, management commitment, technical capacity, and operational capacity.
Data will be collected using observation, survey, and interview methods. The
Health Facility higher officials including each department head will be interviewed
and a questionnaire will be distributed to them. The IT infrastructure status will
also be observed and inspected using the below tool.
The first part of the assessment tool covers the Health Facility leaders and staff
readiness and the second part helps to identify the status of IT infrastructure for
EMR deployment in the health facility.

Health Facility EMR Readiness Assessment Tool

The following tool was adopted and customized to analyze the health facility
readiness to implement EMR in a selected health facility.
Tool- Score Interpretation

There are five sections in part One of the assessment tool; General information,
Organizational alignment, management capacity, operational capacity, and
technical capacity. Average scores are provided at three levels of detail: by
category of readiness within each Readiness Area; average scores can be broadly
interpreted as follows for administration and staff capacity and for IT
infrastructure:

Health Facility leaders and staff readiness

Average Score of 3.0 - A score in this range may indicate that
the health facility has a solid understanding of this particular
readiness issue and may not need to spend too much additional
focus to ensure success in this area.
Average Score of 2.0 - A score in this range may indicate that
the health facility is not as strong in this area as it could be.
Average Score of 1.0 - A score in this range may indicate that
the health facility is not currently prepared to move forward with
EMR adoption without increasing specific readiness in this area.
Section One : General Information

Facility Name: Facility Type:

Region: Zone/Sub City:
Woreda:
Respondents Name: Phone
email:
Respondent Position: Date completed:
Data collector Name:

Baseline Data

Response Remark

Number of inpatient Service Units

Number of emergency units

Number of Outpatient service units

Number of Drug dispensing units

/pharmacy units/

Number of drug stores

Number of Lab service units

Number of MRU Windows

Number of Triage Units

Average Number of patient visit the

facility per-day

Health Workforce Staffs

Number of Specialists

Number of GPs

Number of Health officers

Number of Nurses (all types)

Number of Midwives

Number of Lab technologists

Number of Pharmacists

Others(Specify and note their number)

Supportive Staffs

Number of Admin and Finance officers

Number of Cashiers

Number of MRU workers

ICT Structure and Professionals

Availability of IT Structure (Yes/No)

Number of IT professionals with

BSc/MSc

Number of IT professionals with

diploma

Number of Permanent IT professionals

Number of Contractual/Temporary IT
professionals

Available Health Systems Implemented in the Hospital

Is there Functional Health

Systems(Yes/No)

Department Software Number of

Name Patient record
MRU

Pharmacy

Laboratory system (Yes/No)

Radiology

OPD

ART

Other Digital Health systems

implemented in the Hospital? Yes/No
Is there any Other EMR system
available? yes/No

Number of Service units Implemented

the EMR

Ever used the previous EMR for

monitoring Facility's performance
(Yes/No)?

Ever eHMIS/PHEM data extracted

from Previous EMR (Yes/No)?

Does the hospital have plans to relocate/change service delivery rooms in

the near future? If Yes please explain below
 Section Two: Organizational Alignment

Readines
Not Yet Highly
s Areas & Moderately
Elements Prepared Prepare Rating
Categorie Prepared 2
1 d 3
s
Culture As a health
facility As a technology to
EMR is As an IT project to technology to enable quality care
viewed… “go paperless” only. achieve workflow improvement
efficiencies. goals.
primarily
All departments
The EMR
Top management Key planners or are team-oriented
planning
and/or designated departments and and emphasize
process
investigator only. is participatory. communication
includes…
and collaboration.
Embrace limited
amounts of change;
Modify existing
The facility new solutions and
processes when Embrace change
has the programs are
faced with and create new
ability and created in response
significant solutions.
tendency to… to significant
change.
pressure or funding
opportunities.
Data is… Not used regularly Viewed as one A key part of the
to prevent or solve component of management
problems. decision-making, mindset and
but is not viewed viewed as critical
 to preventing
problems,
as a preventative
improving
tool.
efficiency, and care
delivery.
Quality
Are driven by a
improvement,
department or
population Permeate all
Are not a current specific
health aspects of the
focus. individual, but
management, organization.
are not a
and workflow
pervasive focus.
efficiency…
Discussed and
approved the Discussed and
Discussed the need need for EMR approved EMR
for EMR technology to strategy, created
The Board technology but has support health an EMR
has… not been closely facility quality subcommittee, and
involved in the goals and will will receive
initiative. receive progress progress reports
Organizat reports regularly.
ion periodically
Have been
established and
Priorities for managed through
Are in the
EMR Have not been the systematic
process of being
implementati defined. rollout of features
defined.
on and use… and functions
including go/no-go
decision points.
 Understands the
benefits of the
EMR and risk of
Has studied the
failed
Believes EMRs are pros and cons of
implementation,
necessary but are implementing an
and sets a clear
divided as to how to EMR and can
Leadership… and consistent
communicate why make an
vision for how
and when to pursue argument for why
EMR supports
them. benefits outweigh
efficiency and
costs.
quality
Leadershi improvement
p goals.
Substantial staff
The Limited staff time to Time for key
time from multiple
Executive EMR management to
departments for
team has implementation prepare for EMR
EMR
designated… activities. implementation.
implementation.
Actively engages
Generally,
Rarely engages physicians in data
engages
Physician physicians in used to improve
physicians in
leadership…. efficiency and workflow
efficiency and
quality initiatives. efficiencies and
quality initiatives.
quality.
Strategy IT strategic Not been Been carved out Been an integral
planning considered part of as a separate part of the
has… the strategic part of the organizational
planning process, organizational strategic planning
but operational and strategic process, resulting
addressed through planning in a 3-year
 process, Strategic Plan that
special projects. resulting in an IT guides EMR
Strategic Plan. procurement.
Documented as
key objectives in
Objectives, but the Strategic Plan
Discussed, but not
not clearly with measurable
clear objectives of
Quality and defined in a objectives,
the organization
efficiency measurable way corresponding
nor connected with
are… nor connected time horizon, and
EMR technology
with EMR management,
use.
technology use. connected with
EMR technology
use.

Please verify the availability of the documents (Strategy and

related documents)

Section Three: Leadership Commitment

Readines
Not Moderat
s Areas
Yet ely Highly
& Elements Rating
Prepa Prepared Prepared 3
Categorie
red 1 2
s
Staffing Are generally Have been documented in
Medical Have not been
needs for understood, a staffing model, detailing
and analyzed.
EMR but a staffing current staffing and
 proposed needs;
plan has not
implementati requirements have been
been
on and use… included in the planning
developed.
process.
Have a basic
Are experienced, have
understanding
Staff been educated about EMR
administra of EMR
dedicated to functionality and workflow
tive staff functionality
change Have not been impacts, are authorized to
and are
management specifically lead the decision-making
participating
and quality identified. process, and will work
in the EMR
improvemen closely with management
decision-
t… to resolve issues
making
throughout the process.
process.

Section Four: Operational capacity

Readiness Not Yet Highly

Moderately
Areas & Elements Prepared Prepare Rating
Prepared 2
Categories 1 d 3
Training Skill-sets Thought to be Assessed periodically; Continually being
and sufficient after scheduled training assessed; periodic
EMR vendor training. occurs when training schedule
training implementing a new is in place.
 needs are… feature only.
Training will be
Training will be Needs assessment
integrated into formal
provided to new and training will
new hire orientation,
hires and current be integrated into
but is not provided for
employees as part of new hire
EMR use and in a formal ongoing
on-the-job training; orientation,
data training program;
subsequent training ongoing training
quality… needs are assessed as
provided at the curriculum,
needed and not
request of the annual review,
incorporated into an
employee or and budgeting
annual review or
manager. processes.
budget processes.

Section Five: ICT Technical capacity

Readiness Not Yet Highly

Moderately
Areas & Elements Prepare Prepare Rating
Prepared 2
Categories d 1 d 3
IT IT is Ad hoc across By an By an information
manageme managed… resources with individual or technology team
nt and technical group of segmented into
support knowledge technical skill-based roles
throughout the resources that and dedicated to
organization. manage IT managing IT
 projects,
supporting the IT
environment, and
projects and
working hand-in-
support the IT
hand with
environment.
functional experts
in each
department.
Experience
Limited
with system Strong experience
experience with
integration or with system
system integration
data integration, data
IT or data conversion
conversion but conversion, and
Management relies heavily on
tends to rely managing expert
has… external resources
on the vendor resources to fill
for IT planning
to detail the internal skill or
and decision-
tasks and knowledge gaps.
making.
activities.
IT Staff IT staff hiring are generally
Availability for EMR understood,
implementatio Not included in the but a staffing included in the
n is health facility plan has not health facility
included in the annual plan been annual plan
facility's developed.
annual plan
Availability of There are very few There are few Enough IT
IT and HIT or no IT IT staff personnel exists in
personnel personnel in the available but the health facility
health facility not enough and can handle
EMR
 Implementation.
Budget
There is a There is enough
allocation
Budget and There is no budget budget budget allocated
for
Finance allocated for EMR allocated but is for EMR
Sustainability
minimal Implementation
of EMR is…

Health Facility leaders and staff readiness summary score(30%): _______

 Part Two: ICT Infrastructure Readiness Assessment

This assessment tool assesses the status of infrastructure readiness for EMR implementation at Different
health facilities. There are two sections in this tool, which are IT infrastructure assessment and IT
infrastructure risk assessment.

1. Network Assessment
This section assesses the status of network infrastructure including LAN, and LAN Equipments availability

1.1. Networking Device (Switches, Router and Wireless Access Points)

Location
Connected to (the Service
# of hope from Inclosed in Rack
S.NO Networking Device Type / Model /# of Port (Switch / unit/room
Server ?(Yes/NO)
Router) where it is
kept)
1 MAIN CORE SWITCH
2 Non Manageable switch 1
3 Distribution switch 2
4 Distribution switch 3
5 Distribution switch 4
6 Distribution switch 5
 1.2.
1.3.
1.4.
1.5.
VLAN Configuration(if any )
Does the Network segmented in VLAN(Yes/No)?

SN VLAN Name VLAN Subnet Subnet Default Reserved IP

ID Mask Gateway Addresses

2
 1.6. Server Assessment

Rack mounted
Server Model Processor Memory Virtualized Storage OS UPS Running Services Remark
Yes/NO)

NB: The minimum server requirement for the EMR implementation is

1. For HC - 16 Gb of RAM and 2 TB storage with 2.9 GHZ of processor speed
2. For Primary Hospitals - 32 GB of RAM and 2TB Storage with 2.9 GHZ (2X) of processors speed

1.7. Backup Devices (if Available)

Device Model Storage Type / Specification Location (Where the Connection Type: Network Remark
device was kept?) Connected / Direct plugged

User station Assessment

Number of Desktop computers, Laptops, printers and Tablets at each medical care
service units including administration (functional only). Please specify the
Building and Department where the devices are located.
Buildin Service Unit Functional (RAM > Printer(lo UPS Powe Power Network Wi-Fi Generato
g Block Desktop 2 Gb, NIC card) cal/ r extensio Node access r reach
 Computer shared) Socke n cord (Functiona point
t l)
Existing Required

01
02
03
04
05

1.8. Laboratory Equipment’s

Device Software Brand Service Unit Full control Remark

(Administration
Privilege)
 I
2. Power backup
Device Availability Type / Specification Capacity (Duration on power Remark
outage , )

IT Infrastructure Scoring

Networking Total score

Fully Functional Local Area Network(out of 25)1

Server Room: Server for storage and Backup.(out of 25)2

User station: Availability of Desktop computers,

Printer(Local/shared), UPS and/or backup Generator(out of 20)3
Total

Total Score

EMR Readiness Score

Health Facility leaders and staff
readiness(out of 30%)
IT infrastructure (out of 70%)
Total (out of 100%)

1 if all the available service units are connected with Local Area Network and can access the server, the score will be 25 pts.
2 If Server for production and/or Training instances is available with the specified minimum specification, it will be scored as 25 pts.
3 If all the available service units have desktop computers and get the backup generator for power outage, it will be scored as 20 pts.
EMR Readiness Score out of 100 (Interpretation)

Range 55 – 100 Ready

Range 30 – 54 moderately ready (needs facility enhancement)

Range 0 – 29 Not Ready