Anticlue

A house is only as good as the foundation, and your EHR foundation is your technology and security infrastructure. Are you still running windows 2000? Has wireless been installed and widely tested? Is there a patching plan for the core, distribution switches, and access switches along with the Microsoft update plans? Will your standardized tablet work in a clinical setting? Do you have a standardized tablet? Is there a redundant wan pipe to your hosted EHR solution? Do you have enough bandwidth for when everyone signs in before rounding? How will mobile printing work? Perhaps there needs to be clinical system and technology support onsite at night? As you move forward with your EHR planning, let make sure the infrastructure is able to support the growing need.

Let's take off those rose colored glasses and frankly assess our infrastructure services.

• Red Flag - Running legacy operating systems for computers and network switches. Have not solved the batteries need to be charged problem in clinical areas. Wireless has not been installed or fully tested. No standards for wireless usage. The security process for ePHI abuse is not known. Evening support is a help desk which just takes tickets and routes, doesn't solve problems.


• Yellow Flag - Under our yellow flag, our operating systems and switches are relatively current, we have a patching window for updates. There exists and is funded a technology refresh plan along with a technology strategic plan. The security process for ePHI abuse is known, but not often followed.


• Green Flag - In this item, availability and capacity needs are monitored an assessed. Technology Services are reviewed as a part of the requested projects design to assure capacity and availability will exist. Service levels have been agreed to from the business process owners and support is based upon the agreed to service levels. Business Continuity Plans have been developed and have yearly testing and review cycles. Load testing of equipment is completed way before first productive use.

Depending upon the ascertained risk, you may have to prepare to do a complete assessment of your infrastructure and security practice. It is better to have known risks than unknown risks. From an operational consideration, address the intolerable risks.

Although the foundation isn't glorious, it is essential. Having the infrastructure in place to support the clinical usage on an EHR is critical.

Further Readings on the Getting Ready for Meaningful Use Series:

• Using Rules to support clinical decision support


• Assessing your vendor management skillset


• Assessing your project execution ability


• Discovering the organization's perception of an EHR


• Getting your physician leadership engaged


• The 5 levels of healthcare IT Credibility


• Understanding the refinement of meaningful use

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