Resource Search Results

Getting Started on the Quality Journey: Case Vignettes (2016). Resource Type: Publication. Description: Launching quality work at first can feel like a daunting task – even more so if you do not have the support of leadership in your organization.  Some individuals have successfully launched quality work by following the mantra: “What can I get done by next Tuesday?”  This mantra helps them sidestep inertia, extensive collaboration, and time consuming benchmarking research. Instead, by identifying small steps they can take to improve quality on their own, within the context of their existing job, they can start on the journey quickly. Furthermore, success in these small steps can help with Leadership Buy-In for the importance of Quality work. The vignettes in the attached document are not intended to be literal examples of such efforts, although they rely heavily on real-life experiences.  Nor are they intended to be instructions for specific projects the reader can pursue at their own health center. Rather, these are intended to be aspirational examples of quality work that can be launched by an individual with relatively little support and produce results “by next Tuesday” (or relatively quickly).  The vignettes are written to encompass both health centers with many resources and those with less, to provide a variety of perspectives.  We hope that they inspire associative thinking for the reader, helping to identify specific work that can be accomplished “by next Tuesday.” More Details...

Health Center's guide to the MEHI EHR Planning and Procurement Toolkit (2016). Resource Type: Publication. Description: An introduction to creating an EHR RFP using the MEHI EHR Planning and Procurement Toolkit. This resource shows the user how to use a comprehensive tool such as the EHR Planning and Procurement Toolkit from the Massachusetts eHealth Institute (MEHI) to guide your organization through the process of EHR procurement. The process documented in the EHR Planning and Procurement Toolkit offers a field-tested and proven methodology for a health center that is procuring an EHR. The Toolkit offers a process that will lead an organization through readiness and preparation, vendor solicitation, evaluation and selection, and vendor relationship management. Embedded within the Toolkit at critical steps along the way are the tools needed to execute an effective procurement process.  More Details...

Health Center EHR RFP Addendum (2016). Resource Type: Publication. Description: This is an addendum template to be added to an EHR Request For Proposal (RFP) to help health center further specify the EHR functionalities needed. You may also consider using the available template introductory letter for your RFP as well. For further guidance, this resource can help to guide your organization through the process of EHR procurement using a comprehensive tool such as the EHR Planning and Procurement Toolkit from the Massachusetts eHealth Institute (MEHI). This template is intended to be an addendum to the Request for Proposal (RFP) Template for Health Information Technology. This template can be used to add requirements specifically relating to the specialized requirements and operating environments of health centers. More Details...

Health IT-Enabled Quality Improvement: A Guide to Improvement: 10/4 HITEQ Highlights Webinar Transcription (2016). Resource Type: Publication. Description: A transcription of the October 4th HITEQ Highlights webinar. A transcription of the October 4th HITEQ Highlights webinar.  Improving care delivery is a business and mission imperative for health centers, and the HITEQ Center offers a growing collection of tools and services to support this journey. The foundation for these particular offerings is the "Guide for Improving Care Processes and Outcomes in FQHCs."  This web-based resource provides step-by-step guidance on understanding and improving workflows and information flows that drive performance on key targets such as hypertension control and colorectal cancer screening. Guide centerpieces include worksheets for documenting, analyzing, sharing and improving care processes for such targets. Strategies and tools in the Guide have been used successfully in various quality improvement (QI) initiatives, and a HITEQ Center focus is spreading this value more quickly and widely among health centers. This introductory training session introduces health centers and their partners to the Guide's proven approaches, worksheets and other health IT-enabled QI tool More Details...

Orientation Follow-up Survey (2016). Resource Type: Publication. Description: This follow up survey is given to the employee following the first 2-4 months of employment. This follow up survey is given to the employee following the first 2-4 months of employment. This information is used to inform the supervisor how helpful the orientation was and what, if any, information was missing. It can help improve the new employee orientation for future employees. More Details...

New Employee Orientation Evaluation Form (2016). Resource Type: Publication. Description: This is an evaluation form to give to a new employee immediately following the orientation program. This is an evaluation form to give to a new employee immediately following the orientation program. The feedback generated from its completion will help the supervisor learn what can be done to make the orientation more effective in the future for future employees as well as on what topics the new employee still may need clarification. More Details...

Benefits and Tools for Onboarding and Orientation of New Staff Members: Guidance and Methods for Health Centers (2016). Resource Type: Publication. Description: This document outlines the ways in which effective onboarding and orientation methods will result in shorter learning curves, improved job satisfaction, and improved retention.  This document outlines the ways in which effective onboarding and orientation methods will result in shorter learning curves, improved job satisfaction, and improved retention. It then provides explicit direction for how to organize an effective process, complete with checklists for supervisors to use to plan the process, and surveys for the employee to fill out immediately following the orientation and then again 2-4 months afterwards. More Details...

Encrypting Data at Rest on Servers: Implications for Health Centers (2016). Resource Type: Publication. Description: It is common practice today to encrypt data at rest, that is, data stored on servers. This is especially applicable to health centers who are less frequently actively transporting data across disparate networks. Like many smaller healthcare organizations, Health Centers are particularly vulnerable to potential attack and infiltration by data hackers for several reasons: they tend to have fewer technical support staff, resource limitations make it harder to assess, implement, and maintain safe data practices, and organizational inertia limits preventive action when no threat is perceived.  It is common practice today to encrypt data at rest, that is, data stored on servers. Like many smaller healthcare organizations, Federally Qualified Health Centers FQHC are particularly vulnerable to potential attack and infiltration by data hackers for several reasons: they tend to have fewer technical support staff, resource limitations make it harder to assess, implement, and maintain safe data practices, and organizational inertia limits preventive action when no threat is perceived. To build off an old adage, no one ever got fired for encrypting their data. But what protection does that really provide? Is just encrypting data enough? First, let’s distinguish between three methods for encrypting data at rest. Full-disk encryption. Most modern operating systems like Linux or Windows Server provide the capability to encrypt their disks in their entirety. This is accomplished with symmetric encryption whereby there is a key or passphrase that a computer operator has to enter when the disks are encrypted and when the system boots to allow access to the data. Typically, the password must be manually entered on the physical server console, though some virtualized and cloud-based environments offer remote passphrase entry and varying degrees of passphrase management and automation. With full-disk encryption, software installed on the server does not need to know or do anything special to operate normally: the operating system provides transparent access to the encrypted data as necessary with very little performance loss. But note that the initial encryption needs to be done on a new disk or set of disks as an existing disk will be wiped clean in the process. So it’s easiest to do this during an initial deployment or migration to a new server. File system encryption. Physical disks are typically divided into one or more file systems by the operating system.  As an alternative to full-disk encryption, file system encryption allows administrators to encrypt only selected file systems or even just selected folders within file systems. This makes it possible to configure a server than can boot without a passphrase; and then require a passphase only after the system is up and running and needs to access its encrypted file systems.  Similar to full-disk encryption, the encryption is transparently provided to applications by the operating system.  Unlike full-disk encryption, developers and administrators need to be careful not to store sensitive files on non-encrypted file systems. Database encryption.  Another way to encrypt data at rest is at the database level: The database software Oracle, SQL Server can provide application-level encryption. Like operating system level encryption, a key or passphrase is entered by an operator when the database starts up, after which all database operations access the encrypted data transparently hence the name: Both Oracle and Microsoft SQL Server call the feature “Transparent Data Encryption”. For servers that may store sensitive data in files outside the database, this provides less protection than encrypting the entire file system, but likely protects the most sensitive data on the system. What kind of protection does encrypting data at rest really provide? Here are a few salient points: Benefits of Encrypting Data at Rest First and foremost, encrypting data at rest protects the organization from the physical theft of the file system storage devices which is why end-user mobile devices from laptops to cell phones should always be encrypted. While this might sound unlikely, the physical disk devices are only as secure as the data center where they are located. While data center access control policy is usually quite strict, in practice it can be quite lax. Door entry can employ weak precautions like old push-button unlock devices, and the proliferation of easily-swappable modular disks for quick maintenance makes removing a disk quite easy. Encrypting data at rest can protect the organization from unauthorized access to data when computer hardware is sent for repair or discarded. Encrypting data at rest can help to satisfy information security or regulatory requirements such as the Payment Card Industry Data Security Standard PCI DSS or the Health Insurance Portability and Accountability Act HIPAA. In some deployments, the actual file system where data resides is somewhat disconnected from the server upon which applications are loaded either through the use of a storage area network SAN or cloud-based storage. This introduces the possibility that an intruder could break in to the storage subsystem but not the rest of the system. Encrypting the storage subsystem can protect against such attacks. Limitations of Encrypting Data at Rest Encryption of data at rest provides little protection against intrusions in which a hacker gains remote privileged access to a running server in which the passphrase has already been entered. Even more so, if the applications that access the encrypted files or databases web applications, query systems are not themselves secured, a hacker who penetrates one of these applications gains access to the data, whether it is encrypted or not. For database encryption, note that some database management systems only support data encryption in more advanced read more expensive versions of the software. When full-disk encryption is enabled on a physical non-virtualized server, remember that an operator – a human being – will need to type the passphrase into a console whenever the system starts up. For database-level encryption, the passphrase will need to be entered when the database starts up. While this intervention increases the level of protection, it is at the expense of convenience, as systems cannot reboot automatically without a passphrase or even without someone actually being in the server room which can be especially inconvenient if the system manager is not collocated with the hardware. File system encryption can mitigate some of these startup issues. And, of course, if that passphrase is ever lost your data will be encrypted forever. Special Considerations for Virtualized and Cloud-based Environments As mentioned, some virtualized and cloud-based environments offer remote passphrase entry and varying degrees of passphrase management and automation for full-disk encryption – but be aware that there is often a tradeoff between convenience and security with automated solutions. For example, if a cloud provider keeps your passphrase and automatically provides it to the operating system at boot time, the level of security offered by the full-disk encryption solution is largely dependent on how securely the cloud provider manages the passphrase. While encrypting data at rest can be a useful component in a data security toolbox, it must be implemented with a full understanding of the protection it does and does not provide. Organizations should consult with their vendors, data security staff, system staff, and application staff to determine an appropriate set of actions to secure institutional data. More Details...

How to Effective Manage Social Media within the Health Center Setting: A HITEQ infographic of key principles (2016). Resource Type: Publication. Description: This article written by Dr. John Halamka, CIO at Harvard Medical School and a Health IT adoption thought-leader, provides examples from the Beth Israel Deaconess Medical Center on best practices for healthcare providers in trying to manage social media efforts. This article written by Dr. John Halamka, CIO at Harvard Medical School and a Health IT adoption thought-leader, provides examples from the Beth Israel Deaconess Medical Center BIDMC on best practices for healthcare providers in trying to manage social media efforts. Topics covered include communication strategies, responding to positive and negative comments, and staff awareness. These topics, while garnered from Mr. Halamka's experience with being CIO for BIDMC  are discussed in a way that is relevant to all health care settings, including health centers. Included in this article are straightforward policies or concepts that are easily adopted into an organization's social media policies no matter what their size. Click on the link below to gain access to the related article... More Details...

Using the Systems Usability Scale to Assess Patient Portal Systems: English and Spanish Templates (2016). Resource Type: Publication. Description: When deploying personal health information systems such as patient portals Health Centers will often encounter challenges in effectively engaging their patient population. Understanding where these challenges are originating can at times be difficult to determine. One obvious area of evaluation is in determining whether the system being deployed is appropriately usable for the population. When deploying personal health information systems such as patient portals Health Centers will often encounter challenges in effectively engaging their patient population. Understanding where these challenges are originating can at times be difficult to determine. One obvious area of evaluation is in determining whether the system being deployed is appropriately usable for the population. Patient perception of the overall usability of the patient portal system can be evaluated through use of survey instruments such as the Systems Usability Scale (SUS). SUS is a well-established and validated usability scale that helps to determine the value, ease and interest of users of a particular system. Located in the Downloads section below are English and Spanish SUS survey instruments. Also located below is a link to further information on leveraging the SUS measures.  More Details...

Guide to Improving Care Processes and Outcomes in Health Centers: An approach to quality improvement (2016). Resource Type: Publication. Description: The quality improvement QI approach outlined in this Guide can be used to augment current QI approaches used in your health center, or can serve as a placeholder QI methodology when there isn’t already a robust QI process in place. It provides a framework and tools for documenting, analyzing, sharing and improving key workflows and information flows that drive performance on high-stakes care performance measures, and related improvement imperatives. This webpage provides strategies and tools that health centers and their partners can use to enhance care processes and outcomes targeted for improvement, such as hypertension and diabetes control, preventive care, and many others. More Details...

Professional Organizations and Associations for Health IT/Quality Staff: Resource Listing and Background (2016). Resource Type: Publication. Description: This is a list of professional and industry organizations and associations that can serve as a resource for staff interested in Health IT and quality and for those wanting to become more immersed in the field. Some of these may be appropriate for staff to join. This is a list of professional and industry organizations and associations that can serve as a resource for staff interested in Health IT and quality and for those wanting to become more immersed in the field. Some of these may be appropriate for staff to join. They offer resources such as training, conferences, research, literature, networking, and in some cases, certification. More Details...

Job Postings: A template for Human Resources and Hiring Managers (2016). Resource Type: Publication. Description: The following resource provides links to organizations that include job postings for Health IT and Quality jobs. This may be helpful to those both seeking employment or simply looking to learn more about the field and the kinds of positions that are available. The following resource provides links to organizations that include job postings for Health IT and Quality jobs. This may be helpful to those both seeking employment or simply looking to learn more about the field and the kinds of positions that are available. Job titles are not standard across the industry so perusing the various job openings will give a sense of the types of functions people perform in the Health IT/Quality area. In addition, employers may post openings on many of these sites. More Details...

Health IT Staff Resume Screening Tool: A template for Human Resources and Hiring Managers (2016). Resource Type: Publication. Description: This is a list of key words and phrases that can be used to pre-screen resumes for HIT/QI jobs to help quickly identify candidates for an additional screen. More Details...

Health IT Staff Recruitment Strategies: A template for Human Resources and Hiring Managers (2016). Resource Type: Publication. Description: This resource provides ideas about the latest recruiting tips used by community health centers as well as leading organizations from other industries. Review the strategies and identify ones that could work in your organization.  Adapt them as necessary to fit your particular needs and resources. This resource provides ideas about the latest recruiting tips used by community health centers as well as leading organizations from other industries. Review the strategies and identify ones that could work in your organization.  Adapt them as necessary to fit your particular needs and resources. More Details...

Health IT Interviewing Questions: Examples for Human Resources and Hiring Managers (2016). Resource Type: Publication. Description: This resource provides a list of sample questions that can be used to interview job candidates. The questions are organized into four categories: 1) questions for HIT staff positions; 2) questions for quality improvement staff positions; 3) questions for either position; and 4) questions for senior HIT or Quality positions.   This resource provides a list of sample questions that can be used to interview job candidates. The questions are organized into four categories: 1) questions for HIT staff positions; 2) questions for quality improvement staff positions; 3) questions for either position; and 4) questions for senior HIT or Quality positions.   These questions are intended to be a menu of items that an organization can pick or choose from, adapt to meet their organization’s needs, or use to generate additional/new questions. More Details...

Access to Information about Database Structures: Issues and Suggestions for Contract Negotiations (2016). Resource Type: Publication. Description: This issue brief discusses a critical concern during health center’s health IT contracting process – the need to have access to the underlying database structures to the health IT applications (e.g., EHR, reporting system… etc.) The lack of access to database structure will hinder the health center’s ability to access the data captured in the system, and risk vendor lock-in and have records trapped in data silos in the future. Electronic health record (EHR) system customers that can access their data have found that they also need information about the database structure used by the EHR technology developer in order to effectively use the data for custom reports or to even understand the customer’s own patient population and the unit costs of care. Some EHR technology developers are reportedly unwilling to provide data models or “data dictionaries” or are charging significant fees for information that helps the customer understand how the data is held in the EHR and may be efficiently extracted and used for other purposes. More Details...

Ability to Use Data Without Excessive Charges: Issues and Suggestions for Contract Negotiations (2016). Resource Type: Publication. Description: This issue brief discusses a critical concern during health center’s EHR contracting process – the need to preserve the ability to use data without excessive charges, which had hindered many health center’s ability to meet UDS and other reporting requirements. Electronic health record (EHR) systems and related technology are increasingly important as health centers face additional quality reporting requirements and are expected to bear more risk in accountable care organizations (ACOs) and other alternative payment models.  Some health centers have found that their decision to use a hosted EHR (rather than operating the EHR on their own hardware) and the terms of data access in those arrangements are important factors in how well they can respond to these changing requirements. More Details...

Hiring Test to Screen Possible Candidates for Data Knowledge: Gauging an Applicant’s Basic Data Knowledge and Abilities (2016). Resource Type: Publication. Description: This test is intended to gauge an applicant’s basic data knowledge and abilities.  Applicants are to go through all the tabs in order and follow the instructions in the red boxes. Included is an answer key that accompanies the Hiring Test. After giving a candidate the test, the hiring manager can use the Answer key to assess how the candidate did on the test. This test is intended to gauge an applicant’s basic data knowledge and abilities.  Applicants are to go through all the tabs in order and follow the instructions in the red boxes.  Hiring managers can administer this test as they see fit: they can email it to the applicant after a phone interview to see if they want to offer them an in-person or second interview it can be completed after the interview to determine whether the applicant has the basic skills needed for the position if the person is the right choice for the company because of mission-fit and soft skills, it can be used as a training assessment This also allows employees to assess if the job is the right fit for them. Note: Patients listed are fictitious examples More Details...

Motivating Factors for Engaging in Health IT Enabled QI: Guidance for Health Center Leadership and Partners (2016). Resource Type: Publication. Description: This white paper explores what is bringing a health center to the world of Health IT Enabled QI and lays out some motivating factors and barriers as well as what skill areas may need further consideration in planning next steps. Health centers across the country have a high EHR adoption rate and most have been using an EHR for several years. However, we know that the proliferation of EHRs and their companion reports have not always lead to accurate and robust data that can be used for quality improvement. Many challenges have been identified, including provider workflow and training issues, challenges with scalability, and limitations to data that can be extracted from various EHR systems. In response, a need has been identified for tools and resources that can guide health centers and those working with health centers through some key skill areas in the pursuit of Health IT Enabled QI. More Details...