EHR Assessment and Readiness Starter Assessment

Instructions for Completing the Starter Assessment

Answer each question from the perspective of your clinic or a group. Each readiness area is
divided into levels showing various stages of readiness. The stages are represented by points
that range from 0 to 5. The higher point values indicate a higher level of readiness. For each
element, identify the description that best describes your clinic’s current status and note the
point value that best describes that level. You are likely to discover that, with some elements,
your organization will not fully match any of the descriptions; in these instances, simply identify
the description that is most suitable for your organization. Your honesty is essential. It is better
to underestimate than overestimate your organization’s capacity. Sum the points in each
section (e.g. total Organizational Alignment score, total Organizational Capacity score and
total Overall score) and see the scoring interpretation section at the bottom for feedback on
your level of readiness. With an accurate portrait of your readiness, your clinic will be better
prepared to design a plan that meets your specific needs.

Section 1 – Organizational Alignment for EHR

Readiness Readiness Not Yet Prepared Moderately Highly Prepared Score
Area Component 0 -1 Prepared 4- 5
2 -3
Culture EHR is as an IT project to “go as a clinical primarily as a
viewed… paperless” only. technology to technology to
achieve workflow enable quality
efficiencies. care improvement
goals.
The EHR- top management key planers or all departments
related and/or designated departments and and is team-
planning investigator only. is participatory. oriented.
process
includes…
Physician limited to a physician primarily occurs is active in both
involvement in advocate to represent for key decisions; planning and
the EHR clinical interests. clinical interested decision-making;
process… are valued. clinical and
managerial
interests are
aligned.
Framework for not been thoroughly been discussed been documented
outlining top discussed. but not before initiating
EHR priorities documented prior vendor evaluation
has… to initiating and is being used
vendor to facilitate the
evaluation. decision-making
process.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

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Leadership Leadership… believes EHRs are has studied the understands the
necessary, but is pros and cons of benefits of the
divided as to how to implementing an EHR and sets a
communicate why and EHR and can clear and
when to pursue. make an argument consistent vision
for why benefits for how EHR
outweigh costs. supports
efficiency and
quality
improvement
goals.
The Executive relies on vendor to delegates EHR devotes
team… provide EHR planning planning to substantial time to
guidance. managers or a planning for
specific team. quality
improvement with
EHR technology.
Strategy IT strategic not considered part of been carved out been an integral
planning has… the strategic planning as a separate part part of the
process or Strategic of the organizational
Plan, but operational organizational strategic planning
and addressed through strategic planning process, resulting
special projects. process and in a 3-year
resulted in an IT Strategic Plan that
Strategic Plan. guides EHR
procurement.
Quality and discussed, but not objectives, but not documented as
efficiency clear objectives of the clearly defined in key objectives in
are… organization nor a measurable way the Strategic Plan
connected with EHR nor connected with measurable
technology. with EHR objectives and
technology. corresponding
time horizon and
are clearly
connected with
EHR technology.
TOTAL Organizational Alignment Score

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

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Section 2 – Organizational Capacity for EHR
Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
Information The Practice has not been optimized or has been has been
Management Management utilized for patient mostly utilized, optimized
system… management. including a and modules
number of that support
features that patient
facilitate management
patient fully utilized.
management.
Standard have not been defined or have been have been
EHR- documented. partially defined,
generated defined but documented
reports for have not been and
management, documented. requirements
population included in
health and the product
quality evaluation
improvement process.
...
Clinical and Staff and are involved in specific has a general are
Administrative other human aspects the EHR decision- understanding experienced
Staff resource(s) making process but does not of the trade- in IT vendor
dedicated to have vendor selection or offs between contracting,
EHR vendor negotiation experience; products but driving
contracting publicly available RFP is may not have analyses of
… used “out of the box” for vendor products’
system selection. selection or ability to
negotiation meet clinic’s
experience; needs and
publicly capabilities
available RFP and
has been used determine
as a guideline optimal
to determine contract
high priority approach and
requirements. terms;
clinic’s
requirements
have been
documented
in a detailed
RFP that will
become an
addendum to
the contract.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
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Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
Staffing have not been analyzed. are generally have been
needs for understood, but documented
EHR a staffing plan in a staffing
implementati has not been model,
on and use… developed. detailing
current
staffing and
proposed
needs;
requirements
have been
included in
the planning
process.
Staff have not been specifically have a basic are
dedicated to identified. understanding experienced,
project of EHR have been
management, functionality educated
change and are about EHR
management participating in functionality
and quality the EHR and
improvement decision- workflow
for EHR… making impacts and
process. are
authorized to
lead the
decision-
making
process.
Training A formal is not part of the planning including EHR including
training process; clinical and implementation EHR
plan… administrative staff will and skill-set implementati
receive training from the gaps for on, workflow
vendor and on-the-job. necessary redesign and
physicians and skill-set gaps
key staff is part for
of the planning management,
process. physicians
and staff is
part of the
planning
process.
Training have not been included as will be have been
programs for part of the EHR initiative. identified as identified to
project necessary by ensure these
managers management. staff possess
and IT staff appropriate
involved in skill sets.
EHR

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

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http://www.communityclinics.org Page 4 of 11
Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
adoption…

Workflow Current and not developed. generally documented

Process proposed understood and in a process
EHR-enabled incorporated map and
administrativ into product requirements
e and clinical evaluation, but are included
processes, workflow in product
including redesign and evaluation
estimated change process;
patient management planning
volumes and approaches are process is in
staffing not place for
are… documented. workflow
redesign and
change
management
approaches.
Policies, have been considered but not have been have been
procedures analyzed. analyzed and a analyzed and
and protocols plan for developed
necessary for development in including
EHR-enabled place. information
processes… access rights,
medical
record
correction,
system
downtime,
data storage
requirements
and record
printing.
Accountability Roles and have not been established or have been have been
responsibiliti assigned or may exist in a developed; assigned and
es for functioning group (i.e. requirements are clear;
analyzing Management Team). are generally requirements
product understood and and
options, prioritized expectations
contract accordingly. have been
terms and captured and
negotiating vendor
with the response
EHR documented.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
http://www.communityclinics.org Page 5 of 11
Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
vendor…

Finance and EHR more of an expense than an an investment an

Budget technology is investment requiring a return- requiring less investment
considered… on-investment based on than 2-year rather than
traditional IT or office timeframe for an expense;
automation models. return-on- business case
investment. is analyzed
over a longer
time horizon
and
incorporates
non-
quantifiable
returns.
EHR funds have not been will be funded will be
acquisition identified. with one-time funded with
and on-going discretionary capital
maintenance funds. earmarked
for such.
Patient Patient has not been evaluated. considered, but determined
Involvement interaction no with patient
with EHR requirements input and
has been… have been requirements
documented. have been
included in
the planning
process.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
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Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
Policies and have not been evaluated. have been have been
procedures discussed but analyzed and
for patient not requirements
corrections documented; a included in
or plan is in place the planning
amendments to develop process; a
to electronic policies and plan is in
medical procedures. place to
records and develop
release of communicati
patient ons for
information patients and
… external
organizations
.
EHR-enabled have not been evaluated. have been have been
referral discussed but designed and
processes, e- no specific plan requirements
prescribing exists. included in
and other the planning
patient- process.
specific
hand-offs…
IT Management IT limited experience with experience with strong
and Support Management system integration or data system experience
has… conversion, and relies heavily integration or with system
on external resources for IT data conversion integration,
planning and decision- but tends to data
making. rely on the conversion
vendor to detail and
the tasks and managing
activities. expert
resources to
fill internal
skill or
knowledge
gaps.
IT staffing has not been analyzed. is generally has been
for EHR understood but documented
implementati is not in a Staffing
on, documented in Plan and
maintenance, the planning requirements
infrastructure process. have been
and users… included in
the planning
process.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
http://www.communityclinics.org Page 7 of 11
Readiness Area Readiness Not Yet Prepared Moderately Highly Score
Component 0 -1 Prepared Prepared
2-3 4- 5
IT staff… are determining IT are involved in have been
infrastructure requirements decision- educated
without involvement in making process about EHR
process. to determine IT objectives in
infrastructure order to
requirements. actively
engage in the
EHR
decision-
making
process and
determine
necessary IT
infrastructure
requirements.
IT A needs is generally understood but has been has been
Infrastructure assessment has not been evaluated. performed but performed
of hardware, not documented and
desktop in the planning requirements
terminals and process. included in
other devices the planning
necessary to process.
support EHR
use…

A plan for a is not in place; infrastructure is being is in place

technical will be upgraded according to developed and and will be
infrastructure projected needs as standards- will be standards-
using a high- compliant as possible as new standards- compliant
availability systems are purchased. compliant with with HIPAA,
platform, HL7 being HL7 and
upgraded to considered. other clinical
be and
standardized, administrativ
scalable, and e transaction
easily standards.
maintained…
.
TOTAL Organizational Capacity Score
TOTAL Overall Score

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

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Score Interpretation
The Starter Assessment is one of the first steps in the evolutionary learning process of EHR adoption. Thus, it
should be used as a tool to educate this process along with continual clinic exploration and use of more in-depth
tools like the Readiness Assessment. Score interpretation is designed to help you understand how to move
forward in the process by learning from expertise embedded in these tools as well as learning what is important
from your clinic. Although strong technology and industry research are very important, successful EHR adoption
will require teamwork, collaboration and readiness.
Below are ranges of scores for each section and the overall score with some general interpretation and advice.
• Organizational Alignment for EHR Adoption:
o Score = 31 - 45: A score in this range may indicate that leadership understands and communicates the
value of EHR adoption clearly throughout both the documented planning process and the clinic
environment. There is likely an environment for achieving success that comprises team work, flexibility and
mechanisms to manage communication and collaboration. Organizational alignment is strong and, pending
the Organizational Capacity score, consider further assessment with the Readiness Assessment tool that can
be found in the library on the Community Clinic website.
o Score = 16 - 30: A score in this range may indicate that there is an understanding of the value of EHR,
but that detailed exploration of how EHR enables the clinic’s ability to achieve its strategic goals and what
impact it will have on clinic operations and patient management may be less clear. Consider additional
management and cross-departmental planning discussions about the areas of weakness, using this tool
and/or the Readiness Assessment as a guide to understanding where differences in opinions or lack of
detailed understanding may be.
o Score = 0 - 15: A score in this range may indicate that there is not a strong enough understanding of the
value of EHR or how it will impact the clinic’s goals or operations to move forward without a process for
management and clinic-wide discussion. Consider adopting a longer-term set of planning discussions and a
methodology to develop a clinic vision and decision-making to support quality improvement before moving
forward with other EHR adoption activities.
• Organizational Capacity for EHR Adoption:
o Score = 67 - 100: A score in this range may indicate that managerial, operational and IT capacity are
strong, although further analysis of scores in individual areas will reveal relative strength in each area. There
is likely the capacity for achieving success including management methodologies, staff resources and IT
environmental strength. Pending the Organizational Alignment score, consider further assessment with the
Readiness Assessment tool that can be found in the library on the Community Clinic website.
o Score = 34 - 66: A score in this range may indicate that there is adequate capacity in some areas, but not
consistently throughout management & staff capacity, operational processes &mechanisms and the IT
environment. Identify the exact categories of weakness and consider further management and cross-
departmental planning discussions about areas of weakness, using this tool and/or the Readiness Assessment
as a guide to understanding how to increase clinic capacity.
o Score = 0 - 33: A score in this range may indicate that there is weak capacity in several areas that are
critical to EHR adoption success. Identify the exact categories of weakness and consider a more
comprehensive analysis of requirements for EHR adoption and develop a plan to improve capacity in those
areas before moving forward with other EHR adoption activities.
• Overall Score:
o Score = 98 - 145: A score in this range may indicate that your clinic both understands the value of EHR
and has the capacity to see a long and potentially challenging adoption through to success. To ensure
readiness for adoption, consider further assessment via the Readiness Assessment tool available through the
library on the Community Clinic website.
o Score = 50 - 97: A score in this range may indicate that your clinic is strong in some areas and weak in
others. It is important to identify strength in each area of the assessment to determine where to focus

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
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 additional managerial and planning attention. Consider using this tool and the Readiness Assessment to
inform the process and develop a more targeted plan toward EHR adoption.
o Score = 0 - 48: A score in this range may indicate that your clinic is not currently prepared to move
forward with EHR adoption. Consider developing a more comprehensive plan to facilitate management and
cross-departmental education and planning processes to determine why your clinic is interested in EHR
adoption and how to build the capacity to ensure successful adoption and use.

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

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California Community Clinics EHR Assessment and Readiness Starter Assessment
Glossary
Organizational Alignment
• Culture: values; environment for achieving excellence; ability to manage change and maintain flexibility;
team approach
• Organization: infrastructure to support information flow, decision making, and problem resolution; role of
the board and leadership team; vision for quality; ability to collaborate with external organizations
• Leadership: the characteristics of leadership team: setting vision, commitment to quality; alignment across
organization
• Strategy: mission and vision and priorities documented in a strategic plan; internal and external
communications

Organizational Capacity
• Information Management: quality, accessibility, relevance and communication of data/information
• Clinical and Administrative Staff: staff capacity; staff training and competence; consistent policies and
procedures; methods to motivate and drive individuals/groups to achieve goals
• Training: Infrastructure and resources dedicated to initial and on-going IT training
• Workflow Process: tools and methods for managing change, developing policies, procedures, protocols;
Quality Improvement model; process for monitoring and communicating performance; analysis and actions
taken to improve processes and performance
• Accountability: how results are achieved and mission/vision fulfilled; role and responsibility of patient in
care process
• Finance & Budget: extent of infrastructure and management of IT budget; capital and operational resources
• Patient Involvement: preventative and chronic care processes; patient follow-up and care continuum;
comprehensive care
• IT Management and Support: IT staff skill-set and capacity for IT management and support; consistent
policies and procedures
• IT Infrastructure: information systems environment and infrastructure

This material was prepared by Masspro, the Medicare Quality Improvement Organization
for Massachusetts, under contract with the Centers for Medicare & Medicaid Services
(CMS), an agency of the U.S. Department of Health and Human Services. The contents
presented do not necessarily represent CMS policy. 8sow-ma-doqit-o6-13 Practice Starter
Assessment-oct

Excerpt from: California Community

Clinics EMR Assessment and Readiness.
http://www.communityclinics.org Page 11 of 11