Question	Category	Answer
What do I do with a all the paper charts, scan everything, or some things? Store the rest?	General	Recommended approach is to scan key documents before and after first visit. Physician summarize the chart prior to patient visit via dictation. It is not recommended to scan all charts.
I already have a PM or EMR system. Can I convert?	General	Yes. You will need to run out the A/R on your existing practice management system. Typically, this takes 4 to 6 months.
I don't want to take it all at once, can I implement in steps? Can I take the PM portion now, then after my staff gets used to that, implement the EMR?	General	Although the system can be implemented in steps, the approach will be to implement everything together to meet timeline for 'meaningful use' and take full advantage of Stimulus dollars.
After many years of evolution what is the sense of urgency with regard to the Hanover EMR?	General	Availability of Federal funding as an incentive and the consequences of penalties if not "meaningfully" implemented.
What are the consequences of doing nothing at this time?	General	Losing federal funding as an incentive and receiving penalties after 2015 if not "meaningfully" implemented.
Why is it essential that we all sign up at the same time?	General	There is a greater cost savings and best possible training and support.
In order to get the ARRA Stimulus money do we have to scrap our current EMR systems?	General	Not necessarily if the current EMR system can meet "meaningful use." Exchange of patient data with the community and CCHIT certification will be significant considerations for currently installed systems.
Can chart elements be e-mailed? If so, what formats are available? (PDF, Word, etc.)	General	Documents will be shared through the Hub and eClinicalWorks internal messaging system to secure data and comply with HIPAA.
Will I need additional staff for implementation?	General	Depends on changes to work flow defined during implementation, size of practice and approach to scanning.
Do we all have to have the same system features?	General	No. There will be flexibility with regard to template development and work flow.
I have HIPAA concerns, how safe is my patient information? If I use a wireless network, can others get to my charts?	Legal	No, if specifications for implementing a secure wireless network are followed. These will be provided to each practice and ComputerWorks or other support vendor.
Will we need to sign a contract?	Legal	Yes.
Who owns the data?	Legal	The physician practices will own the data.
Are podiatrists and PAs/NPs included in the stimulus package? We have a lot of both. If not, can the hospital still subsidize for these providers under STARK?	Legal	Podiatrists are covered with the ARRA Stimulus funds. PAs/NPs are not. Yes these can fall under the subsidized program but not receive the stimulus funds.
What would happen if the hospital were to be sold to another institution? How would the providers get their data?	Legal	It will be protected in the master agreement with eClinicalWorks and sublicense contracts with each individual practice.
What if a provider leaves the area? Would they be able to take their medical records with them?	Legal	Yes.
If I am using an existing PM or EMR system, how can I archive my information and ensure that it's retrievable?	Legal	This would need to be discussed and planned with the practices existing vendor.
On average, how much training time is needed?	Costs	Average training of a Physician takes 1-3 weeks.
How much productivity is lost while training, both staff & physicians?	Costs	To be determined during implementation planning; reference checks stated that doctors were at full productivity within 1-3 weeks depending on physician.
Is it essential to buy both the PM and the EMR portions of the EHR system?	Costs	No however, industry experience has been that the cost of the interfaces between existing PM systems and EMR systems are higher than the conversion to an integrated solution.
What will our cost be later on if some of us sit back and wait and see how the implementation goes?	Costs	Incremental costs would be assumed by the practice.
Will there be a charge per page for scanned images?	Costs	Yes over a threshold to be established by the Goverance Implementation Team.
What's a patient portal and why is it important?	Community/ Sharing	Patient portal allows patients and physician practices to communicate bi-directionally in a secure environment. Patients can make appointment/prescription requests, fill out pre-appointment paperwork, and send questions to your office. This may be required under "meaningful use."
Can patient information be restricted to a need to know basis?	Community/ Sharing	eCW allows the patient to "opt out" of having their clinical information shared with the community. Additionally protected information such as AIDS, social history can be blocked.
Can I opt not to share my patient information at the community level?	Community/ Sharing	To be determined by the Governance structure.
Will hospital progress notes be available (ER notes, inpatient clinical documentation)?	Community/ Sharing	Yes, via interface.
Does the hospital sponsored system offer a one patient/one chart configuration option?	Community/ Sharing	eEHX allows practices to share clinical data across practices. The Goverance Team will determine what information is shared at the community level. However, eClinicalWorks has the ability to" opt out" of sharing individual patient information.
Can I manage diagnostic images from the hospital?	Community/ Sharing	The hospital PACS system will be linked to eClinicals for display purposes.
What is a "master patient identifier" system and who maintains that file?	Community/ Sharing	John Doe at Practice A may have 12345 as an account number and at Practice B as 34567. However, eCW eEHX assigns one eMPI number to John Doe at the community level. The hospital HIM department will manage the community enterprise MPI.
Will ER physicians be able to access my patient's information in an emergency?	Community/ Sharing	Yes. Even if your patient's information is not being shared, eCW offers a "break the glass" feature that will allow access to patient information in emergent situations which is tracked and audited.
The patient portal is going to create more work for me. I am not sure I want to take on the burden of answering e-mails from patients.	Community/ Sharing	During the selection committee site visits, we posed that question. The majority of providers find that responding to patients via e-mail is less time consuming/more efficient than responding to telephone calls. This may be required under "meaningful use."
Can tests (labs and radiologies) be ordered at the hospital and the results received directly from the office?	Diagnostics	Yes, we plan to implement a bidirectional interface between Hanover Hospital's MEDITECH system and the community sponsored EMR for all ancillary testing.
If I use transcriptionist services, will I still be able to do so if I opt to go with the hospital sponsored system?	Documentation	eCW offers functionality that will allow you to continue using transcription services should you desire to do so.
Can templates be customized and created by individual practices and providers?	Documentation	Yes. eClinicalWorks comes with a robust set of templates that are fully customizable.
What types of documentation methods does the system support?	Documentation	Free text, touch screen, voice recognition.
How will I be able to move information from MEDITECH or York's system into the new EMR? Will I have to print and scan or can this be done automatically?	Documentation	Information from MEDITECH can be moved to the EMR automatically. Information from other hospital systems will be discussed through the Governance Team and timelines established. Any document can be scanned.
Does the system having automated faxing capabilities?	Documentation	Yes.
What if I have mid-level providers? Can the system support this model?	Documentation	Yes.
What if I have an existing E-Prescribing software system and am under contract to use their tool?	E-Prescribing	No, it will need to be replaced with eClinicalWorks.
Does the system do automatic insurance and formulary verification?	Billing	Yes.
If we go with the hospital sponsored system, can we still apply for payer specific subsidies?	Billing	Yes.
Some PM systems have the ability to outsource the billing. Does eCW offer this option?	Billing	To be determined during contract negotiations.
Will I have to use the hospital sponsored PM/EMR system's claims clearinghouse?	Billing	To be determined during contract negotiations.
Can my financial information be restricted from being viewed by other community practices?	Billing	Yes.
Will the new system be able to accept ICD-10 codes?	Billing	Yes.
Will we still need encounters/superbills?	Billing	No.
Can the system do pay for performance?	Reporting	Yes.
Can the system do payer specific pay for performance?	Reporting	Yes.
Since eCW is web-based, what if the internet is down?	Connectivity	Each office will have a primary connection and a backup connection. The primary connection is not dependent on the internet.
How secure is the internet connection?	Connectivity	The internet used as a backup is very secure using VPN technologies and encryption.
Is eCW a thin client?	Connectivity	eEHX allows practices to share clinical data across practices. The Goverance Team will determine what information is shared at the community level. However, eClinicalWorks has the ability to" opt out" of sharing individual patient information.
What about back up systems, in case my server crashes?	Hardware	Servers will be housed centrally at the hospital with full backup and redundancy capabilities.
Do I still need to do other backups?	Hardware	No, not for PM or EMR.
Will there be a published list of available interfaces for the EKG, Sonography, and other instruments I use in my office? What requirements will you have for me when I bring in a new machine that I want to interface?	Interfacing	Yes, eClinicalWorks does have a partial list of those that need to be interfaced by practice and are working on the pricing to have these interface to the eCW system.
What if there is a power failure, unplanned disasters, etc. Who develops the "downtime" routine? Is this something each office must prepare?	Support	The system will be support by backup generators and redundancy. However, each practice should have downtime procedures in place to ensure that the clinic can continue to function in the event of an outage.
Will system updates cause a disruption in my practice?	Support	Updates will be scheduled off hours to not interrupt services.
Will the hospital assist us with the implementation?	Support	Yes.