V11 Phase II Note Upgrade Process

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Phase II Note Upgrade Process

V11 Phase II Note is included in the V11 Upgrade Contract. This phase is much more reliant on the client than Phase I, only the Upgrade Consultant and Upgrade Technician are involved, there is no PM. The due dates for this phase are flexible and are primarily determined by the client as to how aggressively the want to proceed. Of course the UC must be in agreement with the dates since they are responsible for guiding the client through the Phase 2 project and will assist with reviewing the build tasks and providing support during Go Live.


Another important difference between Phase I and Phase II is that the UC and UT are only involved with taking the initial client pilot group live on Note. Once this pilot group is live on Note the client is once again transitioned to Support. Once transitioned to Support the client continues to bring their remaining specialties and users live on V11 Note as they please.


Since v11 Note is not anything like v10 Note, the organization will need to make clinical decisions on how to build their notes. Allscripts has pre-delivered content with Note templates (inputs/outputs) and associated note forms available and reviewing those would be a start. Clearly, the more content that is used right out of the box will require less building and less time on the project. Other factors that make up the project timeline are how many note types that will be used as delivered versus how many will be built from scratch.


Allscripts offers an Advanced Note training class that will guide the client on how to build noteforms from scratch and/or edit them. It is a 1 1/2 day class and it would prove useful to someone in the organization to attend this class only if you plan on building most of your noteforms from scratch, as the class is strictly geared to noteform building itself.


The first steps would be to decide who will be the main person responsible for Note Admin and to register for the Advanced Note class if the client has decided to attend the Advanced Note training. The upgrade technician will be applying the latest content to the test system to include the latest noteforms, SSMT/CMT, and note templates.


Typically, the Phase 2 project takes 8-10 weeks depending on resource allocation but it can extend as long as 6-9 months depending on client momentum. The UC will work with the organization to define the timeline based on organizational needs.

Prerequisites

Enterprise EHR Version

  • The server must be on Enterprise EHR V11.1.7 or higher to start Phase II Note. This task belongs to the client. They will enter a case in Supportforce if they need to upgrade to the latest version if not already on v11.1.7. This must be completed prior to entering a case into Supportforce requsting to initiate the Phase 2 project.

Medcin

  • The server must be on the appropriate release of Medcin based on the Noteform release being installed. This information can be obtained from the Supportforce Product Documentation under the Clinical Content>Noteform Release. This task belongs to the client to ensure they are updated to the appropriate release of Medcin. This must be completed prior to entering a case into Supportforce requesting to initiate the Phase 2 project.

SSMT and CMT

  • The servers must have the latest release of SSMT and CMT installed on them. This task belongs to the upgrade technician. The UC will open a Supportforce case to request the latest SSMT/CMT be applied to the server. *

Noteforms

  • The test and production servers must have the latest noteforms installed prior to beginning the Phase 2 project. This information can be obtained from the Supportforce Product Documentation under the Clinical Content>Noteform Release. This task belongs to the client. The UC will open a Supportforce case to request the latest SSMT/CMT be applied to the server. *


Pre-configured Content

  • The test server must have the pre-configured content-from the Gold Database installed on the test server. This task belongs to the upgrade technician. The UC will open a Supportforce case to request the Gold database be applied to the server. *
    • The Gold Database is what Allscripts has for all the pre-delivered Note template (input/output) content by Specialty.
  • SSMT/CMT, Noteforms,and Pre-Configured Content *These tasks are initiated once the client has requested to begin the Phase 2 project. Please expect this task to be completed in 1- 1/2 weeks post request.

Step One - Supportforce and Initiating the Upgrade Process

  • The client will open a Supportforce case requesting to start the Phase 2- V11 Note project.
  • The client will have a UC assigned to the project and the UC will be their primary contact throughout the duration of the project.
  • The UC will contact the client to arrange an Intro Call to begin the project and the next steps.
  • The UC must pull up the clients profile in Supportforce and add the following comments to the "Client Warnings" section. "UC Name should receive v11 note upgrade tickets - client started on Phase 2 Note implementation". This allows Support to forward the tickets to the UC for processing. During Phase II all Supportforce issues go directly to the UC, not the UT and the UC works them accordingly.

Education and Training

If the client is planning on attending the Allscripts - V11 Advanced Note Training Classes, they should start early in the process so there is ample time for scheduling and attending to meet your organizational timeline goals.

The client should make every effort to review the following material and webcasts before beginning V11 Phase II Note. There are many aspects of Note that need to be understood before, during and after the design. Your UC will be helping you to perform the many BAW tasks but you and your team will need to know what you want to build and a basic knowledge of how to build it before beginning. Allscripts documentation can be found on Supportforce under Clinical Content.

  • Review the clinical content and pre-delivered content and specialty content. This is located under Supportforce>Product Documentation>Clinical Content
  • Review Pre-Delivered Configuration Templates.
  • Review V11 Note - Intro and Understanding Note Build Planning- KB article 00006857.
  • Review Note_2_Note Setup- KB article 00006784.
  • Review Series 3 V11 Note - Input Template and Note Sections 00006610.
  • Review Note_4_Note Output Template Definition- KB article 00006726.
  • Review Note 5 Note Forms Review and Edits- KB article 00006624.
  • Review V11 Note Series 6 Note Text Templates-KB article 00006517.
  • Review V11 Note Quick Reference Guide- KB article 00006264.

Step Two - NoteForms

The next step is to make sure the client has the most recently released version of V11 NoteForms. Although these Noteforms are loaded by the Upgrade Technician as part of the Phase I upgrade they will need to be updated with the latest version just before starting Phase II V11 Note. The Physician Champion and Clinical design team will review the noteforms.


  • The UC is responsible for requesting the latest Noteforms for the client and will open a Supportforce case requesting the UT to perform this task.
  • The client clinical design team will review the information on Noteforms from the Allscripts. The core team will decide if the noteforms will require editing or new forms will need to be developed. The client is responsible for building any new Noteforms.
  • Review Creating and Editing Noteforms

Step Three - Document Types

Next, the Document Types for Note must be loaded for the pre-configured templates as developed by Allscripts. It is important to note that the Document Types must be loaded before the V11 Note Templates get loaded. Note: The Document Types share the same excel spreadsheet as the Note Templates. All documents will be installed on the test system and the client can decide which will be used and moved to production along with the note templates. The document types will be on the client's test system in the Gold database that can be extracted with SSMT and moved to the client Test database.

  • The UC loads all of the available v11 Note Document Types into the Clients Test Server.

(The most recently released Document Types may be found on the Allscripts Shared file in an excel spreadsheet named "v11-1-7PreConfiguration_Layout_Final" under "IC Process Documents"/"Phase 2 -V11 Note".)

Step Four - V11 Note Templates

Note Templates are chosen by the client. They may chose to have them all loaded, some loaded or none loaded, it's entirely up to them. All of them will be loaded into the Test System. The upgrade technician will deliver the Gold database onto the client test server for the UC to be able to extract the Note templates (inputs/outputs) and move to the client test server. CMT is used to move note templates from one database to the other.

  • The UC will move all the pre-configured note templates to the clients test system from the Allscripts Gold database.
  • The client will review each template and decide what will be used by the pilot group and all subsequent roll outs.
  • The UC will train the client on how to use CMT to move Note templates and noteforms.
  • The client will edit any templates as desired and move final templates to Live in preparation for Go Live.

Step Five - Phase 2 Build Activity Workbook (BAW) Tasks and Testing

  • The UC will review each Build Activity Workbook (BAW) task with the client during the Intro Call.
  • The client is responsible for completing all the BAW tasks. The client completes all necessary system configuration of the system in Test/Production.
  • The UC is available for questions of system configuration, issues reported from testing and/or building, and workflow and note design consultation. This project does not include building noteforms or templates outside of steps on “how to” for the client.
  • The BAW will be reviewed by the UC prior to moving/making changes to Live. The client will be instructed on how to move content from Test to Live during this process using SSMT and CMT.
  • Note Build and Implementation
  • Client - System Admin Add Note Clinical Desktop view to all v11 Note users How to add Note to Clinical Desktop Views
  • Client - System Admin Review all the Note preferences What needs to be reviewed
  • Client - System Admin Extract final preferences
  • Client - System Admin Note Specialty and Sub-Group Assignments
  • Client - System Admin Ownership & Finalization Authority- User/Provider setup
  • Client - System Admin Review dictionary settings- Document Type
  • Client - System Admin Extract final document types
  • Client - System Admin Note Input Template Definitions
  • Client - System Admin Note Forms - Review delivered content for Note Forms and modify if needed
  • Client - System Admin Note Forms - Create New Note Forms (this should include reviewing Medcin Symptoms for HPI Section as part of the Note Form)
  • Client - System Admin Note Output Template Definitions
  • Client - System Admin Note section mapping
  • Client - System Admin Note Text Templates - Review existing templates and assign to note sections and specialties if needed. V10 text templates will be existing from upgrade and they will need to be inserted into the proper sections of v11 Note and the correct specialty if they will be used in v11 Note.
  • Client - System Admin Note Text Templates - Create new Note Text Templates
  • Client - System Admin Note Tasking
  • Client - System Admin Note and Tasking Impacts
  • Client - System Admin Dictation Markers
  • Client - System Admin CC Functionality
  • Client - System Admin Test Note/Charge integration
  • Testing
  • Client - Test Note Associated Workflow Testing
  • Client - Test Note Associated Print/Fax Testing
  • Client - Test/UC Issue Resolution

Step Six - Training, Go Live Planning, and Go Live

There are several tasks that need to be completed before going live on v11 Note. These tasks appear in the BAW primarily in order. The UC will work with the client to complete these tasks.

Training

  • Each v11 Note workflow needs to be documented prior to end user training and it is recommended to use the Allscripts Certified Workflows. The Certified Workflows can be found on Supportforce under Product Documentation for the appropriate release.
  • The client will be responsible for training the pilot group of end users prior to Go Live.
  • The client will need to sign off on testing and pilot group end user training prior to going Live.

Go Live Planning

  • The client will return the signed CCF to the UC.
  • The client and UC will mutually define the pilot group Go Live date.
  • The client will move the Note Content and Configuration from Test to Live using SSMT/CMT.

Go Live

  • The UC will be available to work any Supportforce cases entered during Go Live.
  • The client will be transitioned to the Support team 1 week post pilot group Go Live.
  • The client is responsible for rolling out the remaining of the practice.