New Imaging Capabilities Available

Physicians in private practice who use Cleveland Clinic’s MyPractice Community electronic medical record system (EMR) can now access medical images generated in any Cleveland Clinic imaging facility by simply clicking the Get Image button in their EMR. Selected images appear directly inside the context of the patient’s record.

To save time and bandwidth, the data associated with these images is not downloaded to the clinician’s hard drive. Instead, data is quickly “rendered” through a system of secure, dedicated servers that then simply “paint” the workstation’s screen.

Find frequently asked questions about MyPractice Community.

»What are this system's features?

MyPractice Community comes pre-populated with patient data. So if your patient has ever been treated anywhere within the Cleveland Clinic health system, the information is already there. The system keeps your patients' records current and available and transmits your prescription and laboratory orders electronically. You can add information to a patient's file or share the information contained in the file with other physicians and care team members. Outside results, referral letters and limited progress notes that are not in a digital format may be scanned into the MyPractice Community system and displayed as an image for future reference.

The system features automated, real-time physician decision support alerts, minimizes medical errors, encourages formulary compliance and ensures that patients receive recommended health-maintenance and disease-management services.

MyPractice features include:

• Structured clinical documentation
• Comprehensive medication management
• Disease management and health maintenance alerts
• Electronic physician order entry, such as lab, X-ray and the capability to provide electronic prescription refills
• Access Medical Images generated at any Cleveland Clinic imaging facility
• Smart Links (data linked to patient), Smart Phrases (commonly used words and phrases) and Smart Text (commonly asked questions and documentation templates)
• Patient information integrated with the entire MyPractice Community users environment
• Remote access with security token
• Upgrades and maintenance done during down times (weekends) at no cost to practice.
• Disaster recovery.

»What degree of connectivity does this system offer?

MyPractice Community is an "interoperable" electronic medical record system, building upon the connectivity of a private physician practice by securely interfacing with the electronic systems used by other medical service providers.

As a secure, HIPAA-compliant system, access is limited to medical professionals actively participating in a patient's care.

Private physician practices can use MyPractice Community to significantly streamline daily workflow.

Physicians receive, in real time, the following patient information related to the specialty care a patient receives within a Cleveland Clinic hospital.:

• Laboratory test results
• Radiology reports
• Progress notes.

MyPractice Community is pre-loaded with 100+ million data elements related to approximately five million patients.

MyPractice Community is connected to Cleveland Clinic health system laboratories and laboratory services and most major pharmacy outlets, including:

• Acme
• CVS
• Giant Eagle
• RITE AID
• Sam's Club
• Walgreens
• WalMart

MyPractice Community is connected to the following transcription companies:

• C-Bay Transcription Services
• Premier Office Technologies, Inc.
• Spheris.

The connectivity capability of MyPractice Community describes technical interfacing systems and in no way implies an association with or endorsement of any of the above mentioned organizations or corporations by Cleveland Clinic.

»Who owns the data and where is it stored?

The data contained in the secure MyPractice Community master patient database is stored at the Cleveland Clinic Information Technology building on servers on the east side of Cleveland.

Technically, a patient is the owner of any personal health-related information documented by healthcare professionals during the course of treatment.

Data captured during the course of patient encounters is associated with the physician and practice providing a patient's treatment and is accessible only to caregivers involved in a patient's care.

All the data is backed-up nightly to two off-site storage systems that provide additional data security and complete system redundancy.

»Who is responsible for upgrades?

Any applicable MyPractice Community software upgrades—which automatically occur as vendor system upgrades become available—occur during weekend, non-business hours.

All software system upgrades are pre-tested by MyPractice Community technical specialists prior to integration, and all new functional additions to the system are communicated to practice personnel prior to the launch of any system upgrade.

»What happens if I discontinue this service?

Following the termination of your MyPractice Community service, you will receive a copy of your practice's data in an HL7 format, or if you prefer, as paper documents.

The data you entered while using the MyPractice Community service does remain in the MyPractice electronic medical record database and will be accessible to you or your patient's care team if, in the future, you require specialty medical services from Cleveland Clinic.

»Can other providers see my schedule?

Access to your schedule and other operational information is limited to those individuals who are involved in accomplishing your practice's daily workflow tasks.

»What is required of my staff when using MyPractice?

Because MyPractice Community is a flexible system that may be customized to meet the needs of your practice, it is important to identify a member of your staff who will assist the MyPractice Community implementation team with your system's initial workflow design, build and development.

This individual can expect to spend approximately one to two hours per week working with the MyPractice Community implementation team until your practice's system specifications are completed.

»What are standard interfaces for MyPractice Community?

Standard interfaces include:

• Practice Management System: Inbound interface to EMR of demographics and physicians' schedules
• Interface charges by Practice Management System are the responsibility of the physician
• CCHS Lab Systems
• Transcription services: C-Bay Transcription Services, Premier Office Technologies, Inc., Spheris.

Other interfaces will be considered, though possibly at an additional cost.

»What are the technical specifications for MyPractice Community?

Workstation requirements include:

• CPU: Pentium III class, 1 Ghz or higher (Pentium IV recommended)
• RAM: 512 MB Minimum – or higher (1 Gig of RAM – recommended)
• Video adapter and monitor capable of displaying 24 bit color at 1024 x 768 screen resolution
• Monitor – 17 inch or higher recommended
• Network Adapter (NIC).

Software requirements include:

• Operating System: Windows 2000 Service Pack 4 or Windows XP Service Pack 2
• Internet Explorer version 6 or higher
• Current antivirus software
• Citrix Program Neighborhood client version 9.1 or higher (MPC will provide).

Printing requirements include:

• Hewlett-Packard 2000, 3000, or 4000 series Laserjet printer
• Dual (2) paper trays are needed if printing after-visit summaries, prescriptions or orders
• TCP/IP network capable internally or Hewlett-Packard JetDirect external print server
• Hewlett-Packard 2000 series – Recommended printer is the 2015. External JetDirect print server IS required. Extra tray model: HP Q5931A
• Hewlett-Packard 3000 series – Recommended printer is the 3005n. Extra tray model: HP Q7817A
• Some legacy HP printers are still supported and will be noted in site write-ups.

Network includes:

• Broadband DSL/Cable internet connection
• 50KB guaranteed bandwidth per user (Down-stream)
• Static IP address from ISP.

MyPractice Community supplies a virtual private network termination device.

»What happens during software upgrades of MyPractice Community?

Software upgrades take place regularly. MyPractice Community practices are notified in advance of the software installation date as upgrades sometimes cause the system to be down for a few hours overnight.

During the downtime, which, in most cases, does not affect the MyPractice Community practice, a MyPractice Community information-technology specialist tests new functionality along with current functionality. The practice is notified of new functionality if training is needed, usually by screen prints.

Following any upgrade, issues with functionality can be reported to the help desk. There is no charge to the practice for upgrades.

»Does the MyPractice team provide ongoing support and services once the application is installed?

Yes. MyPractice Community offers ongoing system training, telephone support and a dedicated practice liaison who will help your team successfully utilize the features and functions that will positively impact your practice's efficiency and effectiveness.

MyPractice Community has the following dedicated support personnel:

• Help desk
• Clinical analyst
• Systems analyst
• Technical analyst.

Normal Hours of Support

MyPractice Community provides user support to the MyPracticeCommunity support desk Monday - Friday, 8 a.m. - 5 p.m. Access problems reported outside of business hours are addressed on the next business day.

After-hours Support

Support outside of normal business hours (Monday - Friday, 8 a.m. - 5 p.m.) is also available for a fee. An after-hours support analyst can be reached by calling 216.738.5720.

A MyPractice Community support representative will respond, prioritize and attempt to resolve all issues or questions consistent with the severity of the issue (i.e. more severe issues will receive higher priority and quicker response than immaterial or less severe issues).

Ongoing Updates

Choosing MyPractice Community also means you receive regular software upgrades when they are introduced by Epic Systems, ongoing system maintenance, and scheduled user group process improvement training courses and support.

»How much does MyPractice Community cost?

Our MyPractice Community representatives are prepared to review the pricing structure of the service at the time of your scheduled, in-office system demonstration. Or you may call 216.738.4617 to speak to a MyPractice Community representative.

Download information about MyPractice Community electronic medical record system.

• MyPractice Community FAQ sheet.

To establish a MyPractice Community Account:

1. Work with a technical analyst.

   Before a contract is established, approved and signed, a MyPractice technical analyst will come to your office to do the following:

   • Document current hardware and determine if any additional hardware will be required
   • Document current connectivity and connectivity requirements
   • Identify vendors of current software, lab, radiology, etc., and establish contact with these vendors
   • Document Interface needs.

2. Approve and sign the MyPractice Community service agreement.

   The contract will include details regarding all MyPractice Community services and responsibilities and participant's responsibilities, system security, fees, terms and termination, etc.

3. Begin an eight-week implementation process.

   During the implementation process, MyPractice Community analysts will be on-site to work with your practice's project team. An initial walk-through during Week 1 will ensure a strong start toward achieving Go Live! status.

   During the walk-through, MyPractice Community analysts:

   • Discuss the operational flow with the project and review issues specific to your practice
   • Conduct a MyPractice Community walk-through with your project team representative
   • Identify additional equipment needs based on operating flow, equipment requirements and current inventory.

   In the weeks leading up to week eight of Go Live!, your MyPractice Community system is built in a test mode, employees receive training, assistance is provided for the building of templates/smart tools, and determinations are made as to where documents will print and be submitted for order approvals.

4. Go Live!

   Once MyPractice Community is implemented, Go Live! support personnel remain on-site at your practice for two to three weeks to ensure a smooth transition. Support activities include the following:

   1. MyPractice Community Go Live! site leader kick-off meeting takes place to review all steps leading to and following Go Live!.
   2. MyPractice Community Go Live! team familiarizes your office staff with all MyPractice Community operations. Other key functions the on-site personnel will complete prior to Go Live! include: testing of printer functions, validation user IDs and security, and support training.
   3. To ensure the effective placement of MyPractice Community experts throughout your practice during the first week of Go Live!, we will ask you to identify the physical locations for key activities, type of activity and approximate number of employees performing the activity.
   4. The MyPractice Community Go Live! Project Manager will complete the staffing assignments. We'll ask you to provide input about front desk/check-in, lab appointments made by telephone, triage, provider visits, lab and checkout.
   5. The MyPractice Community Go Live! team arrives at your practice on the first Go Live! day 30 minutes before your practice opens for business. Most of the clinical documentation entry will occur in the MyPractice Community system.
   6. The MyPractice Community Go Live! team stays on site each day until your office managers give approval to depart. The Go Live! leader debriefs staff at the end of each day to discuss issues and review key points.
   7. We are dedicated to providing ongoing support for each and every MyPractice Community practice. Two to three weeks of on-site support is provided by dedicated support personnel after Go Live! Also, help desk support staff are available to answer questions Monday -  Friday, 8 a.m. - 5 p.m. at 216.738.5720 or through email at mypracticecomm@ccf.org. MyPractice Community will address access problems reported outside of business hours on the next business day. After-hours on-call page service is available by calling the same number: 216.738.5720.

The MyPractice Community electronic medical record system is the same electronic medical record system used in all Cleveland Clinic facilities. It is composed of an integrated suite of software modules created by Epic ® Systems, a recognized leader in healthcare information technology systems.

Epic Systems is certified by the Certification Commission for Healthcare Information Technology (CCHIC) and ranked No.1 in the Ambulatory EMR category of the "KLAS 2006 Year-End Top 20."

Below find frequently asked questions about electronic medical record certification standards.

»How does the Federal Government promote the adoption of health information technology in medical practices nationally?

In 2004, President George W. Bush called for widespread use of health information technology (HIT) and for electronic health records (EHRs) to be in use for most Americans by 2014.

As part of the Federal Government's stated goals of promoting the adoption of health information technology in medical practices nationally, and providing electronic health records for most Americans by 2014, the Department of Health and Human Services established the Office of the National Coordinator for Health Information Technology (ONCHIT) and the American Health Information Community (AHIC).

ONCHIT has played a leading role in moving the nation toward private-sector certification of health-information technology products.

»What is the Certification Commission for Healthcare Information Technology?

A direct result of the ONCHIT effort is the Certification Commission for Healthcare Information Technology, (CCHIT), an independent, private-sector organization that serves as the recognized certification authority in the United States for health information technology products. A CCHIT Certified Seal shows that an electronic medical record product meets basic requirements for functionality, interoperability and security.

The goals of CCHIT product certification are to:

• Reduce the risk of Health Information Technology (HIT) investment by physicians and other providers
• Ensure interoperability (compatibility) of HIT products
• Assure payers and purchasers providing incentives for electronic medical record technology adoption that the ROI will improve quality

Protect the privacy of patients' personal health information.

»What is KLAS Ambulatory Electronic Medical Record System Ranking?

KLAS Enterprise, which was founded in 1996, is a research and consulting firm specializing in monitoring and reporting the performance of healthcare information technology (HIT) vendors and products.

KLAS independently measures vendor performance and has created a database of HIT evaluations by healthcare executives and clinicians from over 4,500 hospitals and 3,000 clinics. The KLAS Top 20 Report summarizes performance data about hundreds of software products collected over a 13-month period.

For further information, contact KLAS Enterprises, visit www.healthcomputing.com.

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