What Your Organization Needs for a Successful EHR Go-Live

Efficient vendor, staff and organizational management are critical to a new system rollout.

Every healthcare organization has its own culture and challenges. Despite that uniqueness, there are several common denominators when it comes to IT implementations, particularly related to electronic health record systems. An EHR implementation will have a significant impact on the entire organization and all staff members. A robust change management program is critical, given the multidisciplinary effort required. The CIO and executive leaders, for instance, juggle many priority initiatives at any given time. An EHR deployment will become a primary focus, especially as the go-live date approaches.

CIOs must know where and when to be deeply involved versus maintaining an overall awareness of the project’s progress, and be ready to address issues as they escalate. Engaged executive sponsors, meanwhile, are needed throughout the life of the project. To be successful, an EHR implementation must be a true partnership between clinicians, operations and IT.

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Start with a Review of EHR Vendor Options

When looking to add major systems and functionality, leaders must conduct an in-depth review of their vendor’s current capabilities and have a solid understanding of their product roadmap.

Organizations that pursue a primary integrated vendor strategy, rather than a best-of-breed approach, face a challenge with departmental systems. This is particularly true in academic medical centers. Departmental systems may have been internally developed with customized, unique functionality, or could be a cluster of interfaced vendor products that each support a specific area of the department’s work.

When decisions and trade-offs are made with departmental systems, leaders must keep in mind the overarching goal: a comprehensive, longitudinal, integrated EHR that works in all care settings.

Sue Schade
A healthcare organization’s infrastructure must be able to support any new system at scale.

Sue Schade Principal at StarBridge Advisors

Attending your vendor’s annual user group meeting is critical. You can learn, not only from product experts, but also from other organizations, about how to fully leverage your solution of choice.

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Evaluate Infrastructure Prior to an EHR Roll Out

A healthcare organization’s infrastructure must be able to support any new system at scale. Conduct a thorough system performance evaluation, and if you are considering a hosted solution, take support levels and overall costs into account. At the same time, recognize that peripheral devices will continue to evolve, meaning new clinician end-user tools — such as the latest mobile computers or smartphones — will constantly be on the horizon.

What’s more, many decisions will be made throughout the life of the project. Establish early on very clear decision rights. Know which group makes what decisions and define the escalation path when issues can’t get resolved at lower levels of the project governance structure.

Your plan should also include a readiness assessment at 120, 90, 60 and 30 days prior to go-live. Ensure all teams report their progress and unresolved issues in detail and create a readiness scorecard. This will enable leadership to focus on the areas that are behind schedule and address issues to ensure an on-time, successful implementation.

Contingency planning is a critical part of any project plan, but this is especially true for an EHR implementation. Every major system deployment needs a back-out plan if something goes wrong, but you also must account for the operational impact. For instance, you can’t stop the flow of patients into the emergency room, but could you reduce your surgical or clinic schedules? Each organization must determine what works for it.

In addition, there are unrelated and unanticipated crises that you will have no control over, such as power outages, bad weather or a mass casualty incident. Include your organization’s emergency management team in your activation and contingency planning.

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Make Sure All Staff Get Involved

Agreeing on how many hours of training each user needs and scheduling them is when everyone finally realizes the magnitude of the operational impact. Finding enough space and having enough trainers to conduct all training in a relatively short time frame close to go-live requires creativity. Leverage alternatives to classroom-based training when you can, but don’t try to roll out a new learning management system to manage scheduling and registration at the same time.

At go-live, it’s all hands on deck in the command center and throughout the organization. Everyone has their specific role, and it’s a 24/7 operation for the first few weeks. Leaders must be present and be sure to make the rounds — find out how things are going for frontline staff and thank them for their work.

Once the system is up and running, recognize that optimization will be ongoing. Don’t minimize requests. Listen carefully to users, and at the same time, manage expectations about how much will get done and when.

Multiple communications channels will be needed. Structured processes for receiving change requests and a formal prioritization process with agreed-upon criteria are essential. It’s important to optimize for unique workflows, but don’t get stuck there. Ask others how they leveraged the product. Reach out to your colleagues and learn from them. Many have gone before you.

When you’re ready, be sure to share your experience with others, and not just the successes, but the ugly stories too. Help others learn from what you did — and didn’t — do well.

sturti/Getty Images
Dec 20 2018

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