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Lessons learned

How to smooth your EHR implementation.

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   By Kimberly M. Krisik, March 2013

Having been at ground zero for several dozen EHR implementations – spanning vendors, practice sizes, specialties and geographic regions – here are a few of the common setbacks with which healthcare organizations struggle, and a few insider tips to help any healthcare organization navigate EHR integration:

Are you ready? The first step for any EHR integration is assessing the readiness of the practice. Work with your IT vendor to understand the EHR application’s minimum requirements, and determine the software and hardware your practice already uses; you can often add to those systems instead of starting from scratch. From there, determine the new technologies, bandwidth and/or networking infrastructure needed to ensure optimal EHR use. Finally, check in with end users. It is just as important to ensure that staff is ready and willing to adopt the EHR as it is to be sure IT systems are capable of hosting it.

Do your research. Before you select an EHR solution, compare it to other options. Research product websites and look for certifications and standards lists. Observe as many product demonstrations as possible, and look for guidance from neutral resources, such as HIMSS, CHIME and regional extension centers (RECs) in your area. You can also ask a trusted solutions provider for references.

As you research, keep in mind that no question is trivial. Ask any questions you may have regarding the solution, and do not wait until you have already made a decision to do so.

Involve staff on both sides of the office. Getting your staff on board with EHR integration plans is a key element to successful implementation. Demonstrate and evaluate how the new EHR will influence workflow, documentation time, time spent with patients and even the staff’s ability to communicate. You must also consider specialist needs. When fitting an EHR to a multi-practice group setting, do not let the majority opinions outweigh all others. Specialty needs must also fit into the solution for it to be successful.

Both the administrative and practice sides of the office matter. The front office must be able to schedule appointments efficiently and track insurance information, but it is equally important for practitioners to see more patients and to give better, more personalized patient care. The EHR you choose should be a balance between both sides.

Peer review. As you select and prepare to integrate your EHR solution, talk to peers who have already implemented an EHR. Every EHR adoption and implementation has its growing pains, so consider the experiences of those who have already transitioned. Arrange a site visit to see how the EHR has changed workflow, physician charting and other daily functions, but be sure to consider how long the site has been using the EHR. Lessons learned change throughout the implementation process.

Budgets, expectations and timelines. You need to set a budget for EHR implementation, but you cannot predetermine a total budget until you choose your particular solution. Specific EHR applications have different yearly, monthly and daily costs, and the budget must accommodate hardware, software and training costs. Determine a realistic budget through research, talking with peers and securing estimates from vendors – then add 20 percent for sufficient staff training.

Once you set a budget, try to be realistic during the implementation process. The transition will test patience, and there will be challenges. Going into implementation with clear expectations and a good attitude can only help you succeed, and setting realistic timelines will help to keep the implementation on task. Involve staff, IT and EHR partner when establishing a timeline, and hold everyone accountable for meeting those dates.

Staff success. Your EHR solution will only succeed if staff knows how to use it. Talk with your EHR solution provider about training and ask how much time successful practices typically commit to training, whether or not you should buy more training hours and who will perform the training.

Train immediately after implementation, and again in three months to cover new keystrokes and updates (and to offer assistance to users who are struggling with the solution). Six months out, train again and bring on new users. One year after implementation, train your entire office once more. Do not let a lack of training be the reason that your EHR integration is unsuccessful.

Finally, elect EHR “champions” within you organization. Each practice, floor or wing needs a champion – the EHR expert who will serve as the go-to person for questions, training and assistance. Champions are staff members most in touch with the needs and concerns of others; they will play a huge role in your implementation.

Every EHR implementation has its quirks, so be patient and persistent as questions arise. This list of tips can save physician practices time and frustration, resulting in a smoother implementation. HMT

About the Author

Kimberly M. Krisik is business development manager, CDW Healthcare. For more on CDW Healthcare:

Tags:  EMR / EHR