EHR Implementation Dos and Donts

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EHR Implementation Dos and Donts
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Defining a Good Implementation

• At the start of your implementation
• Do
• Determine what the goals are
• Make them measurable
• Make them reportable
• Manage to those goals
• Dont
• Skip this step (most commonly skipped step)
• Assume that everyone agrees
• Let an outside group determine the goals

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Implementation Goals
Meaningful Use
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Who is Successful and Why?

• Team?
• Vendor / Network?
• Project Management Decisions?
• Technology?

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TeamDo

• Choose the right team (Skills, Temperament and
  Commitment)
• CEO/Executive Director
• Provider Champion
• Project Manager
• Ensure all senior management back the project
• Ensure the provider champion has clinical clout
• Invest in making the provider champion the expert
  in the system early
• Assess the skills of your project manager and
  capacity

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Team Dont

• Train your best up and coming project manager
  on this project.
• Assume that the leadership team has communicated
  enough.
• Assume that a strictly technical person can
  manage the change required for this project
• Underestimate the need for a change management
  and communication plans

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Vendor / Network
Dont
Do

• Choose a network / vendor that has accomplished
  your goals with other organizations
• Complete a full selection process (site visits
  etc)
• Compare your strengths and weaknesses to the
  vendor / network
• Establish a partner organization that has been
  where you are

• Assume that the vendor / network understands your
  needs.
• Ignore documented satisfaction data with the
  vendor / network
• Rely on the relationship
• Assume that you can get out of this relationship
  any time soon

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Project Management DecisionsImplementation
Methodologies

• Big bang vs phased functionality vs phased
  clinics
• Speed of implementation and adequate testing
• Cost and methodology of abstraction and scanning
• Interface development and the need for technical
  skills and ongoing support
• Integration with disease management systems for
  more functionality or rely on one system

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Project Management Decisions (cont.)

• Training
• Mix of web based and classroom
• Temp staff for back fill
• Timing of training
• Note Design and Options
• Development time and acceptance
• Standardization and acceptance
• Standardization and effectiveness
• Dictation, Templates, Voice Recognition etc
• Standardization and reporting

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Project Management Decisions (cont.)

• Ongoing support
• Resourcing super users
• Technical support, internal vs external
• Ongoing training
• New staff - Web based vs elbow support
• Optimization Upgrades etc
• Reporting
• Resourcing the never ending requirement changes
• Technical expertise and personnel availability

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Technology

• Do
• Get expert advice from people with experience in
  your system
• Consider a network or ASP provider if you are
  small or resources are hard to recruit
• Have a disaster recovery plan that is tested
  regularly
• Test your network exhaustively
• Test each of your environments meticulously (if
  you are hosting the application)

• Dont
• Ignore your own experience or lack there of
• Scrimp on your IT infrastructure
• Ignore your ability to recruit qualified IT staff
• Ignore past uptime reports of ASP providers

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General Rules

• Do
• Consider your options for ASP and outsourced
  support and internal hosting
• Get help with contracting and set clear
  performance and uptime requirements
• Expect providers to be working longer hours to
  complete documentation for at least a few months

• Dont
• Expect to implement PM and EMR in 6 months
• Expect to implement disease management at go live
• Expect to get to Meaningful Use within 6 months
  of go live
• Expect to return to past productivity in the
  first 6 weeks without significant excess support