How to do it ... Implementing an EHR system

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Deciding on, preparing for and implementing electronic health records requires a great deal of time, patience and collaboration. But a carefully executed implementation will reap dividends years down the road. Experts offer providers their best personal advice for smooth, effective EHR acquisition, installation and use.

Before shopping for a vendor, conduct a needs assessment. What are priorities? What can you live without? 

“Making a choice to implement an EHR system may take you out of your comfort zone, but bring the conversation back to focus on your facility's needs and you will start on solid ground,” says Karsten Russell-Wood, product director, Remedi SeniorCare Pharmacy.

While assessing your needs, you're sure to wonder whether you have the IT infrastructure required. Also, consider all the systems – both internal and external – with which it will need to integrate.

Technological gaps can lead to discouragement and delays later on, according to Indira Jagernath, vice president, Professional Services, PointClickCare. 

There are connectivity issues as well, warns Steve Pacicco, CEO, SigmaCare: “It's important to not overlook the concept of local interoperability with such entities as labs, radiologists and pharmacies.”

Don't overlook the most critical success factor: people. That means explaining the EHR rationale, identifying project “leaders” and champions, and engaging the right staff. 

Implementing EHRs can have a profound impact on many jobs, and providers should be prepared.

“Staff should be educated about ultimate benefits. Otherwise, they may feel ‘forced' to change with no buy-in,” observes Kim Ross, director of marketing, MDI Achieve/MatrixCare. 

It's about managing change, as Steve Herron, director of Long-Term Care at Cerner, explains: “This means helping users understand why the solution is being implemented and why their processes are changing is a critical part of success.”

Because EHR impacts so many of the daily clinical and administrative tasks a busy facility does, there are key “process” and “workflow” issues. After all, it's more than just an automated medical record. 

Some organizations underestimate how an EHR will impact caregivers' daily workflows, says Aric Agmon, president and CEO of AOD Software. This can be especially true for direct-care staff such as nurses and CNAs.

Be aware that staffing models often change after EHR adoption, and new roles may surface, adds MDI Achieve's Ross.

Understand clearly what EHR can and can't do for you. Too many “novices” look at such systems as the cure for all their billing and record-keeping ailments. 

Don't assume it will resolve existing systemic problems or issues within your organization, says Robert Baker, president, Collain Healthcare, LLC. 

“Technology will not fix leadership challenges,” he notes. “Deal with those challenges proactively or you may find that new technology just exacerbates them.”

Few investments require more homework and diligence than choosing an EHR solutions provider. So don't rely on just marketing materials, say most vendors. 

Of course, you want to make sure you are completely knowledgeable about ubiquitous and ever-changing rules such as Meaningful Use and ICD-10 requirements, says Teresa Chase, president, American HealthTech. 

More importantly, seek input from your trusted partners, says Remedi's Russell-Wood: “Your LTC pharmacy has likely developed interfaces and is supporting EHR deployments across other facilities. Selecting a vendor with tested interfaces hastens the implementation process and can positively play into your overall deployment plan.”

Finally, constantly monitor your implementation to ensure staff don't revert to “their old ways of doing things if they are frustrated,” Jagernath says.

And roll out various features of your system as slowly and deliberately as possible, or risk overwhelming your staff, adds Cathy Jo Land, a clinical consultant and implementation specialist, LINTECH. 

Mistakes to avoid

 - Implementing many components too quickly

 - Assuming that a new EHR solution will resolve existing systemic problems or issues

 - Underestimating how an EHR will impact caregivers' daily workflows

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