Three EHR implementation steps that practices forget about

At this point, it is likely that a practice has planned at least one EHR implementation, and in some cases, a practice may have either the fortune (or misfortune, depending on your experience) of implementing an EHR multiple times. The importance of executing a well-designed  EHR implementation plan cannot be understated as the implementation phase provides the foundation for success by reducing potential disruption to productivity. It also provides an organization with an opportunity to use an EHR strategically as a means to increase a practice’s financial performance and improve how care is delivered from a quality and cost perspective.

However, implementation planning can be an overwhelming task for any practice, and often in the midst of the process certain implementation steps can be glossed over. The following three areas represent some of the most neglected or underemphasized steps that can hinder the overall success of your EHR implementation plan.

1. Drawing up measurable goals and KPIs

The first step in an EHR implementation plan usually involves conducting an assessment of your current practice with an eye toward how an EHR will affect how care is delivered and how the practice is managed from the administrative side. Goals created from this process must be measurable and be based on principles that reflect sound methodologies.

For example, if one of the goals identified is to reduce the time it takes patients in a walk in clinic to make the journey from intake to evaluation, to treatment, to exit, it is important to ask both how your EHR can improve performance in this area, and which metrics you can use to measure progress.

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2. Using front line care providers as a resource

Best practices for drawing up an EHR implementation plan dictate that key stakeholders within a practice should be included in the implementation planning process. Stakeholders within an organization not only bring valuable and practical insight into planning; they also have a metaphorical “horse in the race” as they will be the individuals who will feel the most day-to-day impact of a poorly executed implementation.  

Among the stakeholders who should be consulted are those people who will have the most exposure to patients. The experience of Robert Wood Johnson University Hospital, in New Brunswick, N.J., who experienced a disastrous EHR implementation and rollout due to not taking input from front line nursing staff adequately. After a tumultuous period and a massive leadership overhaul the hospital bounced back and had an opportunity to push reset. This time with the same EHR in place, the hospital reworked how it structured its EHR, effectively re-implementing the system. This time, frontline nursing staff were consulted heavily. Since then the hospital reports massive improvements in a number of quality of care metrics when compared to the period after the failed EHR implementation.

3. Conducting a post-implementation evaluation

Often practices fail to recognize that implementation is an ongoing process that involves a feedback loop of information. There will always be problems that require adjustment. Letting these problems snowball without addressing them will hurt performance and can undo all the hard work in implementation planning and roll out. As such, it is important to conduct a continuous evaluation of a practice's performance and needs after EHR. If there are areas that need minor adjustments or reconsideration, a practice may consider retooling certain aspects of how the EHR is structured or being used.

Of course, these steps aren't the only ones you may potentially miss when conducting an EHR implementation. But they definitely are a common occurrence, a thorough plan and checklist from the outset is key to implementation success.

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green