How to execute a successful EHR go-live

The go-live period of EHR implementation, much like the broader implementation period, presents its own set of risks and accompanying considerations that practices should keep in mind.

It will be the first opportunity to observe how your chosen software performs in real-life conditions; the risks of declines in productivity, revenue drops, and declines in the quality of patient care are greater than normal.

Executing a successful go-live depends on minimizing those risks while getting the users and system operating at optimal efficiency as soon as possible.

The following tips give organizations a foundation to build on

1. Keep all parties informed
2. Address staff anxiety before go-live
3. Set goals for the go-live
4. Support users during go-live
5. Keep patients informed
6. Choosing a big bang or phased approach

Keep all parties informed

Just as is the case during the selection and implementation, the planning process should involve keeping key stakeholders up to speed on project progress. They should include a cross-section of users that can keep the implementation team and the vendor’s representatives apprised of any issues or concerns during go-live.

Address staff anxiety before go-live

After thoroughly testing and retesting your EHR software, you will have a clear picture of how confidently and proficiently your staff use the new system. You will have established workflow processes, and each staff member will know their role. Once you present your testing, modification, and retesting results, you should be in a position to gain go-live approval.

Even so, the go-live date tends to bring anxiety. All that training is suddenly put to the test in front of real patients. Administration and management need to settle those nerves by providing support, encouragement, and acknowledgement of the work already done. Clinical staff, office managers, and super users should be prepared to troubleshoot on the spot, and super users and administrative managers should be on site throughout the launch.

Over the first few days, keep the work schedule lean and extra duties to a minimum so that everyone can concentrate on the new system. Reduce patient caseloads where possible to allow proper input of medical data and care plans. When staff become overwhelmed, frustration follows, and interest in mastering the system drops. Acknowledge openly that learning a new system takes time, and that making and correcting mistakes is part of the process.

Set goals for the go-live

The entire implementation process should be goal-oriented, and go-live is no exception. Set goals that are realistic: staff should not expect to switch to the new system and see an immediate improvement in how their work gets done.

Like any other software, new users will need to adapt how they conduct their work to new processes and will require time to begin to learn how to use the system to their advantage.

Support users during go-live

Even the best training may not fully prepare users to be completely proficient on a system. As such, organizations should provide adequate on-hand support resources available to offer any technical support to clinical and ancillary staff.

Keep patients informed

Inform patients that you are implementing a new EHR system. When confirming appointments, let them know the practice is in the process of going live. Explain the benefits: better care, clearer communication, improved medical record management. Patients who understand what is happening are far more tolerant of minor hold-ups or technical hiccups during their visit.

Patients understand that change and technology carry a degree of friction. The problem arises when they are kept in the dark. Without context, they are more likely to grow frustrated and attribute delays to staff who "don't know what they're doing." Being upfront about the transition avoids that misunderstanding entirely.

Remember that despite months of planning and training, your go-live date will produce at least some hold-ups. Because so many people are involved in an EHR implementation, not every patient encounter will go smoothly. Each one is also a new learning experience that helps staff build real proficiency with the system.

Choosing a big bang or phased approach

Implementation teams can deploy their EHR in a single event, referred to as a big bang go-live, or a phased approach, which, as the name implies, involves an incremental approach carried out in phases. 

Each carries distinct trade-offs:

• A single big bang go-live completes the transition faster, but any problems that arise affect the entire organization at once. For a small practice, this is often manageable; for a larger organization, the risk is amplified.

• A phased approach takes longer, but for larger or more complex organizations, its value lies in scale. Breaking the rollout into segments makes problems easier to identify and address, and allows lessons learned in early phases to carry forward into later ones.

Final thoughts

Planning with an eye toward avoiding the common pitfalls of EHR implementation is ultimately what underpins a successful go-live.

However, as important as planning and stakeholder involvement are in the process, it is also important to be flexible when carrying out the process; rolling out any software into a live setting carries inherent uncertainty, and the teams that handle it best are the ones prepared to adapt.