EHR Implementation Plan

If your practice has long worked with paper records, it may seem like an impossible task to make the transition from paper charts to electronic records. Although it can be a long process, the result is worth the effort. Here you can learn more about electronic health records and find out the best way to implement them into your health care practice.

Electronic Health Records

The term EHR refers to the electronic health record, which should be distinguished from the electronic medical record, a digital version of a patient’s chart. Whereas the electronic medical record is designed mainly to benefit a clinician and their practice, the EHR helps patients access their own medical records wherever they are. This allows for accurate communication between the patient and other members of the healthcare team and ultimately in an increased quality of care.

What Is an EHR?

The EHR keeps track of all pertinent patient information in one easy-to-access digital record. While it does include all of the information that you would find in a paper chart, such as the medical history, progress notes, current and past diagnoses and imaging reports, it also includes demographics, insurance and billing information, as well as records pulled from patient wearables and electronic wellness devices.

EHR Implementation

Adapting to a new EHR when paper records or an older system are all that health care personnel know can be difficult. An attention to the security and privacy of the system as a whole as well as a focus on thorough training is vital for early implementation and easy adaptations. The Office of the National Coordinator states that quality EHR implementation must be based on a well-thought-out plan that identifies the correct tasks and order of tasks while communicating regularly and clearly with the entire health care team.

How to Create an EHR Implementation Plan

Ideally, your EHR implementation plan will focus on three key areas. These include time, cost and scope. First, you will need to plan a sufficient amount of time for the implementation process. Second, you will want to consider your resources and ensure that you stick to a budget. Third, be clear about your goals and determine which EHR features are essential to your practice.

What Are EHR Implementation Steps?

The implementation of any type of EHR is bound to be time consuming. Also there will be a learning curve for the majority of users. Having a solid plan in place can make the process as smooth as possible. The following 11 steps will get you started with your own EHR implementation plan.

1. Set a Clear Roadmap for EHR Implementation

2. Build an EHR Implementation Team

3. Set a Budget and Create Financial Projections

4. Prepare the Software, Hardware and Network

5. Consider the Patient Treatment Room Layout

6. Design the Launch: Big Bang Versus Incremental

7. Migrate Patient and Practice Data

8. Create EHR Training Sessions

9. Develop Procedures for When Your EHR Is Down

10. Test and Plan for Going Live

11. Ask for Feedback

1. Set a Clear Roadmap for EHR Implementation

Start by building a plan based on the specific needs of your facility and clinicians. This is the time to create the outline you will use throughout the process and determine the key tasks.

Assess Your Facility

As you create your roadmap, you will want to start by considering the readiness of your facility. You may need to look into the existing IT infrastructure, the current processes your facility uses for documentation and the type of training modules available that can support your implementation plan.

2. Build an EHR Implementation Team

Next, you will need to determine who will lead the implementation process and who will be key players throughout the project. You should have a strong and dedicated team who can deal with problems that arise along the way.

Create a Multi-Faceted Team

Your team should have three key players. First, you will need a lead super user. This will be the person designated to be an EHR expert. He or she should be able to create templates and smart workflows while also addressing problems quickly. Second, you will need a lead physician. This person will serve as the mediator between IT staff and the clinical staff who will be using the system. Third, you should have a project manager who will serve as the liaison between the EHR vendor and your staff.

3. Set a Budget and Create Financial Projections

Clearly, it is going to cost your facility some money to implement a new system, and nearly all practices find the cost to be more than expected. A budget should cover obvious costs, such as network upgrades, training fees, and productivity loss, while also leaving room for unexpected expenses.

Experience High Return on Your Investment

Think about the return on your investment as you prepare your budget. You do not want to allocate more resources for your EHR than you can regain.

4. Prepare the Software, Hardware and Network

Your facility’s IT network as well as your computer system hardware must be able to handle the increased workload that EHR will require in order to ensure that the completed system works efficiently with the highest possible amount of uptime.

Focus on Security and Efficiency

As you consider your facility’s IT infrastructure, your most important concern should be the safety and security of the network. Everything must be HIPAA compliant to keep patients’ medical records private. A HIPAA risk assessment can show where weak areas may lie so that you can address them before the EHR officially rolls out.

A secondary concern should be hardware efficiency. Not only should computers function well with adequate speed, but also health care workers should have easy access to computers and workstations.

5. Consider the Patient Treatment Room Layout

With all of your focus on your hardware and your network, you may fail to consider where you will place computers in patient rooms, which could be a costly error. Placement should engender quality communication and trust between patient and provider.

Keep Eye Contact High

Be sure to place the computer in an area that allows the provider to maintain constant eye contact with the patient. One of the best ways to achieve this is by using a triangular layout that places the patient, the provider and the computer at each of the three points of a triangle.

6. Design the Launch: Big Bang Versus Incremental

There are two main ways to implement an EHR into a health care system. With the first approach, all users begin using the EHR on the same day, and paper records immediately go by the wayside. With the second approach, the EHR is gradually implemented by group or department, with each onboarding one at a time.

Create a Smart Implementation Strategy

Both approaches have advantages and disadvantages. You must consider how much support you have for implementation and how easily your health care personnel can learn a new system. There will certainly be a learning curve with either option, but the incremental approach may allow users to learn new processes over a longer period, reducing frustration.

7. Migrate Patient and Practice Data

For EHR to work well, you must take the existing patient data and migrate it into the electronic record. This can be a lengthy process that requires numerous steps and great attention to detail. To complete this, you may need to hire temporary staff to cover the additional work load.

Migrate Data in Stages

Of course, migrating data from paper records to the EHR is only the first stage. Other requirements include setting up a new EHR database, testing and verifying new data inputs. If you perform each of these steps carefully, rest assured that future data errors will be significantly reduced.

8. Create EHR Training Sessions

Without sufficient instruction about using the new system, inputting data and finding existing information in the EHR, health care staff will quickly become frustrated and discouraged by the new system. A clear and concise training plan can reduce stress and ensure that users are able to acclimate easily to the new system once it is in place. Furthermore, this same training plan can be used in the future when you hire new personnel.

Extensive Training Leads to High Success

When users are highly trained, they will be confident in using the EHR. You can also ask users for feedback so that you can modify the educational process to make future training sessions as successful as possible.

9. Develop Procedures for When Your EHR Is Down

Unfortunately, EHR downtime is going to be a reality in your facility. Even if you are spared from unexpected downtimes, the EHR network will occasionally be down for scheduled upgrades and maintenance. Knowing how you will handle these times will improve facility workflow.

Prepare for the Inevitable

One option for managing EHR downtime is to use paper charts as a temporary backup. You must ensure that clinicians are aware of downtime procedures. Keep a hard copy of downtime instructions while also having them readily available in the cloud so that staff can access the procedures approved for your practice. In addition, be sure that you have a plan in place for communicating scheduled downtimes to all staff.

10. Test and Plan for Going Live

Before you officially go live, you will want to have a practice launch for your facility. to see what problems might arise. This step should be completed after staff training and data migration so that everything is in place. The EHR team should take note of any problems with the EHR, the network, or work flow issues, and these should be resolved before going live.

Clearly Define Go-Live Activities

When go-live day arrives, have clear expectations of your staff and consider lessening the patient load if possible. You may also want to schedule additional staff for the first few go-live days to decrease anxiety. The EHR launch team should be on hand to address concerns as they arise.

11. Ask for Feedback

Just because the EHR is in place does not mean that everything is perfect. There will always be room for improvement, and the staff using the EHR are the best individuals to provide feedback. Asking for feedback shows that you are committed to continually improving the system.

Post Go-Live Evaluation, Define Critical Success Factors and Evaluation Strategies

In the follow-up evaluations, focus on several key criteria, such as clinician satisfaction, patient satisfaction, overall efficiency and productivity, return on investment and number of data errors. There are several ways you can accomplish this, including paper or electronic surveys, personal discussions and forums. Determine which method is best for your staff and clients.

Conclusion

While the practices and tips outlined here cover the basic steps you will need to take to implement EHR in your facility, they should only serve as a guide as you tailor the process to best meet your practice’s specific needs. However you choose to implement your new EHR, remember that advance planning is vital for creating the smoothest and most successful rollout of your new system.

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