EHR implementations can present a variety of challenges that, if not adequately considered, can jeopardize the success of the entire project. Some of the more common pitfalls organizations encounter are user-centric, in that they stem from how EHR users adapt to and interact with the EHR. The following examples represent three common challenges that can arise during EHR implementation and how to avoid them.
Getting the wrong selection team
Problems during the initial system selection will inevitably lead to later issues in the implementation. Getting the right selection team provides the foundation for a successful implementation process. Organizations often make the mistake of not considering a representative sample of all individuals and groups that can provide valuable information regarding EHR selection and the overall implementation process.
Best practices dictate that a selection team should contain critical stakeholders who represent the key areas of an organization such as clinicians, C-suite staff, administrative staff, and individuals whose background is exclusively in IT. Therefore, a selection team should consist of individuals able to provide input regarding their respective department’s EHR requirements. People actually using the system should be considered during selection, including administrative staff, especially in smaller practices where almost 50% of employees will interact with the EHR in one way or another. When a wide array of stakeholders are included in a selection team, insight regarding EHR requirements can be gathered from each key area of an organization.
Not including a variety of stakeholders during the selection process can lead to an inaccurate list of requirements and functionality of the chosen system. If your clinicians need specialty clinical report templates and these aren’t included, this will lead to issues with buy-in and system usability. Further, if your administrative team needs the ability to electronically verify payments, and your system doesn’t support this function, this will cause friction in your team as their needs have not been met and their job has been made harder.
Lack of buy-in
A study conducted by the MPI Group and Medical Economics indicated that nearly three-quarters of physicians described their EHR investment as not worth the effort, resources, and costs. This type of sentiment reflects the lack of buy-in from users; many EHR projects suffer.
A successful implementation depends on user buy-in or restated users will be engaged and committed to using the EHR to optimize a practice’s operations rather than view it as a necessary evil. Despite the importance of buy-in practices are still failing to bring clinicians onboard to their EHR projects. One method of encouraging buy-in involves bringing in clinicians and other key stakeholders early in the selection process, given them a role in system selection and design.
If physicians are given a role in the selection team they can provide input into how the practice’s EHR is set up. They can also provide detail on where the EHR should operate to make their lives easier, e.g. customized templates to speed up data entry, leading to a system that helps their day run smoothly. This not only encourages buy-in to the system but also helps practices realize the full benefits that an EHR can bring their organization.
As staff becomes acclimated to a new EHR, there will be inevitable productivity and revenue loss due to disruptions related to deploying the system and users learning the new system. A study conducted by Medical Economics shows during implementation “you can expect to see up to 50% fewer patients.” The costs incurred as a result of implementation related productivity loss will vary according to practice and steps taken to mitigate these losses.
To try to mitigate productivity and revenue drops, the planning phase should focus on mapping out how work currently gets work done. With this information, it is essential to consider how to minimize productivity loss during the implementation phase as disruptions are caused to the typical workflow as the new EHR system is put in place and stakeholders become accustomed to the new system. During the planning stage, some organizations elect to rely heavily on an implementation team representing various stakeholders in an organization that provides “on the ground information” regarding workflows how the implementation will affect them.
During the early planning phase selection and implementation, the team can avoid implementation pitfalls by considering the full range of possible issues that they may encounter and craft solutions to mitigate them before they become problems later.
About the author,
Jeff Green, MPH, JD is a writer for EHR in Practice, and consultant in the Healthcare information Technology Space.
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