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Addressing Common EHR Implementation Problems
June 18, 2010
Tammy Geltmaker, RN, BSN, MHA EHR Consulting Manager, Health Care Excel
Bonnie Hollopeter, LPN, CPHQ, CPEHR, CPHITProject Manager, Ohio KePRO
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Staff Resistance
Establish a strong project team– Physician champions – Other motivated practice staff
Communicate the value of the system to staff– Demonstrate benefits on an individual level
Identify staff concerns – Develop plans for addressing them
Maintain staff involvement– Throughout implementation process
Manage expectations – Establish realistic goals – Provide quick wins– Demonstrate progress
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Training
Make it relevant– Tailor sessions to staff roles and responsibilities
Engage participants– Ensure sessions are task-oriented and hands-on
Allow for self-discovery– Provide staff with time to “play” with system outside of
formal sessions Create “super users”
– Ensure they receive additional training Develop aids to support staff learning
– Cheat sheets, quick reference guides, etc.
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Project Management
Clearly define scope of work – Before completion of contract
Develop detailed project plan– Include specific steps and responsibilities
Ensure sufficient allocation of resources – Both practice and vendor side
Identify project risks – Develop plans to mitigate them
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Workflow Automation
Map out workflows – Identify problems or bottlenecks
Determine how system can be utilized within processes– Identify potential problems
Re-map processes– Address identified problems
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Interfaces
Allow sufficient time for installation and testing– Build the time into the project plan
Consider various contingencies– Make sure test plans cover different scenarios and
situations Evaluate the effect of typical message loads or
cycles on system– Allow for any necessary modifications
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Handling of Paper-Based Information
Coordinate decisions on key information– Determine information and documents that need to be
entered into system Establish process for data entry
– How information will be entered into the system Determine process for handling new outside
documents Allocate appropriate resources
– Hardware and staff levels should align with information input volume
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System Performance
Evaluate hardware– Ensure minimum requirements
Load test system – Evaluate effect of typical number of users
Evaluate network capabilities– Test network to determine how it handles increased traffic
and utilization Implement system maintenance procedures
– Ensure that they are in place and working
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Contingency Planning
Ensure that disaster recovery plan is in place– Make sure the plan is practical and appropriate for your
office– Conduct drills related to possible emergency scenarios
Test system restoration process– Verify ability to restore system from backups prior to go-live
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Implementation Approach
Gauge physician preferences– Determine amount physicians are willing to reduce
productivity levels Evaluate staff perceptions
– Receptiveness to system, strength of project leadership Develop rollout of system modules or functions
– Based on desired productivity and receptiveness levels Incorporate appropriate training into plan
– Ensure amount of training matches implementation approach
– Make this training “mandatory”
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Questions
Telephone: 502-454-5112 Fax: 502-454-5113 E-mail: [email protected]
All material presented or referenced herein is intended for general informational purposes and is not intended to provide or replace the independent judgment of a qualified healthcare provider treating a particular patient. Ohio KePRO disclaims any representation or warranty with respect to any treatments or course of treatment based upon information provided.
Publication No. 931300-OH-1256-6/2010. This material was prepared by Ohio KePRO, the Medicare Quality Improvement Organization for Ohio, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.
Ohio KePRORock Run Center, Suite 1005700 Lombardo Center DriveSeven Hills, Ohio 44131
Tel: 1.800.385.5080Fax 216.447.7925
www.ohiokepro.com