EHR IMPLEMENTATION-2

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Western Governors University *

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D235

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Mechanical Engineering

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Dec 6, 2023

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EHR IMPLEMENT$TION % STEPS TO SUCCESS

±²³ Create an implementation team Physicians° nurses° receptionists° M±'/A±’s° compliance oﬃce staﬀ° and administrative staﬀ make up this team L+3E'/A*2D P6HYS7I)1C7I'/AN²guides the organization throughout implementation 4Front²line users ← ² ² ² → technical³administrative staﬀ PROJ+3E)1CT M'/AN'/A5G+3ER²works w³ vendors and all staﬀ to keep stakeholders focused on dead lines Track project progress and manage day²to²day issues L+3E'/A*2D SUP+3ER US+3ER²in²house expert in new +3E6HR conﬁgures the +3E6HR software° creates templates³order sets° and develops revised workﬂows or standard operating procedures to address issues raised by front²line users

´²³ Conﬁgure the software work with your health 7IT vendor to conﬁgure your +3E6HR to meet appropriate security measures± This may require that you conduct a 6H7IP'/A'/A risk assessment ± Practices can also consider customizing software to optimize workﬂow± '/A± *2Develop a list of build elements external to the +3E6HR such as% ( demographics imported from the practice management software ´PMSµ° computerized order entry ´)1CO+3Eµ° treatment regimens³protocols° medication management settings° standing orders° default patient history settings and billing³charge master updated with new codes and consents± (0B± +3E6HR software can be modiﬁed to create specialty² or physician²speciﬁc templates° which are used to support documentation± *2Discuss customization options and cost with your +3E6HR vendor±

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µ²³ Identify hardware needs The right hardware can save an organization time and money± Physician practices may hire an 7IT service company to help them with their system hardware needs± Typically° 7IT service companies are independent from the +3E6HR vendor and may not even specialize in the healthcare industry± (0Both the 7IT service company and +3E6HR vendor can be helpful in ﬁnding the right equipment at the best possible price± The 7IT service company may also supply° install and troubleshoot all devices° including the local area network and routers±

²³ transfer data '/A± *2Determine the approach for migrating data from the former recordkeeping system or other PMS modules to the new +3E6HR± ±FXYXXYXNOLST J]^]NOXYXYZYNOSTL XYXYZYFΒ YZYTU FXYXXYXNOXYXYZY \]\NOYZYM YZYWXWFSTXYXKJWXW TUWXW MNOWXWJ FIINOYZYNOTUSTFQR°YZYJRSUVUTUWXWFWXW^_^ȃ XYXYZYFΒ YZYTU Z[ZUVUQRTUFI IJRSTULWXWFUVUMNOHXYX FSTI UVUFXYXYZY RSJINOHFQR² XYXTUHNOFQR² KFRSNOQR^_^ȃ FSTI RSJINOHFYZYNOTUST MNOXYXYZYTUWXWNOJXYX UVUWXWNOTUWXW YZYTU YZYMJ UVUFYZYNOJSTYZYȃXYX STJ]^]YZY [\[NOXYXNOYZY³ (0B± Prepare a checklist of items to be entered into the +3E6HR± This will ensure that no critical information is missed during the transfer± )1C± Set time limit required to transfer information for the average patient± This allows the practice to properly distribute workload and set realistic dates of completion among staﬀ transferring data±

!²³ Optimize pre¶launch workﬂows Optimize workﬂows before +3E6HR implementation± Problems resulting from ineﬃcient workﬂows or insuﬃcient support staﬀ will be exacerbated during the implementation of an +3E6HR± For each step± ask) 7Is it necessary%- *2Does it add value for the patient%- 7Is it being done in the right order%- 7Is it being done by the right person%- For any step currently being done by the physician± ask) *2Does this require the skills and training of a physician%- )1Can another team member be entrusted with this task%-

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"²³ Consider the room layout Placement of the computer in the exam room impacts patient care± Triangle of trust² use a semicircular desk° which allows the patient and physician to face each other and° as needed° to each turn slightly and include the electronic information source in their discussion± '/Another option is to place the computer on a cart that can be wheeled into a position anywhere in the exam room to accommodate patient and physician communication±

#²³ Decide on the launch approach& “big bang vs² incremental” (0Big (0Bang² convert all users over to the +3E6HR for all functions and all patients on the same day PROS²minimizing the time spent managing both a paper record and the new electronic system simultaneously± )1CONS² highly disruptive and small glitches can be ampliﬁed± 7Incremental² turning on certain functions in a step²wise approach '/Another incremental approach is to implement the +3E6HR in certain sites or departments and slowly roll out to the rest of the organization° learning and tweaking the process along the way ´Once launch approach is decided° begin to acclimate to the new system in the practiceµ PROS² learning and tweaking the process along the way to minimize disruptions )1CONS² more time spent managing both systems

$²³ Develop procedures for when your EHR is down develop procedures for periods when the +3E6HR is down so physicians and staﬀ have clear instructions about workﬂows when the +3E6HR is unavailable± Some key components of downtime procedures include% ( how the downtime will be communicated to physicians° staﬀ and patients and how the patient care ﬂow will continue *2Downtime procedures and supplies should be available electronically and on paper for greater accessibility± )1Compile the procedures in a three²ring binder and store additional copies oﬀsite±

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%²³ Initiate a training plan )1Create a training plan to make sure everyone has the necessary knowledge and skills to use the +3E6HR at the time of launch± A 5Go slowly² Provide users with basic skills in preparation for launch± '/After the users have had a chance to “drive” the +3E6HR for a week or so° conduct additional training to reﬁne their skills and learn more time²saving tricks° ´+3E±X developing smart sets and other preferences° discuss downtime proceduresµ B '/Arrange for colleagues to teach each other² Whenever possible° train super users in each specialty and for each type of role± '/As proﬁciency with the +3E6HR grows° these super users can then be an ongoing resource to their colleagues± C Plan for ongoing training needs² Plan for ongoing learning³improvement± Over time many users will develop shortcuts³ﬁnd new functionalities that they can share with others± additional training will be required as +3E6HR updates with new and³or improved functionality

Ongoing training continued You may ﬁnd that minor modiﬁcations to the system can improve their workﬂow± *2Develop a platform for submitting and tracking +3E6HR enhancement recommendations so the change team can actively set improvement priorities ● Maintain a relationship with the +3E6HR vendor and engage ongoing 7IT support to% ( ○ *2Develop new or further customize templates for data entry ○ Revise or reformat forms and letters that are generated by the +3E6HR ○ +3Enable new clinical decision support rules if available ○ Modify order sets as medical knowledge advances or other health care entities change their service oﬀerings ○ 7Identify opportunities for integration with other systems that are commonly used in the practice or by other providers ● Plan ahead for any necessary group training related to system updates and new functionality± Preparing ahead of time creates less disruption for the practice and its patients±

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