Facing an EHR update? Here are 5 steps for success

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Updating your community hospital's EHR system (or any technology system, for that matter) requires a solid strategy and a methodical process.

If you just "go at it" with a generic plan, you could spend big and still end up with problems that affect patient care, workflow and revenue.

Don't let your next update grind operations to a halt. Before you execute, print out these five success steps and tape them to your monitor.

1) Set The Right Goals

First, think about the value you want your system to deliver: value to the patient, value to the end users (your clinicians) and value to your organization as a whole. Don't make your primary end goal "installing version X" just so you can acquire a new Meaningful Use feature. Instead, focus on tangible, measurable and value-aligned goals, like streamlined clinician workflow, shorter bill cycles and fewer EHR data gaps.

An action plan aligned with value is preferable for a couple of reasons. It helps you prioritize your project spend, enabling you to budget for mission-critical tools and functionalities. It also helps motivate your team, positioning the EHR update as a step forward instead of an inevitable source of problems.

2) Identify Risks And Make A Plan

Once you've aligned goals with value and identified benefits to pursue, ask your vendor about other hospitals that have already installed the version you're planning for. That way, you're able to identify real-world upgrade risks. In addition to any vendor-provided contacts, do some legwork and talk to a third-party consultant or jump into a user group forum and ask questions.

Then, start crafting your update plan. Develop a project management methodology that includes a work breakdown structure, communication plan and issue resolution plan.

Depending on the size and scope of your project, consider implementing a change control methodology and other professional project management methods. Don't undervalue the skills a seasoned healthcare project manager brings to the table.

3) Audit Super-User Testing

Today, most EHR systems let you audit user activity and find out who is doing (or not doing) what. Use these audit trails to figure out how much time super users spend testing before the go-live.

As educators and influencers, super users are a critical part of your success, and they should be held partially accountable for a smooth update.

As Ronald Reagan once said: "Trust, but verify." If a critical user says he's completed testing but the audits reveal he's spent five minutes in the test environment, he has more work to do.

4) Develop Downtime Checklists

To cover your bases before your EHR update, create these two checklists:

  • A downtime checklist that tells your team exactly what needs to happen as you take your system down for the update, such as removing users from the environment, halting all database interactions and executing database backup.
  • A restart checklist that tells your team exactly what needs to happen when you restart your system after the upgrade is performed, such as access verification, client application updates and end-user access notification.

To help you avoid workflow interruptions, prevent data corruption and cut down on redundant data entry, make your checklists as comprehensive as possible. Be sure to incorporate network and desktop environment tasks in addition to application-specific tasks.

Although your vendor can offer helpful advice, they don't know your local environment intimately. Make sure you take some extra time to get your checklists update-ready.

5) Avoid These Common Update Mistakes

Finally, here's a quick primer on common EHR update mistakes you should avoid.

  1. Don't be one of the first to upgrade. Never be one of the first hospitals to execute an EHR upgrade or update. Remember, you should be learning from those who came before and identifying risks to avoid. If you want to be the first, negotiate a vendor discount and staff up accordingly, weighing the risks and benefits of taking on a pioneer role.
  2. Don't stress-test during off hours. If you choose to schedule your restart during off hours, make sure your staff arrives shortly thereafter to stress-test. You want all hands on deck in case something doesn't go to plan and problem-solving is required.
  3. Don't accept the "too busy to test" excuse. If your team members are too busy to test, they're too busy for go-live. Again, you should hold your entire team accountable for your project's success.

Trade Pain For Results

Before you undertake your next EHR update, set the right goals, make a plan and do your due diligence to ensure that go-live goes as smoothly as possible.

And after your EHR update, make sure you measure effectiveness and track progress toward goals.

Phil Stravers has been an advocate for community healthcare since joining ICE in 1995. Prior to joining ICE, he started and oversaw a national helpdesk supporting technology systems for engineering and architectural design. Since acquiring ICE with Keith in 2003, Phil has guided the development of a services portfolio tailored specifically for community healthcare providers' distinct IT needs. Phil was instrumental in the development of ICE's focus on community healthcare. Phil routinely presents and educates through various healthcare associations, such as the Healthcare Information Management Systems Society (HIMSS), Healthcare Financial Management Association (HFMA) and National Rural Health Association (NRHA).

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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